Dr Blair Merrick is a Clinical Research Fellow at Guy’s and St Thomas’ NHS Foundation Trust who specialises in infectious diseases and general medicine. He is currently coordinating the FERARO study that is looking at the feasibility of eliminating of antibiotic resistant bacteria from the guts of affected patients using fecal microbiota transplantation (FMT).

Blair has been invited to talk about the work of FMT, specifically FERARO, at this year’s New Scientist Live, taking place at the EXCEL Centre London on 9 October.

We caught up with Blair to find out more…

What is fecal microbiota transplantation (FMT)?

“Fecal Microbiota Transplantation (FMT) is a medical procedure involving the transfer of microbes such as bacteria, viruses and fungi found in feces, from healthy donors to patients. We know it’s a beneficial treatment for patients suffering from the infection C. difficile, which is a bacterial infection that can develop in the large bowel as a result of previous antibiotic use. Patients with this C. difficile often have an abnormal microbiota meaning the condition can cause an infection – receiving FMT can replenish the microbiota and stop this from happening.

Many other conditions are associated with an abnormal microbiota. These include liver disease, inflammatory disorders such as ulcerative colitis, and even neurodegenerative problems such as Parkinson’s disease.”

Can you tell us about the FERARO trial?

“Since 2020, we’ve been conducting the FERARO study here at Guy’s and St Thomas’ to assess the feasibility of giving FMT to patients who are affected by certain types of antibiotic resistant bacteria in their guts. These patients often get recurrent infections caused by these bacteria which are challenging to treat because antibiotic options are limited. There is hope that FMT may be able to eradicate resistant bacteria from the gut and reduce the chances of this happening.”

How did you become involved in the FERARO study?

“I joined the FMT team at Guy’s and St Thomas’ in early 2020. I decided to take time out of my clinical training as a doctor specialising in infectious diseases and general medicine to conduct some research. I’ve been interested in FMT for a few years, as well as antimicrobial resistance, so this opportunity to work on the FERARO trial seemed like the perfect combination.”

What can a volunteer expect as part of any FMT trial?

“For our healthy donors the process of becoming a stool donor is similar regardless of the FMT study or the use of the FMT. Donors are screened for anything that could potentially be transmitted from them to one of our recipients – this process is conducted according to national guidelines and involves a health questionnaire and blood and stool tests. For our recipients, we explain in great what the study entails, as well as providing written information. All volunteers have the option to leave the trial at any time if they decide it’s not for them.

Trial participants are completely essential to everything we do. Without healthy stool donors and FMT recipients, we could not conduct studies and generate evidence to say whether or not something works. We are completely indebted to all of them.”

What will you be doing at New Scientist Live?

“I’ll be discussing work of the FERARO study and FMT generally with one of the New Scientist Live team then answering questions from the audience. I’ll also be showcasing a video we’ve produced with the support of one of our patients, and some of our donors – this will give the audience a real feel for the ‘people’ behind the work we’re doing. I’m delighted to be part of New Scientist Live because it’s a brilliant opportunity to talk to people who might not otherwise know about all things FMT. Being able to talk about the work at an interactive event like this is something I don’t get the chance to do often, so I’m really looking forward to it!”

What are you hoping the audience will take away from your talk?

“Understanding in the field of FMT is rapidly developing, and it is likely that new therapies will be developed that target the microbiota in the coming years. I hope that by coming to my talk, people will learn a bit about the gut microbiota and FMT, how we make it, and how it helps patients, as well as the specific research studies we are involved in. Plus, they’ll also leave with a bit more knowledge about the world of healthcare research!”

And finally, is there anything else you think we might be interested to know?

“I appreciate that talking about feces, or stool or poo can be uncomfortable for some because it has an associated ‘ick’ factor, but the health of gut microbiota is intimately linked with a person’s general health. Unfortunately there isn’t a magic probiotic or food that will suddenly make you healthy (or certainly not one that we know of yet), so to keep your gut microbiota happy, the best thing you can do is eat a balanced diet, exercise regularly and maintain a healthy body weight.”

Most importantly, FMT should not be tried at home, or outside of a heavily regulated medical setting. We always need volunteers, so if you’re interested in getting involved in FMT trials or would just like some more information, then please have a look on our website and you’ll find everything you need there.”

 

Blair will be speaking at New Scientist Live on 9 October at 11.40am. For more information please visit their website.

If you would like to find out more about the FERARO and other FMT trials, please visit here or contact Dr Simon Goldenberg for an informal discussion.

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