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Is this stool taken?

Tuesday, 15 November 2016

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What leads someone to study something that would cause most of us to recoil in disgust? Professor Tom Riley explains just how he ended up in the poo.

“Ending up in the shit isn’t necessarily a bad thing.”

These are the words Professor Tom Riley uses to describe his research career, in which he has spent a lot of time thinking about, and working with, poo.

Professor Riley was recruited to ECU’s School of Medical and Health Science earlier this year as a Professorial Research Fellow, as part of the university’s drive to develop research activity and impact.

But while today he is a recognised expert in his field, his scatological start came by accident.

“When I was working in a lab in my 20s I had a disagreement with the lab manager about how an experiment should be conducted,” Professor Riley explains.

“It got a little heated and as a bit of a punishment he assigned me to analyse stool samples for a few weeks.”

Little did that lab manager know the punishment would be the beginning of a fruitful research career.

“I had always been interested in anaerobic bacteria, which are bacteria that do not require oxygen to grow. But it was being assigned to work with those stool samples that sparked my interest in the ‘new’ pathogen Clostridium difficile,” Professor Riley says.

“C.diff is a very interesting bacterium. It causes infectious diarrhoea and in some cases can be fatal. 

“It can’t compete with other gut bacteria, but it is resistant to certain types of antibiotics. This means that when patients in a hospital are given a course of these antibiotics that wipe out a lot of the other bacteria, it allows C.diff to propagate and cause problems.”

When C.diff was first identified as a cause of antibiotic-associated diarrhoea in the 1970s it was thought not to be a big problem in Australian hospitals because they did not use much clindamycin, the antibiotic most often linked with C.diff.

However, while working at Sir Charles Gairdner Hospital in the 1980s, Professor Riley helped improve diagnostic methods for detecting C.diff and found that cases were on the rise.

“I then looked into the reasons and showed that a simultaneous increase in the use of certain antibiotics was probably responsible and that this infection was costing the hospital about $1.25 million annually,” he says.

“As a result of this finding, antibiotic policies were changed leading to reduction of C.diff cases.” 

While in the past this bacteria has predominantly infected older hospital patients, Professor Riley says new, virulent strains are now being detected in younger people in the broader community.

“These people are generally quite healthy so they don’t get a severe disease, but the big concern is that these new virulent strains will find their way into hospitals where they could infect and potentially kill more vulnerable people,” he says.

Professor Riley says the best way to avoid a case of C.diff, and the associated bad case of diarrhoea, is to maintain healthy gut bacteria.

“Avoid taking unnecessary antibiotics, because this can clear out your gut flora allowing C.diff to take hold,” he says.

“And if you are taking antibiotics, make sure you wash your hands with soap, because an alcohol‑based disinfectant won’t kill C.diff spores.”

For those who have been infected, one treatment option is a faecal transplant, which works by re‑introducing bacteria from a healthy gut.

And where would be the best place to source faecal matter for a transplant?

Professor Riley’s answer might test even the strongest relationships.

“Generally speaking, the best person to get the poo from is your spouse,” he says.

“Their gut flora is most likely to be similar to yours.”

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