A more cultured approach to fecal transplant?

Mike recently blogged about the increasing interest in fecal transplant for severe and/or refractory Clostridium difficile associated disease (CDAD). The procedure remains very slow to catch on, though. Why? The lack of a controlled trial is certainly one reason, but the other is simply the “ick” factor. The ick factor, and the difficulty in controlling a trial when another person’s stool is the deliverable, is also one reason why controlled trials have been slow to come.

If only one could replicate the stool microbiome using culture techniques, this barrier would exist no longer. However, early studies of the gut microbiome revealed that the majority of species are not cultivatable in the laboratory.

So I found this report from Washington University to be very interesting—these researchers were able to preserve gut microbiome functions in germ-free mice using strict anaerobic culture techniques. If indeed a person’s “readily cultured bacterial community” could exhibit in vivo behavior that mirrors the complete microbiome, then there is the potential for complex microbial communities to be developed and passaged that could replenish the microbiome in patients with CDAD.