Intestinal dysbiosis –an imbalance in the microbiota or population of microorganisms in the intestine– can be used by opportunistic bacteria, such as Clostridioides difficile, to trigger an infection that, in the case of this pathogen, can cause inflammation and severe diarrhea that is difficult to treat. treat and even causes the death of the affected person. There are different therapeutic options against this bacterial infection, but a review of studies has revealed that a stool transplant is more effective than antibiotics in controlling C. difficile.
The results of the research have been published in the Cochrane Review and are based on the analysis of six clinical trials involving 320 adults. The researchers found that 77% of the patients who underwent a gut microbiota transplant did not experience any reinfection for eight weeks, compared to 40% of the individuals in the antibiotic-only group.
When the population of beneficial bacteria found in our intestine decreases, which may be due, among other factors, to an inadequate diet and the consumption of drugs such as antibiotics, intestinal dysbiosis occurs, which is one of the main causes of C. difficile infection, which takes advantage of the situation to colonize the intestine and damage it, causing diarrhea and other symptoms such as colicky pain, vomiting, dehydration and fever.
What is the fecal transplant?
Older people and patients hospitalized for other health problems are often the most vulnerable to a C. difficile infection, but anyone can get this infection, which is usually treated with antibiotics, although these drugs can worsen dysbiosis and contribute to a vicious circle difficult to eradicate is established.
77% of the patients who underwent an intestinal microbiota transplant did not suffer any reinfection by the bacteria for eight weeks
The goal of fecal transplantation is to transfer healthy microbiota from a donor to a patient in whose intestine it is necessary to restore the balance between the microorganisms that colonize this organ in order to eliminate pathogens that cause disease. To carry out this procedure, you can use capsules that are administered orally, or an enema rectally, among other possibilities.
Watch for possible long-term side effects
The review of studies has shown that fecal transplantation was not only more effective in controlling infection than standard antibiotic therapy, but also had fewer side effects. However, in the opinion of Toni Gabaldón, ICREA research professor and head of the Comparative Genomics group at the Institute for Research in Biomedicine (IRB Barcelona) and the Barcelona Supercomputing Center (BSC-CNS), “the study of possible adverse effects -on especially in immunocompromised individuals – would require longer and more extensive follow-up”, as he has declared to SMC Spain.
“This type of treatment is increasingly reaching the clinic and these results coincide with the conclusions of other studies. It can work in this type of alterations where there are no effective treatments, but there is a lot of inter-individual variability, both in terms of the donor of the fecal microbiome and the recipient”, adds the expert, who considers “that these approaches will improve when we have more detailed knowledge about the interactions between the microbiome and our immune system. Surely the technique will evolve towards more selective transplants, not of an entire fecal microbiota, but of defined microbial communities, different depending on the patient and the indication. To get there we still have an arduous path of basic and applied research”.
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