Did you know ten years ago nearly 5000 people were dying of a deadly disease
caused by them being given antibiotics. The disease is called Clostridium
difficile diarrhoea and it's a direct consequence of them having those
antibiotics. I'm Professor Peter Hawkey, Professor of
Public Health and Clinical Bacteriology here at the University of Birmingham.
I've been working on C. diff for nearly 40 years.
So what is this disease and why was it so common? Well back 10 years ago 60,000
people were catching this disease, spores from the hospital environment. Resulted in
profuse diarrhea and their guts literally falling to pieces. The cure is
obviously to stop them getting the spores and we were doing a great job of
that in the NHS. So we're down to, last year, there were about 13,000 cases but
unfortunately this disease not everyone can be treated with special antibiotics
and response is only about 80%. So 20% of people carry on with this ghastly
disease and about half of those probably go on to die and as a lot of these
patients were elderly this is really significant problem. So what do we do to
treat people with recurrence C. diff?
Well, it's a very, sounds very unpleasant
treatment called faecal microbiome transplantation. Where we replace your
damaged flora because that's what's happened to your gut flora. The
antibiotics have destroyed a lot of the balance of bacteria in your gut and this
horrible bacterium called Clostridium difficile, Daily Mail called it C. diff
nice catchy title, moves in produces a horrible toxin substance that damages
your bowl. So we can give you a faecal transplant. The problem is you could
catch all sorts of horrible diseases from those faeces. So here the
University of Birmingham we've developed England's first fully licensed service.
So we're making faeces as a true medicine under control of the MHRA regulatory
body. Seems a bit counter intuitive, so we're making these lovely pure faeces to,
put thing, put your flora back and get rid of the C. diff in these people
who relapsed. How do we do it? We have volunteers, people are very, very fit. We
screen them very carefully for any unpleasant diseases. They collect the
faeces and we process them in a sterile laboratory setting and we wind up with
this pure faeces. This is a medicine believe it or not just like your
antibiotics, just like your aspirins. How do we give it? Well under supervision of
a gastroenterologist or microbiologist in the appropriate NHS trust where this
poor person is dying of C. diff. We send them using blood banks, great charity
they support us free of charge. This sample and when it's thawed out with they arrive
the team at the hospital, will have popped down one of these a nasal gastric tube.
Which would just be put through the nose down into the stomach, painless and great.
We draw up the substance, the faeces into a syringe, squirt it down. You may
say well I can taste it? No, nobody tastes it straight into the
stomach and their symptoms usually resolve in 24 to 48 hours. I have a cure
rate of over 90% so it's a great great treatment and we're very pleased we've
done over 300 now here in Birmingham for various hospitals, around the, round
England. What backs it up our research and say I've been working on C. diff for
40 years. We've got lots of integrated research looking at the way, what sort of
bacteria get lost by the antibiotics and how the C. diff does or doesn't interfere
with those. But also there's some suggestions that actually we can
use faecal transplantation to treat inflammatory disease of the barreleye
coast of colitis and I'm involved in a very big study could Stop-Colitis based
here in Birmingham, Glasgow and London. Which is going to try and work out what
how our efficacious, how efficient faecal transplant is of curing Ulcerative Colitis.
So this is really exciting there may be other indications for faecal
transplantation the future. But the great thing here at the University of
Birmingham is we have established a really good facility for preparing this
pure faeces from normal people to enable those who have their microbiome
disrupted by antibiotics or other factors to be replaced with class one
bacteria from the Midlands. So thank you very much for listening and if you're
interested in faecal transplantation there's a lot of information online but
we also have a website here at University of Birmingham, which you can log in to, and if you have
a relative or a friend who's suffering from severe recurrent disease then maybe
they or their relatives can suggest to the consultants looking after them in
hospital that they might wish to consider faecal transplant. In which case
those professionals can get in touch with the professionals here at the
University of Birmingham prehaps to arrange a transplant. Thank you and goodbye.