AP medical writer
this photo provided by the Centre Montefiore Medical taken Friday 10 December 2010, said Mr. Lawrence Brandt, Emeritus Chief of Gastroenterology, medical center in New York. He?s among a small but growing number of doctors to try a reckless effort against intestinal superbactérie transplanted someone healthy gut sick person?s stool. (AP Photo/Montefiore Medical Center)WASHINGTON — a superbactérie named C-diff is on the rise, a germ that kind havoc tries intestines of some people who repeated the strongest, most expensive antibiotic can conquer their disabling diarrhea.
Now a small but growing number of physicians seeking a reckless treatment: for good bacteria to fight the evil by transplantation of stool a person healthy colon of the ill person.
Yes, there is a factor. But reports of several dozen in a medical journal and a meeting of gastroenterologists nation fall suggest with any disadvantage more colonoscopy, people who have suffered from C-diff for months or more, can rapidly improve.
"This is the ultimate probiotic,", explains Dr. Lawrence Brandt New York Montefiore Medical Center, who conducted 17 procedures.
However, it is much more complex: a bacterial neighbourhood full is transplanted, almost like less than organ transplantation anti-rejection drugs, says Mr. Alexander Khoruts, University of Minnesota. He took a DNA from bacteria of the digestive tract in a woman left emaciated after eight months of serious C-origin not only did disappear from the diarrhoea after faecal transplant, but that the normal bacteria mirroring husband - donor - quickly took root in his gut recovery.
Here's warning: fecal transplants have not studied in the way that science needs to prove that they work - by comparing similar patients graft or more intense antibiotics. History is filled with treatment failures as promising raw physicians in a real test until they were submitted.
"Nothing very good reasons to believe this faecal transplant or bacteriotherapy, may work, but it must be proven before everyone starts to do," says Mr. Lawrence Schiller, a gastroenterologist in Dallas Baylor health care system. Follow-up reports on the American College of the recent meeting of Gastroenterology treatment, but has not joined the emerging trend.
C diff, officially called Clostridium difficile, became a threat in hospitals across the country and can spread outside of one of them, too. Some patients suffer from diarrhea just benign, but others, especially older weakened by the previous disease can develop a more serious condition called colitis. There aren't accurate counts in the indictment, but some Government estimates suggest as c-diff may be responsible for up to 15 000 deaths per year.
Up to one-third of patients experience a second infection, and some will suffer recurrent episodes. Worst patients are placed on more powerful doses of antibiotics Vancomycin for weeks, even months at a time, treatments that Brandt, explains can cost $ 2,500 or with each attempt.
But because antibiotics kill so good and bad germs, C-diff can bounce to a now exhausted colon hundreds of species of bacteria that are supposed to live there.
"They are caught in the cycle of treatment and reprocessing," explains Khoruts Minnesota conducted grafts fecal 21 since discovering how normal bacteria has included in its first patient in 2008. He now began more detailed before - and after mapping of patients to try to determine if special bacteria are essential.
Faecal transplant are new step - the first was reported in 1958, and they performed occasionally since. But 170 cases described in medical journals since then, approximately one-third have been published this year, suggesting increased interest in the problem of C-diff grows, said Brandt at Montefiore.
The doctors who practise transplantation of faeces agree that more rigorous research is needed - without it, there is no way of knowing if only supposed success and not failures are written. Brandt provides a pilot study.
"I used to say it is just a measure of patient how desperate and their doctors." ' There came a time when there was nothing else to do, ", explains Dr. Christina Surawicz Harborview Medical Center at the University of Washington to conduct its 16th procedure last week.
How they are doing? There is not a method. Brandt insists on a list of tests to ensure that the donor has no diseases such as hepatitis or HIV or intestinal parasites. And then the donor, usually a close parent, brings a fresh stool that liquefies and drips mainly in the colon for colonoscopy Brandt routine patient sample.
Insurance companies do specifically cover faecal transplant, but they pay colonoscopies for patients to C-diff, Brandt, explains. Donor test can be run to several hundred dollars. If the insurance does not cover it, patients pay.
One patient Brandt has undergone recurrent episodes of C-diff for about 18 months to find the option. "You start to look like a leper," said honestly, Ruth, a woman in New York, who asked that his name be not used. She said that she felt great two years since graduation of treaties, while "I'll tell you that I did not take another antibiotic."
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NOTE for the editorial - Lauran Neergaard covers medical and health for the Associated Press problems in Washington.
