Dr. Nitsan Meharshak and stool sampling..
(photo credit: COURTESY OF SOURASKY)
Tel Aviv Sourasky Medical Center has launched a new service to deal with “nosocomial” infections acquired in hospital. While the source of the treatment – fecal donations from a healthy person – might turn some off, it is very effective.
The US Food and Drug Administration has approved “fecal microbiota transplantation,” or “bacteriotherapy,” after being persuaded that it cured such infections in a few days with a success rate of 90 percent. Abroad, it has created a “treatment revolution” that has now been adopted in Israel for the first time.
Also known as “stool transplants,” the procedure is used for patients suffering from Clostridium difficile infection, which produces effects ranging from diarrhea to pseudomembranous colitis.
Since about 15 years ago, hospitals have noticed strains of the bacteria that are resistant to antibiotics.
In the US alone, there are an estimated three million cases each year acquired in hospitals by patients who have weak immune systems. More than 100,000 US patients die each year due to the inefficacy of antibiotics against the infection.
The use of healthy stools to treat or even cure diseases has been known by Chinese medicine for some 1,500. In recent decades, antibiotics have been known to change the structure of bacteria in the gastroenterological system and allow Clostridium difficile to multiply dangerously.
Research has shown that up to a fifth of hospitalized patients who were admitted without such infections catch them during their stay there, resulting in nosocomial infections. These may result in diarrhea, stomach pains, fever and, in extreme cases, system failure and even death. In 20 percent of the patients, the bacteria remains in the gut and will continue to cause trouble in the form of chronic diarrhea over a period of months. It greatly compromises the quality of life and may even shorten the patients’ lives.
But the new service in Tel Aviv is available to bring the chronic condition to an end, said Sourasky gastroenterologist Dr. Nitsan Meharshak, who heads the service at the hospital. He studied the technique at the University of North Carolina over a period of two and a half years. The healthy stool is donated by volunteers after they undergo rigid medical tests and fill out questionnaires; the stool is then frozen. The cost of processing a single donation is NIS 3,500. The processed feces are introduced into the infected recipient via gastroscopy or colonoscopy.
As the treatment is expensive and not included in the basket of health services provided by the health funds, patients must pay. In addition, a bank of healthy frozen stools is being collected at the hospital to be used in research to see whether patients suffering from obesity, diabetes and ulcerative colitis can be helped with such a transplant.