100 Years Later: The Lone German Soldier Whose Poop Fights on

And why we shouldn’t always treat E. coli as the enemy.

This week, we’re going back in time.

Precisely 100 years back in time, as a matter of fact, to bring you the fascinating story of a remarkable strain of bacteria that was first isolated on a World War I battlefield in the Balkans, back in 1917.

At that time, the Romanian and Russian armies were fighting the forces of the Central Powers (Germany, Austria-Hungary, the Ottoman Empire, and Bulgaria) in a Balkan region called Dobrudja, which lies between the lower reaches of the Danube and the Black Sea.

Dobrudja now straddles Romania and Bulgaria.

Much of the fighting was taking place in what sounds like thoroughly unpleasant marshland, heavily contaminated with enteric pathogens: the types of bacteria that can make people very sick, and not exactly a great environment for soldiers whose officers expected them to be fighting fit.

The German army had been particularly affected by intestinal infections, and thus welcomed a visit from a physician and bacteriologist from Freiburg, named Alfred Nissle (later, Professor Nissle) who examined patients in field hospitals, and also collected stool samples from soldiers who had been unaffected by intestinal infections.

A hundred years ago, there were no antibiotics, so Nissle rather liked the idea of using harmless strains of bacteria as a kind of living drug, which could inhibit the growth of bacterial species responsible for intestine-based diseases. Salmonella, for example.

In particular he was interested in E. coli.

Now, E. coli, or Escherichia coli, to give it its full name, is something of a Jekyll and Hyde microorganism.

Some strains of E. coli can make people extremely sick, while others promise great therapeutic potential.

The E. coli species as a whole was first identified in 1885 by another German, Professor Theodor Escherich.

Possibly a modest man, he originally called it Bacterium coli commune, but eight years after his death, others decided it should be renamed Escherichia coli, in honor of the man who discovered it.

Anyway, back to Nissle in 1917, who was busy collecting stool samples from German soldiers in Dobrudja (well, someone had to do it).

He became intrigued by one man in particular, a non-commissioned officer, who had remained stubbornly healthy, while most of the other men in his unit had fallen sick.

Nissle said: “In contrast to the large majority of his comrades, he had suffered neither from dysentery nor from any other intestinal diseases.”

On examining the stool specimen collected from this (sadly unidentified) officer, Nissle found a particular strain of E. coli that appeared to behave in similar ways to what we would now term a probiotic.

Perhaps lacking the modesty of Escherich, he immediately labelled this strain E. coli strain Nissle 1917, since abbreviated to EcN.

In his laboratory, Nissle tested different bacterial strains for their abilities to suppress the growth of typhoid bacteria, and it was EcN that he found most effective in its antagonistic actions.

Clearly certain he was onto something, Nissle grew the strain on agar plates, then packed it into small gelatin capsules, sealed with wax.

Next, knowing full well of course that the bacteria had originated from the bottom of a German soldier, he bravely popped a capsule or two into his mouth and knocked them back with a glass of water. Fortunately there were no ill effects.

These days of course, it can take many years for a drug to progress from discovery to prescription, but there was clearly less red tape a hundred years ago.

That very same year – 1917 – Nissle began manufacturing his capsules under the trade name Mutaflor (meaning flora-changing).

It’s a medication that has stood the test of time.

We know, for example, that Adolf Hitler’s physician, Theodor Morell, prescribed Mutaflor to his patient in 1936 – apparently for flatulence.

Doesn’t it make you think that Robert Harris’s book about Hitler, Fatherland, could just so easily have been called Farterland?

In fact, Mutaflor is still manufactured today, and prized for its probiotic qualities, although it isn’t legally available in the USA.

Studies have suggested that EcN may help with ulcerative colitis and Crohn’s.

Its commercial value is highlighted by its deposit as an industrially-used strain under “patent deposit” rules at the German Collection of Microorganisms and Cell Cultures – which sounds like a fun place for a day trip.

As far as we’ve been able to assert, the Collection’s deposit, as well as the entire output of Mutaflor manufactured since 1917, all started life in a culture grown from that stool sample collected from a single German soldier in the First World War Balkan trenches.

Demonstrating, perhaps, that not all crap business ideas are bad ones.


Further reading

Disruption of Escherichia coli Nissle 1917 K5 Capsule Biosynthesis, through Loss of Distinct kfi genes, Modulates Interaction with Intestinal Epithelial Cells and Impact on Cell Health

Dobruja

Probiotics for Crohn’s & Colitis

Probiotics – In Depth

Romania during World War I

A probiotic E. coli from the trenches of World War

The K5 Capsule of Escherichia coli Strain Nissle 1917 Is Important in Mediating Interactions with Intestinal Epithelial Cells and Chemokine Induction

The non-pathogenic Escherichia coli strain Nissle 1917 – features of a versatile probiotic

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