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24 June, 2022 - 17:12 By Tony Quested

£500k boosts Quadram Institute fight against superbug

A pioneering poo transplant treatment implemented locally by scientists and NHS doctors at the Quadram Institute in Norwich for people with recurrent infections of a superbug is benefiting from a £500k investment in new facilities.

Faecal Microbiota Transplant (FMT) is a National Institute for Clinical Excellence recommended treatment for NHS patients with recurrent Clostridioides difficile infection.

FMT transfers the microbiota from healthy donors into patients who have recurrent C. diff infections. This is done by taking poo or poop from a healthy donor and giving it to the patient via a tube passed into their stomach. The treatment in Norwich has proved effective in more than 90 per cent of patients.

The therapy’s implementation locally at the Quadram Institute (QI) has been led by Prof Arjan Narbad and Dr Ngozi Elumogo, consultant microbiologist at the Norfolk and Norwich University Hospital (NNUH).

Previously, 26 patients were treated at NNUH, using material prepared by Quadram scientists. FMT is believed to be more effective than antibiotic treatment as antibiotics can wipe out many different bacteria, not just the problematic C. diff. 

FMT breaks this cycle by replacing the patient’s microbiome with a healthier one, delivering almost immediate health benefits at a significantly lower cost than a course of antibiotics.

In England there are approximately 15,000 cases of C. diff infection (CDI) a year and ​recent estimates put the rate of recurrence at around 15–35 per cent of all CDI cases. 

Data suggests second and subsequent recurrent CDI (rCDI) is common among those patients who experience a recurrent infection. The cost to the NHS is estimated at £500 million a year.  

The Biotechnology and Biological Sciences Research Council (BBSRC) has awarded a grant of £500,000 to build and equip a new facility at QI that meets Good Manufacturing Practice (GMP) standards. 

The Medicines and Healthcare products Regulatory Agency classes FMT as a medicine which means it needs to be produced in a GMP-standard facility.

Quadram Institute translational microbiome group leader Professor Arjan Narbad said: “This is a significant investment to create a GMP facility for FMT and we are grateful to BBSRC for this investment which will give us and the hospital the facilities we need to progress both a clinical service and further research into FMT.”

Work to develop the new FMT facility on the ground floor of the Quadram Institute will ensure the clinical NHS service can be extended to patients in the East of England beyond NNUH, meets MHRA standards and provides the basis for continued research into the treatment of both rCDI and other microbiome-associated health conditions – including a research clinical study funded by the charity Invest in ME Research for the application of MRT for treatment of myalgic encephalomyelitis (ME).

Professor Simon Carding said: “With the very generous support of Invest in ME Research we look forward to running our RESTORE-ME trial once the construction work and FMT facility have been completed and validated later this year.”

The construction work and validation of the FMT facility at the Quadram Institute is expected to take around nine months at which point an MHRA licence application will be submitted. Work is expected to complete in late 2022.

• PHOTOGRAPH: Dr Ngozi Elumogo and Professor Arjan Narbad. Courtesy – Quadram Institute.

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