To Ease Fecal Treatment, Stool Bank Starts Producing Long-Awaited ‘Poop Pill’

Introducing: the poop pill  (Courtesy of OpenBiome)

Introducing: the poop pill (Courtesy of OpenBiome)

By Gabrielle Emanuel

Fecal transplants may have just gotten a lot easier to swallow.

OpenBiome, the nation’s first stool bank, is beginning large-scale production of a poop pill. This week marks the first time such a pill will be commercially available to hospitals and clinics.

Early tests suggest the pill is highly effective and comparable to traditional, more invasive delivery methods — for instance via colonoscopy, enema or a plastic tube through the nose and into the stomach or intestines.

“Fecal transplants came from what used to be this dark art — where you needed a donor and a blender,” says Mark Smith, research director at OpenBiome and one of its founders. “And now you basically take something out of the freezer and can treat the patient immediately. I’m very, very excited about this.”

Try not to get grossed out because this is an upbeat story. It’s about a very effective medical treatment for a really nasty infection.

Earlier, we reported on fecal transplants and OpenBiome’s struggle to survive.

Founded by MIT students and based in Medford, OpenBiome is just like a blood bank but for poop.

“Fecal transplants came from what used to be this dark art — where you needed a donor and a blender. Now you basically take something out of the freezer and can treat the patient immediately.”

– Mark Smith, OpenBiome research director

It collects healthy poop and then gives it to doctors so they can perform fecal transplants. This procedure is used for patients with recurrent Clostridium difficile or C.diff infections. The bacterium is in the gut and can cause bad — sometimes debilitating — diarrhea.

C.diff sickens hundreds of thousands each year and kills nearly 30,000 people annually in the U.S.

But fecal transplants have proven to be remarkably effective when it comes to C.diff. Technically called Fecal Microbiota Transplantation (FMT), the procedure has been shown to be nearly 90 percent effective in treating C.diff. That’s compared to standard antibiotics, which cure less than 40 percent of recurrent C.diff patients, according to OpenBiome.

This procedure involves collecting stool from a healthy donor and infusing it in the gut of a sick individual. But the catch is that the delivery method is both unpleasant and invasive. Continue reading

Report: Fewer Infections Overall At Mass. Hospitals (But Problems Remain)

(UCI Irvine/flickr)

(UCI Irvine/flickr)

For the most part, patients are contracting fewer infections inside Massachusetts hospitals — but some problem spots remain, according to numbers from the state’s Department of Public Health.

WBUR’s Martha Bebinger reports:

It’s almost impossible to compare the quality of specific hospital procedures, but you can make a few hospital system comparisons.

For instance, the latest data show lower rates for three types of hospital infections — central line and surgical site infections for hysterectomies and colon operations. On the other hand, rates for urinary tract infections from catheters have increased.

Still, required reporting is spurring change, says Patricia Noga, VP for Clinical Affairs of the Massachusetts Hospital Association.

“When there is reporting and particularly when there is public reporting, people stand up and take notice of it,” Noga says. “Sometimes more than they would otherwise.”

Here are some specifics from the state Center for Health Information and Analysis:

•Central line-associated blood stream infections in Massachusetts have declined by 47%. In Massachusetts’ Intensive Care Units and neonatal ICUs, [such infections] declined by 57% and 49%, respectively.

•Surgical site infections related to abdominal hysterectomy declined by 23% in Massachusetts hospitals. While 8% of reporting hospitals had an observed to expected ratio greater (worse) than the national ratio, overall Massachusetts’ improvement is on track with positive national trends.

•Surgical site infections related to colon surgery declined by 19%. Massachusetts’ ratio of observed to expected infections is in line with the nation’s.

•Catheter-associated urinary tract infections have increased by 45% in the Commonwealth. In Massachusetts ICUs, [these types of infections] have increased by 64%. Among reporting hospitals, 15% had an observed to expected ratio greater (worse) than the nation’s. Massachusetts significantly lags national performance on this measure.

Continue reading

Mass. Public Health Officials Looking Into Vaginal Hysterectomy Infections

The Boston Globe’s Liz Kowalczyk reports here:

Massachusetts public health officials have called together patient safety leaders to determine why hospitals reported a high rate of surgical infections among women who received vaginal hysterectomies over the past two years.

Hospitals reported 23 of these infections in 2010 and 25 in 2011 — out of 4,313 procedures total — about twice as many as expected based on national rates. Health officials said further investigation is needed to pinpoint the reasons.

The infection rates for vaginal hysterectomies emerged as health officials released report cards today for 71 hospitals, showing how many patients contract potentially serious infections from surgery and other medical care that is intended to heal them.

The numbers are highly preliminary and it’s not yet clear what they mean. Dr. Madeleine Biondolillo, director of the state’s Bureau of Health Care Safety and Quality, said after yesterday’s Public Health Council meeting, at which the numbers were released:

“One interesting finding is that for the surgical procedure called vaginal hysterectomy where a woman’s uterus is removed, there was a higher than expected rate of infection across the board in the commonwealth. Putting the data forth in this matter allowed us to identify that as an area for concern.

We think that there’s work to be done in terms of understanding how much of the increase in rate is related to actual increases in numbers of infections versus what could actually be a difference in the way the technique is being done. Surgical technique has changed, and we need to make sure that we capture the information correctly based on the changes in the technique. Continue reading

A ‘Spoonful Of Sugar’ Could Help Antibiotics Kill Bugs

You know that sinking feeling. Your bladder is feeling constantly full, announcing the return of your urinary tract infection. Or your baby is screaming again, just as he screamed the last time he had an ear infection. Or your teenager says, “My throat is hurting — feels like the strep is back.”

Certain bacterial infections have an infuriating tendency to recur even after they’re treated with antibiotics, and scientists have determined a key reason why: A few of the bugs go into a dormant state that protects them from antibiotics. Known as “persisters,” they are the bacterial villains behind those pesky infections that just keep coming back.

Today in the journal Nature, researchers report discovering a surprisingly sweet method to get rid of those nasty persisters. From the Boston University press release:

James Collins, a pioneering researcher in the new field of systems biology and a MacArthur Genius, says: “You know the old saying: ‘a spoonful of sugar makes the medicine go down?’ This is more like ‘a spoonful of sugar makes the medicine work.’

Dr. Collins, a professor of Biomedical Engineering at Boston University who is also a Howard Hughes Medical Institute investigator and a core faculty member of the Wyss Institute for Biologically Inspired Engineering at Harvard University, is talking about his recent development of an effective, low-cost – and surprising – way to treat chronic bacterial infections, such as staph, strep, tuberculosis, and infections of the urinary tract.

Boston University professor of biomedical engineering Jim Collins

He and his team of scientists discovered that a simple compound – sugar – dramatically boosts the effectiveness of first-line antibiotics. Their findings appear in the May 12 issue of Nature (online May 11th).

Dr. Collins, 45, who is also a founder of the new field of synthetic biology, has a personal interest in this research. His 71 year old mother, Eileen Collins, was hospitalized several times in recent years with recurrent bouts of a serious staph infection. Doctors treated her with multiple intravenous antibiotics and still the infection could not be killed. It was his mother’s suffering that added urgency to Dr. Collins’ research.

You’ve probably heard about the looming problem of bacteria that have become resistant to antibiotics largely because the drugs are so heavily prescribed these days. Persisters are different, the release explains: Continue reading