Fecal Transplant: Early History of FMT

Infection with antibiotic-resistant microbes, often referred as "super-bugs," in hospitals can be a common problem. A conventional solution to the problem is to find a new antibiotic. This solution simply accelerates an arms race between microbes and pharmaceutical companies which try to develop an effective antibiotic. We should search for a completely new approach to the problem. This book might suggest an alternative approach for the superbug problem. It describes the tragic experience of a student nurse, Betty, who performed the world's first fecal transplant. It is not well known to the general public, but there are some diseases that infect mostly patients in hospitals. These diseases are often referred to as post-operative complications or a new infection, due to patients' weakened immune system. Pseudo membranous colitis (PM colitis) was one of such diseases, which predominantly affects patients after surgery of the digestive system. It had a high fatality rate, but there was no known effective treatment. An odd circumstance pushed Betty to perform the world's first fecal transplant and demonstrate its effectiveness. However, because of the stigma attached to feces, fellow medical staff ridiculed her to such a degree that she could not remain as a staff nurse. Later academic researchers identified the pathogen of PM colitis as Clostridium difficile (C. diff), and renamed the disease C-diff infection. Again although fecal transplant was an effective treatment for the disease, the mainstream establishment of the medical community ignored the treatment. When C. diff evolved an antibiotic-resistant strain, hundred-thousands of patients died in hospitals every year around the world. In the United States, bureaucratic hurdles prevented research of fecal transplant, despite such a high mortality rate. Eventually, the news of effectiveness of fecal transplant spread on the Internet and many patients started doing by themselves with help of friends and relatives because medical doctors were unwilling to perform such illegal treatment. In 2013, after more than fifty years from Betty's action, FDA finally and reluctantly allowed doctors to perform fecal transplant for limited cases of C-diff infection. FDA also renamed the procedure FMT (Fecal Microbiota Transplantation.) Meanwhile Betty suffered personal tragedy, but she finally retired and enjoyed her peaceful life knowing that the mainstream of the medical community accepted fecal transplant, even for limited cases. This book also comments on the FDA and NIH's role in new drug development, especially concerned about Ebola epidemic.