History of fecal transplantation; camel feces contains limited amounts of Bacillus subtilis spores and likely has no traditional role in the treatment of dysentery

Abstract

Introduction: A widely cited story on the origins of fecal transplantation suggests that German soldiers in North Africa used camel feces containing Bacillus subtilis to treat dysentery in World War 2. We investigated if this story is accurate and if there is sufficient Bacillus subtilis in camel feces to be potentially therapeutic.

Methods and results: A literature analysis shows that all references to the story are based on a single review paper that mentions the use of camel feces in passing and only provides indirect evidence for this claim. An extensive literature search failed to find independent evidence that camel feces has traditionally been used in the treatment of dysentery in North Africa. With 16S sequence analysis we did not detect Bacillus subtilis in feces from two different Egyptian camels. Using a more sensitive culture-based assay we could detect low amounts of Bacillus subtilis spores in these fecal samples, with comparable concentrations to those present in human feces and soil.

Conclusions: Because we could not find evidence for the use of camel feces in the treatment of diarrhea and because we show that only low amounts of Bacillus subtilis spores are present in camel feces, we conclude that the use of camel feces should no longer be mentioned in the context of origins of fecal transplantation.

Fig 1. Relative abundances on family level per dromedary, determined by 16S sequencing.

Only family names of the 400 most abundant amplicon sequence variants are shown, less abundant families are group under ‘Other’. The relative abundance of the Bacillus family is 0.08 and 0.16, for dromedary 1 and 2 respectively.

Fig 2. Identification of colonies growing from ethanol resistant bacterial spores by MALDI-TOF.

The combined results of two different fecal samples are presented.