Fatal transplantation
The first case of death as a result of fecal transplantation was registered
A patient with a weakened immune system got a microbe with broad drug resistance
Polina Loseva, "The Attic"
The Food and Drug Administration (FDA) The United States reported the death of a patient after a transplant of intestinal bacteria. Among the donor microbes was a strain of resistant E. coli, which the already weakened patient's body could not cope with. This is the first documented case of death as a result of such treatment.
Fecal transplantation is the transplantation of intestinal microbes from one person to another using a special capsule, enema or probe. Such procedures have not yet been officially approved for use in medicine, but scientists are actively investigating them in clinical trials to combat a variety of conditions – from pancreatitis and obesity to Parkinson's disease and bipolar disorder. The most successful so far is the transplantation of bacteria with Clostridium difficile infection – it is already actively used in cases where other methods of treatment do not work, however, with the caveat that the technique is experimental and not fully understood.
The other day there was a serious reason to doubt not only its effectiveness, but also its safety. American Food and Drug Administration (FDA) told about the serious side effects of fecal transplantation. Without disclosing details – the location of the procedure, as well as the names and diagnoses of patients – the FDA reported that two people developed serious bacterial infections after transplanting microbes, one of them died.
In both cases, the infection was caused by a supermicrob – a strain of E. coli that produces broad-spectrum beta-lactamase. This enzyme destroys not only penicillin antibiotics (like regular beta-lactamase), but also next-generation drugs, cephalosporins. Some beta-lactamases can even cope with carbapenems – antibiotics of the latest generation, which are used in cases when all others are powerless (although the FDA statement does not specify whether this particular supermicrobial had such an ability). In addition, the weakened immunity of both patients played a role, but even here the FDA does not report what led to the disruption of its work.
Subsequently, it turned out that both patients received a fecal transplant from the same donor. Indeed, a pathogenic strain of E. coli was found in his stool samples. Until now, the donor microflora has not been tested for antibiotic resistance, and work with recipients was limited to the fact that doctors talked about potential risks and received informed consent to transplant someone else's microflora.
Now, the FDA has demanded to check all transplanted bacteria for broad drug resistance, as well as to be more attentive to the patient's condition. In addition, The New York Times reports that many clinical trials of fecal transplants will be suspended until researchers prove they can meet these conditions.
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