A study conducted by the Bellvitge University Hospital (HUB) and the Bellvitge Biomedical Research Institute (IDIBELL), presented at the European Congress of Microbiology and Infectious Diseases ESCMID Global, has revealed a significant recovery in fecal microbiota diversity in most cases of Clostridioides difficile infection treated with fecal microbiota transplantation (FMT).
“These results are relevant, since C. difficile infection can be life-threatening for patients, and these first results support the use of microbiota transplantation as a safe and effective alternative,” according to Dr. Daiana Guevara, coordinator of the Microbiome Unit of the HUB and researcher at IDIBELL.
The results are based on the sequencing and subsequent study of microbial diversity of samples from fecal microbiota transplant donors and recipients carried out at Bellvitge Hospital from the end of November 2021 to June 2022. Fecal samples from patients with C. difficile infection were found to show low microbial diversity, compared to samples from healthy donors.
“The gut microbiota is made up of millions of microorganisms that perform a wide variety of health-promoting functions. External factors such as eating habits or the consumption of antibiotics, among others, generate changes in the usual microbiota that can trigger imbalances that predispose to gastrointestinal infections, such as C. difficile infection, one of the leading causes of diarrhea associated with health care,” explains Dr. Guevara.
Altruistic Stool Donations Are Necessary
Fecal microbiota transplantation (FMT) is a medical procedure in which the fecal microbiota of a healthy donor is transferred to the gastrointestinal tract of another individual, in order to confer a health benefit.
Bellvitge Hospital has a long history of using FMT to treat C. difficile infections – specifically, since 2014 – as a result of which it created the Microbiome Unit and has been one of the two promoters, together with the Hospital Clínic, of the Fecal Microbiota Bank of Catalonia. In fact, the HUB is the only centre in Catalonia that is capable of manufacturing freeze-dried capsules of gut microbiota from the feces of donors with a healthy gut microbiome. This oral treatment is effective in less than 48 hours.
To produce these capsules, altruistic donations of feces are necessary. Three out of four potential donors are discarded in a very demanding selection process. People with conditions such as diabetes or obesity, or any chronic pathology, as well as carriers of multidrug-resistant germs or pathogens in the stool, are ruled out. The mission of the Microbiome Bank is to accelerate these steps by immediately providing frozen stool samples.
In addition, these stool samples also “allow us to start experimental programs to explore the use of this pioneering transplant in other pathologies and to study the human microbiome, the community of variable microorganisms that inhabit the digestive system and other areas of the body, with next-generation sequencing (NGS) techniques,” explained Dr. M. Ángeles Domínguez, head of the Microbiology Service of the HUB and of the Epidemiology of Bacterial Infections group at IDIBELL.
“These techniques will revolutionize clinical microbiological diagnostics in the coming years and will probably make an important contribution to the personalized medicine of the future,” according to Dr Jordi Guardiola, head of the HUB’s Digestive System Service.
The Bellvitge Biomedical Research Institute (IDIBELL) is a biomedical research center created in 2004. It is participated by the Bellvitge University Hospital and the Viladecans Hospital of the Catalan Institute of Health, the Catalan Institute of Oncology, the University of Barcelona and the City Council of L’Hospitalet de Llobregat.
IDIBELL is a member of the Campus of International Excellence of the University of Barcelona HUBc and is part of the CERCA institution of the Generalitat de Catalunya. In 2009 it became one of the first five Spanish research centers accredited as a health research institute by the Carlos III Health Institute. In addition, it is part of the “HR Excellence in Research” program of the European Union and is a member of EATRIS and REGIC. Since 2018, IDIBELL has been an Accredited Center of the AECC Scientific Foundation (FCAECC).