Synthetic Stool Found to Stop C. Difficile Infections

Emma Allen-Vercoe (University of Guelph)

Bioscientists at University of Guelph and University of Western Ontario in Canada created synthetic fecal matter for transplants that in early human trials stopped C. difficile infections. The findings of the team led by Guelph’s Emma Allen-Vercoe (pictured right) appear online in the inaugural issue of the journal Microbiome.

Clostridium difficile (C. difficile) is a bacteria that emits toxins and often spread in health care settings as a result of antibiotics killing healthy intestinal bacteria. Symptoms include severe diarrhea, fever, and loss of appetite. Infections from C. difficile can lead to more serious conditions, such as colitis, perforated colon, and sepsis.

Few effective treatments have been found for C. difficile, but stool transplants — infusing a donor’s stool into the intestine of the recipient — are among the more successful therapies. Transplants of live human fecal matter, however, are often resisted by patients and pose risks from unknown pathogens, which as Allen-Vercoe says, “puts people at risk for future disease.”

Allen-Vercoe and colleagues developed the synthetic stool, called RePOOPulate, as a super-probiotic from purified bacterial cultures grown in a lab device at Guelph that simulates the environment of a large intestine. Allen-Vercoe notes the synthetic fecal matter removes the risk of spreading bacterial infections because, “the exact composition of the bacteria administered is known and can be controlled.”

The researchers tested RePOOPulate on two patients to prove the concept as part of a clinical trial of the technique. The two patients had chronic C. difficile infections and had previously failed to respond to several rounds of antibiotics. After treatment with the synthetic stool, both patients were free of symptoms within three days, and after six months tested negative for C. difficile.

Follow-up tests with genomic sequencing also showed the some of the administered bacteria in the synthetic stool were retained and stabilized in the colons of the patients. This finding shows, says Allen-Vercoe, “the introduced microbes were able to persist,” adding, “This is important because most commercially available probiotics only colonize transiently.”

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