In the latest bout of germ warfare, doctors are trying new techniques to combat recurring infections of Clostridium difficile, a pesky bacterium that causes symptoms ranging from diarrhea to death. According to the Mayo Clinic, over half a million people get sick each year from C. difficile and those most at risk are the elderly and patients on prolonged antibiotics. It's become the most common cause of healthcare associated infection, turning hospitals into veritable hot zones where the pathogen is spread through contaminated fecal matter.
Not only have C. difficile infections become more common, they've also become more severe and difficult to treat. The infection is now cropping up among younger, healthier patients, even those not on antibiotics and outside the healthcare setting.
Mild cases of C. difficile cause frequent watery diarrhea, along with abdominal cramping and tenderness. In severe cases, the frequent diarrhea is accompanied by fever, nausea, severe cramping and even kidney failure. If the condition persists, it can lead to toxic megacolon, which is just as scary as it sounds. The infected colon, unable to expel gas and stool, becomes greatly distended and can eventually rupture, thereby releasing the deadly bacteria into the abdominal cavity, resulting in life-threatening peritonitis. Of the 500,000 cases in 2011, about 30,000 of those patients died, many within the initial 30 days of infection.
Traditionally, doctors have treated the infections with aggressive antibiotics. But now, they are testing a new weapon: other bacteria.
Researchers from Loyola University Health System in Illinois are literally infecting patients with a non-toxic strain of C. difficile, hoping the less virulent version will outcompete the deadly strain. And it seems to be working. Sixty-nine percent of the patients treated overcame their infection, with only 2% showing signs of reinfection.
"What we're doing is establishing competition with the original, toxic strain" researcher with the team at Loyola, Dr. Dale Gerding says. "I'm excited about this and looking forward to a larger trial. We think it'll go a long way to reduce C. difficile recurrence."
This latest therapy falls on the heels of another recent trend in bacterial grafting: fecal transplants. Known in professional circles as fecal microbiota transplant (FMT), this emerging alternative therapy is now being used to treat recurrent C. difficile infections. Although it has yet to pass muster with the FDA, clinical studies are underway and the success rates have been impressive. Donor stools are inserted into the patient via a colonoscope or nasogastric tube and the healthy bacteria eventually displace their toxic counterparts. So far, FMT has success rates in the 90 percentile, giving hope to the mass of patients suffering from this deadly condition.