Question

Clostridium difficile (C. diff) is a gram-positive bacillus that produces produces spores and toxins that can cause extreme diarrhea, abdominal pain, fever, loss of appetite and nausea. The main transmission of C. diff is from person to person through the fecal-oral route and contaminated surfaces, such as doorknobs, bathtubs and medical equipment. If a surface becomes contaminated with C. diff it can be transferred to patients mainly via the hands of healthcare personnel who have touched a contaminated surface or item. The infection is usually treated with antibiotics and (20%) of these individuals recover, while in other patients the antibiotics kill their normal flora and C. diff is the predominate organism in the gut.

A fecal transplant takes a healthy diversity of bacteria and transplants ‘healthy’ bacteria that can re-established in the patient’s intestine. The donor’s fecal matter is tested to ensure that the stool do not contain any infectious agents (ex. HIV infection, hep B or C,etc.) that could be transmitted to the patient and other criteria are taken into consideration, as well. The donor feces is put into the patient by preforming a colonoscopy or by delivering the donor feces by injecting liquid feces via an enema.

What are your thoughts on this type of procedure? (If you feel comfortable answering, would you be a donor or be a patient receiving the fecal transplant? You do not need to answer if you are not comfortable.)

What questions or concerns would you have for medical professionals, if any?

The FDA warns about infections linked to fecal transplant. The donor feces has a very rare antibiotic strain of E.coli that went undetected in the screening process. The patient passed away due to a weaker than normal immune system. Does this passing of 1 patient discredit the practice of fecal transplant?

https://www.statnews.com/2019/10/30/details-first-death-fecal-transplant/

Answer 1

- What are your thoughts on this type of procedure? (If you feel comfortable answering, would you be a donor or be a patient receiving the fecal transplant? You do not need to answer if you are not comfortable.)

This is a very practical treatment, it focuses on providing a direct solution to a concrete issue, ignoring the social/cultural obstacles that may come to mind from feces, but that is common in medicine and science. The purpose of this procedure, and every medical procedure, is to heal someone, and that goal is bigger than any social/culture reason against it.

Yes I would be both a donot and a patient if necessary, in one case I would have the oportunity to aid womeone and help to heal, and in the other I would be given an opportunity to heal easily

- What questions or concerns would you have for medical professionals, if any?

I would have questions about :

- The origin: Who can be donors? Is there any special requirements besides not having infectious agents?

- The advantages: How fast is the patient going to recover after recieving the microbiota? What is the difference between recieving it and not recieving it?

- The FDA warns about infections linked to fecal transplant. The donor feces has a very rare antibiotic strain of E.coli that went undetected in the screening process. The patient passed away due to a weaker than normal immune system. Does this passing of 1 patient discredit the practice of fecal transplant?

No, there are many treatments that have a small failure frequency, but the general practice of this procedure leads to greatly more lives saved than lives lost. It is one failure against all the success cases