Allegheny Health to offer stool bank to fight treatment-resistant superbug
Allegheny Health Network is banking on fecal matter as medicine for patients suffering from a sometimes fatal superbug that ravages their digestive systems.
The health system Tuesday announced the formation of a stool bank to help people with recurrent Clostridium difficile, or C. diff, infections. Fecal transplants are on the rise as a form of successful treatment for the infection. The treatments are administered by transferring a solution of stool and saline to a person through a colonoscopy or endoscopy.
“Stool is like gold; you never realize the value of it,” said Dr. Marcia Mitre, a gastroenterologist at AHN. “It may not sound aesthetically pleasing, but it really is lifesaving.”
C. diff causes inflammation in the colon, severe diarrhea and cell death, infecting half a million Americans a year, according to the Centers for Disease Control and Prevention. The number of such infections doubled between 2000 and 2010.
A February 2015 study published in The New England Journal of Medicine linked the fierce bug to 29,000 deaths in one year in the United States. About 15,000 of those deaths were directly attributable to the infection, while the rest had other contributing factors. More than 80 percent of those who died were 65 or older.
AHN contracted with Massachusetts-based OpenBiome, a nonprofit stool bank, to acquire frozen, cultured and screened stool samples that are immediately accessible to patients. The samples are shipped to AHN on dry ice and stored until they're needed.
The transplants help repopulate the gut with healthy intestinal flora and beneficial bacteria to restore digestive harmony, experts said.
AHN is the first in the region to receive prescreened samples from a Food and Drug Administration-approved stool bank, thereby streamlining the fecal transplant process, said Dr. Kofi Clarke, chief of AHN's division of gastroenterology.
“Finding a personal donor involves a large cost because each donor has to be screened,” Clarke said. “Screening can take weeks — and if something disqualifies the donor, you have to start all over.”
UPMC has administered about 17 fecal transplants since 2014 from donors selected by recipients, said Dr. Scott Curry, director of the UPMC Fecal Microbiota Transplant Laboratory.
Mitre said AHN patients can select donors, but the new bank provides more options. Donors must be screened for a variety of diseases and infections, ranging from forms of hepatitis and inflammatory bowel disease to parasites and syphilis.
Donors must undergo blood tests and give a stool sample before approval. The screening process is not covered by insurance and costs around $1,000, Mitre said. AHN has performed fecal transplants for about five years. OpenBiome pays donors on a per-stool basis.
Allegheny General Hospital staff members in the gastroenterology lab are trained in preparing the samples for donations.
AHN is one of 460 medical centers across the country that buys fecal preparations from OpenBiome.
Mitre believes the fecal transplants will evolve to treat other patients with food allergies and intestinal diseases like Crohn's and ulcerative colitis.
“There's a lot of potential here,' she said. “It's going to become more mainstream and more acceptable.”
She recently treated a woman who, at age 89, suffered severely disabling bowel problems from C. diff. A fecal transplant cured her.
“A few months later, she sent me a picture from her 90th birthday, and she was doing great,” Mitre said. “This is so great for so many patients.”
Ben Schmitt is a Tribune-Review staff writer. Reach him at 412-320-7991 or bschmitt@tribweb.com.
