Loyola Researchers Make C. Diff Infection Discovery | Loyola Medicine
Tuesday, May 5, 2015

Loyola investigators show that oral spores of harmless C. difficile prevent repeated C. difficile infection

MAYWOOD, Ill. (May 5, 2015)  – In what is a major step towards the prevention of recurring bouts of Clostridium difficile (Cdiff) infection, an international team led by Dale Gerding, MD, Hines Veterans Administration (VA) research physician and professor of Medicine at Loyola University Chicago Stritch School of Medicine, has shown that giving spores of non-toxic Cdiff by mouth is effective in stopping repeated bouts of Cdiff infection which occurs in 25-30 percent of patients who suffer an initial episode of diarrhea or colitis. The study is published in the May 5 issue of the Journal of American Medical Association (JAMA) and is the focus of a JAMA-produced video

“The results of this study are very gratifying because the preclinical laboratory and patient studies were all done through our VA research program supported by the Department of Veterans Affairs Research Service,” says Gerding. “Results of this study confirm findings of earlier studies that showed that if we can establish non-toxic Cdiff as a resident of the gut of the patient, that we can protect the patient from infection by the toxic strains of Cdiff.”  Viropharma and Shire pharmaceutical companies supported the clinical trials. 

These results warrant additional study to confirm that treatment with non-toxic Cdiff spores can reduce recurrent Cdiff infection and prevent a first episode of Cdiff infection in those who are taking any antibiotics and are at high risk of infection, he added.

Gerding and an international team of infectious disease researchers, including those at Loyola University Medical Center (LUMC), randomly assigned 168 adult patients with Cdiff infection who had been treated for their infection with antibiotics to receive doses of 10 thousand or 10 million spores per day of non-toxic Cdiff in liquid form for 7 or 14 days, or to receive an identical placebo. Of those assigned any dose of non-toxic Cdiff , 11 percent experienced a repeat of infection within 42 days compared with 30 percent of those given a placebo, a statistically significant reduction.  For the most favorable dose tested, 10 million spores a day for 7 days, the recurrence of Cdiff infection was reduced to 5 percent.

Hospital-acquired infections (HAI) including Cdiff, which causes severe diarrhea and inflammation of the lower bowel or colon, continues to escalate in frequency and severity in the U.S.  According to the Centers for Disease Control and Prevention (CDC), almost 500,000 Cdiff infections occurred in the U.S. in 2011, with 83,000 recurrences and 29,000 deaths within 30 days of diagnosis. Older adults taking antibiotics and who receive care at medical institutions are most vulnerable. 

Cheryl O’Riordan, who has had repeated bouts of Cdiff infection, said having Cdiff  made her visit the bathroom on an average of 10 times per day.  “Before receiving effective treatment, I was unable to leave the house,” says the active cyclist, skier and hiker. O’Riordan went into remission after being treated successfully at LUMC. “I am back cycling more than 3 miles every day and have several major adventure trips planned.”    

Gerding, who has published more than 135 studies on Cdiff is considered one of the leading international experts on Cdiff. (Watch an interview where Gerding discusses the study.)

Stuart Johnson, MD, infectious disease specialist at LUMC, is also the director of research at Hines VA hospital. Together Gerding and Johnson have partnered on Cdiff research for almost three decades, involving many LUMC patients. 

“The study offers real hope for those debilitated by recurring bouts of Cdiff,” says Johnson, who cares for O’Riordan at LUMC in Maywood. “This study represents a novel and potentially highly effective bacteriotherapy approach to restoring colonization resistance against toxic strains of Cdiff in these patients,” he adds. 

Loyola University Health System is recognized internationally as a leader in infection control and prevention.

LUMC is one of a few select hospitals who invest in universal screening of all inpatients for MRSA. Loyola was one of the first institutions to require all staff  to have mandatory flu shots as a condition of employment. Loyola was one of several academic hospitals that participated in this recent benchmark international study.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.