Saturday, May 4, 2013

Doctors save patient from deadly superbug by transplanting faeces through his NOSE



  • A faecal transplant was used to treat the Clostridium difficile patient
  • The radical procedure involves mixing donor faeces with saline solution
  • Transported to the bowel through nasal tube that runs through the stomach
  • Works because 'good' bacteria in donor stool fights the infection
  • Cure rate of 94% compared to 31% using antibiotics for recurrent cases


Doctors have used a radical way of curing the superbug Clostridium difficile in an 88-year-old man.
Dr Robert Porter, at the Queen Alexandra Hospital in Portsmouth, treated the man by pumping his daughter's faeces through his nose and down into his small bowel.
He told MailOnline that this was the first time that the treatment - which is becoming increasingly popular - has been used at the hospital.
The treatment involves mixing stools from a donor - ideally a family member - with saline solution and transferring it by tube through the patient's nose.
It is most effective in patients who have recurrent C. difficile and who have been treated with antibiotics so many times that they are no longer effective.
It works because the solution contains 'good' bacteria which fight the infection. If successful, the patient starts to feel better almost immediately.
The treatment was first developed in 1958 but was rarely used.
However, in 2011, a Dutch study published in the New England Journal of Medicine showed that 94 per cent of people with recurrent C. difficile could be cured using faecal transplants.
This can be compared to a cure rate of just 31 per cent of people with recurrent infection who are treated with antibiotics.
Dr Porter, a microbiologist and infection specialist, said: ‘These recent findings are so impressive and allowed us to develop the faecal transplant as something to take forward.

Using someone else's poo has an “ick” factor about it - it's not the think you would think of as the first think you would like to have.
‘People don't like the idea so it takes a bit of understanding as an option.
‘Even in the medical world, the topic is a bit of an eyebrow raiser and people are surprised to hear it's so effective.
‘But in recent years we've seen a rise in more aggressive forms of C. difficile and higher mortality rates, with standard treatments becoming less effective.’

He added: ‘One of the reasons this has not been particularly popular up until now is that we haven't had good studies to back it up.
‘Then we had an open trial in The Netherlands, which was stopped early because it was so effective compared to normal therapies.
‘An ethics committee ruled that it was doing so well it would be unfair to continue other methods.
‘It has given us the basis to say we have safe, scientific evidence that this is a very good treatment and very safe as well.’
C. difficile is a bacterial infection that most commonly affects elderly hospital patients.
It causes severe diarrhoea, fever and painful cramps. It can also result in life-threatening complications such as severe swelling of the bowel.
Patients with recurrent C. difficile only have a 75 per cent chance of survival and are often ill for many months.

Dr Porter said: ‘There's a distinct lack of downsides with faecal transplants.
‘It takes 20 minutes to enter the patient and they feel no sensation as it is transferred.
‘We tend to use family members as it's more palatable for people to think about their daughter's, husband or sister's poo inside them than Joe Bloggs in the street.’
This treatment was also used in October 2012 to save a 20-month-old boy with C. difficile.
Jesse Williams was struck down the the infection and no conventional treatments managed to cure him.
After nine months, doctors in his home town of Baltimore, U.S., decided to try treating him with a faecal transplant.
His mother, Tatum Williams, said he started to improve almost immediately.
She said: 'Within two days, I saw changes. It was unbelievable. Now, he’s a typical two-year-old.'



Source: http://www.dailymail.co.uk/health/article-2318363/Doctors-save-patient-deadly-superbug-transplanting-faeces-NOSE.html

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