When the internal ecosystem of the intestine is disrupted,

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image: A ring-tailed lemur at the Duke Lemur Center in North Carolina
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Credit: Photo by David Haring, Duke Lemur Center.

DURHAM, NC – Dr Cathy Williams knew something was wrong. The vet had felt unwell for weeks after her 2014 trip to Madagascar.

At first, she just felt bloated and uncomfortable and was not interested in eating a lot. But eventually, she developed a fever and chills which sent her to the emergency room.

During tests, doctors found that what she had was not just a stomach problem. She suffered from an infection of Clostridium difficile, a germ that causes severe diarrhea and abdominal pain and can quickly become fatal if not treated promptly.

“It was horrible,” Williams said.

The condition is often triggered when antibiotics disrupt the normal balance of bacteria that inhabit the intestine, allowing “bad” bacteria such as It’s hard multiply without control and wreak havoc in the intestines.

To bring her infection under control, Williams asked her doctors if they could try an approach she and other vets have used for decades to treat lemurs with digestive issues in the region. Duke Lemur Center. The procedure, known as a fecal microbiota transplant, involves removing stool from a healthy donor and giving it to the patient to add “good” germs and reset the gut.

At the time, it was considered too experimental for clinical use in human cases like Williams’. She was prescribed the standard treatment and sent home from the hospital, although she does not feel well enough to return to work for another month. But now new search in lemurs confirms what Williams and others have long suspected: that this old, but gross-sounding treatment may help a quirky gut microbiome return to normal.

In a recent study in the journal Animal Microbiome, a research team led by Professor Duke Christine Dréa, former doctoral student Sally Bornbusch and colleagues examined the gut microbiomes of 11 healthy ring-tailed lemurs over a four-month period after receiving a seven-day course of a broad-spectrum antibiotic, amoxicillin.

Lemurs were divided into two experimental groups. One was a waiting group, with continuous follow-up but no further treatment after antibiotics. The other group received a slurry of their own feces, collected before the antibiotic treatment, then mixed with saline solution and injected back into the same animal after the end of their antibiotic treatment.

“It sounds crazy,” Williams said. But she has used a similar procedure since the 1990s to treat diseases of Coquerel’s sifaka lemurs, whose infants have been known to eat their mother’s poop during weaning – presumably to get the germs they’ll need to switch to the solid food.

Drea, Bornbusch, and their team used genetic sequencing techniques to track changes in the gut microbiome of lemurs before, during, and after treatment.

As expected, even a single course of antibiotics caused the number of microbes in their gut to drop compared to controls, briefly erasing the species diversity in the two experimental groups before returning to baseline.

“Antibiotics have had dramatic effects, even in healthy animals,” Drea said.

But in terms of what types of bacteria rebounded and when, the recovery patterns in the two groups were different. Lemurs that received the “poo soup” treatment began to stabilize and regain their pre-antibiotic microbiome in about two weeks. In contrast, the bacterial composition in the waiting group continued to fluctuate and still had not quite returned to normal even after four months of observation.

This kind of therapy is not new. Reports of the use of fecal transplants to treat people with food poisoning or diarrhea date back to the 4th century in China. Evidence of its effectiveness in captivity prompted Bornbusch to advocate freezing stool at the Smithsonian National Zoo, where she is now a postdoctoral fellow.

“If we can store animal feces when they are healthy, it can be a huge benefit down the road,” Bornbusch said. “It can help animals get better, faster. “

And now if one of his lemur patients got sick It’s hard as she did, Williams said, “I would absolutely choose a fecal microbiota transplant.”

“People are put off by this,” Drea said, “But disgust with this approach might actually have delayed a fairly cheap and useful remedy.”

This research was supported by the National Science Foundation (BCS 1749465), the Duke Lemur Center Director’s Fund, and the Duke Microbiome Center.

QUOTE: “Antibiotics and fecal transfaunation differently affect microbiota recovery, associations, and antibiotic resistance in lemur guts”, Sally L. Bornbusch, Rachel L. Harris, Nicholas M. Grebe, Kimberly Roche, Kristin Dimac -Stohl, Christine M. Drea. Animal microbiome, October 1, 2021. DOI: 10.1186 / s42523-021-00126-z.


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