Six patients got sick after the transplant of intestinal bacteria. Two of them recovered at home, and two in the hospital. Two died, but it is still unclear whether to link their death with the consequences of the transplant. Cause diseases are called pathogenic strains of Escherichia coli. Now the samples of the donor of the chair will check on them too. About it reports a press-release on the website of the Bank donor chair Open Biome.
Fecal transplantation is considered a promising tool to combat a range of diseases, from obesity to autism. Despite the fact that the use of officially approved only in the case of some intestinal infections, the method is actively used in numerous clinical studies. However, this procedure, like any other, is associated with some risk. When a person receives the wrong intestinal bacteria, his body is usually weakened. And if the donor microbes be any pathogenic strain, it gets the chance to multiply and invade the patient’s body.
On two such occasions, the doctors reported in the summer of 2019: after the transplant patients were infected with E. coli resistant to many antibiotics. One of them to rescue failed. This happened because the sample donor chair, who received deceased patient has not been tested for resistance to antibiotics. Disposal FDA, which is obliged to carry out such inspection, appeared after the sample was selected and frozen.
Now, doctors reported new side effects from the transplant, intestinal microbiota. Two patients with a weakened immune system received microbiota from different donors to fight clostridiales intestinal infection. Soon one of them developed diarrhea, the second was in the hospital for other reasons, but both the chair found enteropathogenic strain of Escherichia coli. It is known that some people can carry it without symptoms, and others is developing a bowel disorder which takes place over a few days. Both patients shortly discharged from hospital, but the samples they transplanted bacteria were destroyed.
Four patients also suffered clostridiales infection and received microbiota from the same donor. Subsequently, they found strains of Escherichia coli that produce Shiga-like toxin (similar to the one emitted by the bacteria Shigella, the causative agent of dysentery). When breeding this strain in the intestine, the patient may experience pain, fever, nausea and diarrhea. Two of the infected patients were treated at home, two in the hospital, and all recovered.
Later it was reported that two patients who received a transplant of bacteria from the same donor, died. However, it is still unknown whether their death with transplantation. One of them suffered from chronic heart disease, and the other chair had failed to detect the pathogenic strain of Escherichia coli.
All stool samples that received these patients were kept in the Biobank OpenBiome. As told the representative of Biobank portal STAT, the Bank has already sent about 55 thousands of samples for clinical trials. This is the first case of complaints of side effects, which shows that the probability of their development is extremely small. However, the FDA issued a warning about the risks of fecal transplants and OpenBiome has reinforced the procedure of testing of donor stool for pathogens. The previous methodology did not allow to identify the strain that produces Shiga-toxin, and the enteropathogenic strain samples are generally not tested.
From the editor
Do not think that the side effects and, possibly, the death of patients associated with careless testing. The fact that the intestinal the human microbiome consists of many types of bacteria with its own characteristics. To check all of their safety is impossible. In addition, it is difficult to predict in advance how a particular strain behaves in a weakened body, and what kind of infection will be fatal on the background of comorbidities of the patient. Because it turns out that every accident is cause in order to make a stricter selection procedure donor samples.