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Article: Patient dies after FMT containing drug-resistant bacteria

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Ulcerative Colitis
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Posted 6/14/2019 7:39 AM (GMT -5)
Be careful out there with screenings before getting a FMT:

Patient dies from fecal transplant containing drug-resistant bacteria

One person has died after receiving a fecal transplant containing drug-resistant bacteria, the Food and Drug Administration announced Thursday.

Two patients with weakened immune systems who received FMT from the same donor developed serious infections, the FDA said. One patient died.

The FDA noted that the donor stool had not been tested for the drug-resistant bacteria, called extended-spectrum beta-lactamase (ESBL)-producing E. coli, prior to the transplantation. After the illnesses and death occurred, however, a stored preparation of the donor stool was tested, and found to be positive for the identical strain of bacteria found in the two patients.
https://www.nbcnews.com/health/health-news/patient-dies-fecal-transplant-containing-drug-resistant-bacteria-n1017426
Posted 6/14/2019 9:01 AM (GMT -5)
Ugh, scary.
Posted 6/14/2019 9:50 AM (GMT -5)
Very scary! I'm confused about why the sample wasn't screened for e coli? It seems the FMT was performed in a hospital setting, wouldn't e coli be one of the MAIN things you screen for in donors? Is this a matter of testing falling through the cracks or is this a specific breed of e coli they didn't know to screen for?
Posted 6/14/2019 10:05 AM (GMT -5)
Sounds like the screening done, did not check for multi-drug resistant organisms (MDROs), and the FDA is advising that is done going forward.

Additional Protections for Investigation Use of FMT

-Because of these serious adverse reactions that occurred with investigational FMT, FDA has determined that the following protections are needed for any investigation use of FMT:
-Donor screening with questions that specifically address risk factors for colonization with MDROs, and exclusion of individuals at higher risk of colonization with MDROs.
-MDRO testing of donor stool and exclusion of stool that tests positive for MDRO. FDA scientists have determined the specific MDRO testing and frequency that should be implemented.
Posted 6/14/2019 10:18 AM (GMT -5)
This kind of thing is why FMT will eventually not use raw stool, but rather carefully extracted or engineered artificial stool that has the desired ecosystem of gut bacteria for the condition/patient being treated.

The future is medical grade biotic colonies and not raw fecal matter. There will be a cost fo this material - but there will also be manufacture controls, tracking, quality checking, and a lot-specific system for reporting adverse events.
Posted 6/14/2019 10:59 AM (GMT -5)
That is scary!! It makes me thankful I didn't try it - I was very immune compromised and I have terrible luck. I hope this makes people realize how important it is to do ALL testing prior to FT. These home procedures never seemed very safe to me.
Posted 6/14/2019 3:19 PM (GMT -5)
That is sad sad It definitely deters me from trying fmt.
Posted 6/15/2019 12:24 AM (GMT -5)
I believe the largest provider of stool samples for C. Diff treatment is "open Biome". Their website info lists things the test for, which includes vancomycin-resistant Enteroocus, but apparently not E. Coli.
Posted 6/15/2019 7:42 AM (GMT -5)
That is sad, I was on FMT for 2 years and felt very confident as I was at Macmaster hospital in Canada .
One of the leading hospitals in Canada for research Etc.
Posted 6/19/2019 7:21 AM (GMT -5)

limey said...
That is sad, I was on FMT for 2 years and felt very confident as I was at Macmaster hospital in Canada .
One of the leading hospitals in Canada for research Etc.

Hi limey I just started my FMT at Mac Dr Nurla what doctor were you seeing and what were your results ?
Posted 6/20/2019 6:24 AM (GMT -5)
I've read this article today: https://www.mirror.co.uk/news/world-news/new-poo-donors-wanted-faecal-16545470, and the first thought I've had was that if poo donors are such a 'scarce commodity', there may be less safety involved
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