OpenBiome collects stool for medical treatment

Several members of the local community are helping hospitals treat patients with severe infections simply by pooping, thanks to local nonprofit organization OpenBiome.

According to OpenBiome Operations Manager Laura Burns (E '14), the organization collects stool samples from donors and ships it to hospitals around the country to treat patients through Fecal Microbiata Transplantation (FMT). FMT is used to treat Clostridium difficile (c. diff), an intestinal infection common to patients who have spent time in hospitals.

The difficulty in getting access to FMT prompted Mark Smith, a postdoctoral associate at MIT, to found the organization, Burns explained.

"It's a particularly awful bacteria because it can form spores, so this dormant form of the bacteria can live on surfaces for a very long period of time, and it's very common for people to get infected -- it's the most common hospital-acquired infection," she said.

Burns explained that one of Smith's friends had contracted c. diff and almost had to leave his job due to the severity of his illness.

"He had heard about fecal transplants but couldn't get access to one, so he actually ended up doing an at-home fecal transplant, and it worked," she said. "When Mark, one of our founders heard about this, he said 'that's absolutely ridiculous, no one should have to do this,' so he formed OpenBiome."

As the nation's first stool bank, OpenBiome recruits healthy people to serve as stool donors, Burns said of the the organization's process.

"We find healthy universal donors, we make sure that we screen them to make sure they are supremely healthy people, and then we process their stool, freeze it, and then it is available at all times for anyone throughout the country," she said.

One senior named Dave*, who's last name was kept anonymous due to the nature of stool donations, found out about OpenBiome through his friend and has been a donor for several months. He explained that the application process is long, as the organization wants to ensure its donors are particularly healthy.

"They'll send along a questionnaire about medical history, and then you can go on down to their facility at 196 Boston Ave. and talk it over with the doctor there," he said. "If it looks good on the questionnaire, you proceed with a stool sample ... They'll put that through testing, and if everything looks good then you'll get a blood test. If everything there looks good you can then begin donating."

According to Burns, about 30 percent of people will pass the questionnaire, and then about 50 percent of those people will pass the stool sample. While much of the screening criteria is kept secret to encourage honesty, Burns highlighted some of the major factors that exclude people from providing fecal donations.

"If you've traveled outside the United States or Europe in the past year or so, that's an exclusion," she said. "Antibiotics are a big one because they wipe out all of the healthy bacteria in your gut, and it takes a while to rebuild that immunity. If you've taken antibiotics in the last three months, that's an exclusion. You have to be pretty damn healthy, and sneaky things will pop up in the stool screen. We've excluded quite a few people in the stool screen for rotavirus."

Dave explained that he typically goes to the OpenBiome lab four times per week. He receives $40 per stool sample, and said the donation process is fairly simple.

"The people who work there -- the people you hand off your stool to -- are very professional," he said. "They're always willing to help and get you any information you need. It's a really low stress, low maintenance way to make money and help people out."

OpenBiome has rapidly expanded its operation, according to Burns, who said the staff of 12 people is twice what it was during the summer. She explained that they currently have 14 active donors but have historically had 25. The organization hopes to expand to 40 donors, and it is processing as many applicants as time and space permit.

"In the beginning we had a tough time recruiting donors ... and I think some of that was just the response to poop in general," she said. "We formed a stool donor registry ... Currently we have 6,000 responses to our stool donor registry, which is wild. So it's definitely a little tougher to become a donor now because we have so many responses to weed through."

Overall, Burns said the organization has provided 2,000 FMT treatments to 200 hospitals. While the Food and Drug Administration only allows patients suffering from c. diff to use FMT after the bacterial infection comes back for a third time, OpenBiome is working with partners to expand fecal transplant research in order to see if FMT could be used to treat other infections.

"Our donors are also helping a whole bunch of patients down the road," Burns said. "MIT is still very much doing research and we're closely tied with them. We're working on clinical trials with hospitals throughout the country."

 

*The last name of the donor has been withheld due to safety concerns and to prevent patients from reaching out directly to him.