In the dynamic field of medicine, where innovative treatments are constantly emerging, one such intriguing therapy has been making waves in recent years - Fecal Microbiota Transplantation (FMT). In this blog post, we'll delve into the history of FMT and explore its role in treating Clostridioides difficile (C. difficile or C. diff) infections, shedding light on the promising outcomes seen in clinical research.

Understanding C. difficile Infections

C. difficile is a bacterium that can cause severe diarrhea and inflammation of the colon and is associated with significant morbidity and mortality as well as healthcare costs worldwide ^1–4. The long-term cure rate using traditional treatments, such as antibiotics, is low, with re-occurrence of CDiff in about 15- 30% of patients ^1,2,4,5. In addition, the current use of antibiotics often disrupts the balance of the gut microbiota, leading to both recurrent infections and gut dysbiosis ^6–19. This is where FMT comes into play, aiming to restore a healthy microbial community in the gut.

What is FMT?

Fecal microbiota transplantation (FMT) is the infusion of specially prepared stool material from a healthy, well-screened donor(s) into the gut (intestinal tract) of a recipient to restore a healthy and stable microbial community and confer health benefits and/or treat a specific disease or symptom(s) ^20–23.

The idea here is that FMT will help re-educate the recipient's gut microbiome, inducing the re-colonization of the gut and restoring microbial diversity to donor-like proportions ^24–29. While FMT might sound unusual, but it isn’t anything new, having been around in some way, shape or form for over 1,700 years ^22,30,  but in the last 10 years, there has been increased scientific and clinical research into how modifications of the gut microbiome using FMT can improve health and tackle areas of unmet medical need.

The use of FMT to treat recurrent Clostridium difficile (c.Diff) infections

Currently, FMT is an approved and very effective treatment for patients with recurrent Clostridium difficile infections (c.Diff) who are non-responsive to antibiotic therapy ^31–36. FMT has demonstrated success in treating, decolonizing and preventing the recurrence of c. Diff has high success rates and favourable safety profiles. ^24,37–42. A recent analysis found a 92% clinical resolution rate compared to the first-choice antibiotics against c. Diff, vancomycin ^4,38. In addition, another small-scale study showed that FMT leads to higher overall survival rates, shorter hospital stays, and lower rates of bloodstream infection in patients with recurrent c.Diff than receiving antibiotics alone ^39,43. Overall, FMT has been shown to be effective and has superior long-term efficacy compared to other medical treatments in c.Diff ^3,5,22. 

The key improvements observed with FMT in the treatment of C. difficile infections include:

• Higher Cure Rates: FMT has consistently demonstrated higher cure rates compared to conventional antibiotic therapy ^4,38.
• Reduced Recurrence: Recurrent C. difficile infections pose a significant challenge, but FMT has shown promise in reducing recurrence rates and providing long-term relief ⁵.
• Restoration of Gut Microbiota: FMT helps restore the balance of the gut microbiota, promoting a healthy microbial environment and preventing further infections ^24,37–42.

Conclusion:

FMT has demonstrated clinical effectiveness in treating CDI infections in terms of prevention of recurrence, decolonization, and treatment ³⁹. With a growing body of scientific evidence supporting the use of FMT to improve symptoms and alter the gut microbiota in patients with recurrent c.Diff has led to the expansion of research on the use of FMT for a wide variety of both gastrointestinal (GI) and non-GI disorders ^{20,23,31,41,44}.   As we continue to unlock the mysteries of the human microbiome, FMT stands out as a potential treatment for many conditions, but more clinical research is needed to fully understand its potential.

At Novel Biome, we're passionate about the importance of the gut microbiome and the transformative potential of Fecal Microbiota Transplantation (FMT) treatment to restore health. As an FMT contract manufacturer, we leverage our years of experience in FMT to manufacture high-quality FMT products utilizing our highly-screened donors and stringent manufacturing standards. If you are interested in learning more about our FMT products and manufacturing capabilities, please contact us HERE or to register as a clinical partner to order FMT products, click HERE.

References: 1. Drekonja, D. et al. 2015, 2. Hui, W. et al. 2019, 3. Moayyedi, P. et al. 2017, 4. Quraishi, M. N. et al. 2017, 5. Khan, M. Y. et al. 2018, 6. Antonopoulos, D. A. et al. 2009, 7. Croswell, A.et al. 2009, 8. De La Cochetière, M. F. et al. 2005, 9. Jernberg, C.et al. 2007, 10. Keeney, K. M.et al. 2014, 11. Kim, S.et al. 2017, 12. Lange, K.et al.2016, 13. Lankelma, J. M. et al. 2017, 14. Lozupone, C. A.et al.2012, 15. Modi, S. R.et al.2014, 16. Robinson, C. J. & Young, V. B. 2010, 17. Sommer, M. O. & Dantas, G. 2011, 18. Sullivan, Å.et al. 2001, 19. Young, V. B. & Schmidt, T. M. 2004, 20. Choi, H. H. & Cho, Y.-S. 2016, 21. Gupta, S.et al. 2021, 22. Ser, H.-L.et al. 2021, 23. Xu, M.-Q. 2015, 24. Kelly, C. R. et al. 2016, 25. Khanna, S. et al. 2017, 26. Shankar, V. et al. 2014, 27. Song, Y. et al. 2013, 28. Staley, C.et al. 2016, 29. Wilson, B. C.et al. 2019, 30. Borody, T. J.et al. 2014, 31. Allegretti, J. R.et al. 2019, 32. Cammarota, G. et al. 2015, 33. Kao, D. et al. 2017, 34. Lee, C. H. et al. 2016, 35. Lee, C. H. et al. 2019, 36. van Nood, E. et al. 2013, 37. Austin, M.et al. 2014, 38. Basson, A. R.et al. 2020, 39. Gerardin, Y.et al. 2021, 40. McCune, V. L.et al. 2014, 41. Rinott, E. et al. 2021, 42. Youngster, I. et al. 2014, 43. Ianiro, G. et al2019, 44. Brandt, L. J. & Aroniadis, O. C. 2013.