Nontoxigenic Clostridium difficile for Prevention of Recurrent Infection

Nontoxigenic Clostridium difficile for Prevention of Recurrent Infection


[ Music ]>>The JAMA Network. [ Silence ]>>Cheryl O’Raven [phonetic] loves to bike,
travel, and volunteer but a bout with this bacteria C. difficile changed her life.>>I felt like the lining of my colon was
being ripped out. I needed to be near a washroom at all times.>>Dr. Stewart Johnson from Loyola University
Health System treated Cheryl for C. diff infection.>>C. diff is an opportunistic bacterium.
It can travel down the gut. Start to replicate. Produce the toxins and cause the manifestations
of we refer to as C. diff.>>About 25 to 30% of patients see a return
of the infection. However some patients carry strains of C. diff that do not make the toxins
that are responsible for symptoms of infection. In this case, severe diarrhea. These are called
non-toxigenic strains.>>If that strain can be established in your
gut, it will keep out the toxigenic strains. In fact, it may even force out some of these
toxigenic strains.>>Dr. Dale Gerding from the Edward Hines
VA Hospital and co-authors, looked at 168 patients who had been successfully treated
for C. diff and randomly assigned them to the 4 groups. Three of the groups receiving
varying doses of the non-toxigenic C. diff strain. The fourth group received a placebo.>>The secret clearly was to get these patients
to be colonized with this non-toxigenic strain which just means that these strains set up
housekeeping in the GI tract. We got about 70% of patients to colonize with this strain
after treatment.>>This study appears in JAMA, Journal of
the American Medical Association.>>We were able to reduce the recurrence rate
from 30% in the placebo group down to 11% for all patients who got the non-toxigenic
strain and for the dose that worked the best, the recurrence rate was 5%.>>Administration of non-toxigenic strains
did not result in any severe side effects compared with placebo.>>It’s the first time that we’ve taken the
strain of the same bacteria that causes the disease and actually used it as a preventive
measure.>>Luckily Cheryl did not have a recurrence
of C. diff. Her health is back to normal and she is looking forward to –>>My next trip.>>Catherine Dolf, the JAMA Report. [ Music ] [ Silence ]

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