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Research group Our research focuses on Clostridioides difficile infections and how fecal microbiota transplantation can be best utilized and how it works to cure the infection.
The goal of the research in my group is to study Clostridioides difficile infection in order to provide better treatments for patients affected by the disease. C. difficile infection, also known as clostridial infection, is one of the most common healthcare-associated infections, affecting several thousand individuals annually in Sweden. The disease arises as a result of a disruption of the gut microbiota, almost always following antibiotic treatment. In this situation, the normal protective barrier against C. difficile is lost, allowing the bacterium to grow and cause colitis through the production of toxins that damage the intestinal lining. Symptoms mainly include severe diarrhea, malaise, abdominal pain, and low-grade fever. The disease causes significant suffering for patients and high costs for healthcare.
The standard treatment for clostridial infection is antibiotics targeted at C. difficile. However, the effect of antibiotics is often insufficient, which means the disease can recur after treatment ends. Administering additional antibiotics for a condition caused by antibiotics can also seem counterintuitive. An alternative treatment that has gained increasing interest is fecal microbiota transplantation from a healthy donor. This treatment is superior to antibiotics in achieving cure and also addresses the underlying problem of a depleted gut microbiota that led to the disease.
The Infectious Diseases Clinic in Umeå has used fecal microbiota transplantation for 25 years to treat clostridial infection when antibiotic therapy has failed. Initially, donors were recruited from the patient’s social network, a process that was often time-consuming and could delay treatment. In 2016, I established a stool bank at the clinic. The first preparations were suitable for administration via colonoscopy or enema. To simplify treatment, capsule formulations were developed in 2020, which is now the primary method used at the clinic. These treatments work well and result in faster recovery for patients with clostridial infection.
Despite fecal microbiota transplantation being the most effective treatment for the disease, there are major knowledge gaps regarding how the therapy works and what biological effects occur in treated patients. Potential side effects are usually mild and transient, and there is no evidence of serious long-term effects.
Our research group conducts studies to evaluate the effectiveness of current treatments for C. difficile infection, to increase understanding of how fecal microbiota transplantation works, and to identify biological changes in treated patients. The research includes both retrospective and prospective studies through the creation of patient cohorts with biological sampling and long-term follow-up. We investigate, among other things, gut microbiota diversity and metabolism, as well as the function of the intestinal barrier during infection and recovery.
