Bacteriotherapy - Bacteria in the Service of Medicine
In the last decade, research on human microbiotics – the bacterial population living in the human body, particularly in the intestines – has gained momentum. There are 10 times more bacteria living in the intestines than human cells in our body, and they have an enormous effect on the development of the immune system, metabolism and digestion. The increasing use of antibiotics to treat infectious bacteria may disturb the balance between the various bacterial populations and cause dysbiosis – disruption of the bacterial population balance. In this state, bacteria that are routinely in the intestines and that do not cause damage may become virulent and cause disease.
One of the common intestinal diseases that erupts following extended antibiotic therapy is an infection by a bacterium called clostridium difficile. Intestinal bacteria that are susceptible to antibiotics are killed by the treatment, and this bacterium can proliferate at their expense and form toxins that cause inflammation of the intestinal mucosa, leading to diarrhea, abdominal pain, fever and appetite loss. This disease is common mainly in chronic, old aged and immunocompromised patients.
In an attempt to contend with the increase in frequency of antibiotic resistant clostridium difficile infections, bacteriotherapies that are called FMT (Fecal Microbiota Transplantation) are used in these patients. Within the treatment, a healthy donor’s stool unit containing intestinal bacteria is inserted into the digestive system of a sick person, thus treating the bacterium causing the disease but also allowing for proliferation of a normal intestinal bacteria environment that will prevent return of clostridium once the antibiotic therapy is over. Potential stool donors undergo comprehensive screening to rule out various pathogens and metabolic diseases in order to prevent the transmission of infectious diseases in the transplantation process. Fecal microbiota transplantation treatment has been proved to be highly effective in many studies, with success rates of up to 90% in curing clostridium difficile, even in patients in a very poor condition.
At most medical centers, the fecal microbiota transplantation procedure is done as an invasive procedure such as injecting stool through a colonoscope into the colon or by inserting a cannula into the duodenum. To make the treatment accessible to patients who need it, we at the microbiome research center use an oral method to transplant frozen stool. Transplantation using this method is done using “microbiome capsules” based on stool samples from healthy donors, like ordinary fecal microbiota transplantations. The substance (the microbiome) is processed and packed in special capsules that withstand stomach acidity and break down only after entering the small intestine. A number of initial studies that have been done show that the effectiveness of the oral method is identical to that achieved by fecal microbiota transplantation by colonoscopy or cannula, approaching 90%. The use of this method allows patients to have effective treatment without any invasive procedure.
Who can be a stool donor ?
Any healthy person aged 18-60 can be a stool donor.
Participation as a donor involves a personal interview, filling in a questionnaire and consent form, a weight and height evaluation and laboratory (blood and stool) tests to identify and rule out pathogens and medical disorders related to intestinal bacteria.
A donor who is found suitable will receive a vessel for collecting stool at home. The donor must bring the vessel containing stool within 4 hours of defecating to the microbiome research center at Shamir (Assaf Harofeh) Medical Center.
All medical information of the donor will be treated according to the procedures for safeguarding secrecy.