One man's trash is another man's treasure, as the saying goes. If things go to plan, feces from registered and thoroughly tested healthy donors will in a few years be the standard treatment for the bacterium Clostridium difficile at Danish hospitals. This is the goal of a research project that is being backed by the Innovation Fund Denmark to the tune of DKK 17 million - USD 2,7 million - in the period 2019-2023.
Medical doctors and researchers have long known that fecal microbiota transplantation (FMT) - as the treatment is called - is so effective against the stubborn bacterium Clostridium difficile that nine out of ten patients are cured by only a single treatment. In essence, the treatment involves transferring feces from a healthy donor to the intestine of a patient. By comparison, only about one third of patients become healthy using antibiotics, and several centres therefore offer FMT as a trial treatment.
However, the problem is that the handling of feces and the use of feces as a treatment places high demands on safety, selection and screening of the feces donors and on pa-tient follow-up. This is where the new research project intends to make a big differ-ence, explains Christian Lodberg Hvas, who is a consultant at Aarhus University Hospital and a clinical associate professor at the Department of Clinical Medicine at Aarhus University. He has been involved in establishing the treatment in Aarhus since 2014 and is one of the researchers who will now administer the investment - among other things, with the establishment of a socalled feces bank and the screening of future fe-ces donors.
"The challenge is systemizing everything so that the treatment can be offered to everyone with Clostridium infection and doing this with the highest possible level of safety and effect. This will be one of the main tasks of the upcoming research project," says Christian Lodberg Hvas.
"The effect is really quite dramatic. Clostridium difficile typically affects patients who are already weakened or ill for other reasons. Whereas these patients previously could go through one antibiotic treatment after the other over and over again and experience long periods of diarrhoea and general weakness, with a single treatment we can now prevent the bacteria returning, after which the patient becomes healthy again. At the same time, the number of hospitalisation days also falls significantly, which benefits the patients, hospitals and the economy in general," he says.
Organisationally, the investment by the Innovation Fund Denmark is made to CEFTA (The Centre for Feces Transplantation) at Aarhus University Hospital, which is headed by Christian Lodberg Hvas, and which has treated 200 critically ill patients with FMT since 2014. The coming development, quality assurance and organisation placement in clinical practice will take place in a collaboration between the Department of Hepatolo-gy and Gastroenterology at Aarhus University Hospital, the Blood Bank at Aarhus University Hospital, the Department of Business and Management at Aalborg University and the National Food Institute at the Technical University of Denmark.
"The idea is to use the many years of experience from the blood bank to standardise the selection and screening of feces donors and in this way develop a feces bank that is just as safe as a blood bank. At the same time, the project will contribute to the development of freeze-dried donor feces in the form of capsules that will supplement what we typically do today, which is to provide FMT through an endoscope or probe inserted in the intestines," explains Christian Lodberg Hvas.
"But having said this, our most important product is the scientific publications. It's more a case of ensuring an effective treatment at Danish hospitals than about making money. The research project will help us on a general level, and we are grateful to the Innovation Fund Denmark for making a contribution to this," says Christian Lodberg Hvas.
More about Clostridium difficile:
- Clostridium difficile is an extremely stubborn bacterium that is able to survive even in sterile hospital environments because it makes spores that can withstand both drying and alcohol.
- In a weakened patient, Clostridium difficile damages the intestine and causes a se-vere diarrhoea condition that can be life-threatening.
- For one in four patients, the infection returns even after treatment with antibiotics. If the bacterium returns, it is almost impossible to get rid of, and mortality increases.
- Clostridium difficile is today regarded as one of the most dangerous bacteria for humans.