Gut Microbiota and Therapies Flashcards
What is clostridium difficile?
-a gram +ve, sporing, obligate anaerobe
What can clostridium difficile cause?
-range of GI diseases from, antibiotic associated diarrhoea to pseudomembranous colitis
Why have the amount of CDI cases increased?
-different types of bacterial ribotypes, amount of type 1 decreased and amount of other types increased such as type 27 increased. Type 27 is quicker at spreading and causing disease. It is also resistant to one of the popular antibiotics
How can you treat CDI?
- using antibiotics
- using a faecal transplant
Why do we need to treat with faecal transplant?
because a large proportion of people don’t respond to antibiotics and keep having recurrence of the disease
How does FMT work?
-a blended and filtered suspension of stool from a un-related screened donor which is administered to a patient by enema, colonoscopy, nasogastric or nasoduodenal methods
What are the benefits of using a related donor?
- reduced risk of transmission of an infectious agent
- reduced barriers to donor recruitment
Why do we use unrelated donors instead?
- shorter turnaround from request to treatment
- establish long term donor records of screening and clinical assessment
- one donor can provide samples to solve multiple cases in a relatively short time for the same cost
How is FMT prepared and stored?
- fresh stool prepared in dedicated area of containment
- homogenised with saline
- frozen at -80
- administered via nasogastric tube
- gastric acid needs to be suppressed
How long do frozen stools last?
6 months
Why do we need to regulate FMT?
- risk of pathogens being transmitted
- potential for phenotypic transfer of microbiota-mediated disease
- traceability/governance
- QA of material
- non-standardised practice
