What is it?

It is a transplantation of intestinal bacteria from a healthy carrier to a patient with the objective of achieving a change in the microbiota of the recipient, recomposing it and improving his or her state of health.1

So far, the only clinical indication is for the treatment of intestinal infection caused by Clostridium difficile.

Clostridium difficile is an anaerobic, Gram+, toxin-producing bacterium. It is the cause of nocosomal diarrhea.2 It is a very resistant bacterium and transplantation can control this resistance. The infection is usually treated with antibiotics (vancomycin and fidaxomicin) that alter the microbiota in a wild-type manner so that recurrences of the infection occur. Microbiota transplantation restores the ecosystem and controls bacterial activity.1,2

Transplantation can be performed either by oral capsule administration or by colonoscopy that irrigates a solution of the fecal microbiota directly into the colon. This is a much more invasive technique and not as effective as the first option.2

This concept opens up new possibilities for the treatment of bacteria that are highly resistant to antibiotics, mainly those used at the hospital level. With fecal transplantation, the bacterial ecosystem is regenerated so that these multidrug-resistant bacteria are under control and antibiotics can be used again to treat them.1

As in all other transplants, it is important to know the compatibility between donor and recipient.

In the case of fecal transplantation it may happen that a single donor is specific for a particular pathology because of its microbiota composition. So the goal is to achieve a pool of superdonors for specific pathologies.1

 

Another issue to investigate about this technique is safety since, on many occasions, transplantation is used for a specific pathology, but there are problems with the appearance of other diseases such as obesity or even autoimmune diseases.

Dr. Xavier Aldeguer, member of the Spanish Society of Digestive Pathology, in an interview for infosalus concludes by saying that fecal microbiota transplantation is a "treatment of the future". 1

 

  1. 2021, Fecal transplantation, a therapeutic weapon for more than one pathology, isofaslus, https://www.infosalus.com/salud-investigacion/noticia-trasplante-fecal-arma-terapeutica-mas-patologia-20211105083354.html
  2. Svensson, C. K., Cold, F., Ribberholt, I., Zangenberg, M., Mirsepasi-Lauridsen, H. C., Petersen, A. M., & Helms, M. (2022). The Efficacy of Faecal Microbiota Transplant and Rectal Bacteriotherapy in Patients with Recurrent Clostridioides difficile Infection: A Retrospective Cohort Study. Cells, 11(20), 3272. https://doi.org/10.3390/cells11203272.