Elisabeth Norin Project

Elisabeth Norin & Tore Midtvedt work with an anaerobic cultivated human intestinal microbiota (Achim) and they have succeeded in re-cultivating – under strict conditions - ex vivo for more than 20 years - a diverse ecosystem of human intestinal microbiota from a single healthy donor.

Anaerobic cultivated human intestinal microbiota (Achim)

In patients with recurrent Clostridium difficile infection (RCDI) this ecosystem is an excellent treatment option to reestablish a functional microbiota.

The study is still ongoing at the General Hospital in Gävle and in Oslo, where patients, after several treatment periods with different antimicrobials, were randomly admitted to one of the two arms ”ACHIM TRANSPLANTATION” or ”VANCOMYCIN TREATMENT”.

Most of the patients with RCDI so far included and thus treated have recovered.

Project members

Elisabeth Norin, Associate Professor

Tore Midtvedt, Professor emeritus

Peter Benno, PhD, MD

Bo Tjellström, PhD, MD


A published book: "Gastrointestinal Microbiology"
Editors; Arthur C. Ouwehand Health and Nutrition, Danisco Finland, Finland, Elaine E. Vaughan Wageningen University, Vlaardingen, Netherlands.

Elisabeth Norin & Tore Midtvedt have written a chapter; "Born germ-free - microbial dependent"

Read the introduction


Frederik E. Juul, Kjetil Garborg, Michael Bretthauer, Hilde Skudal, Mari N. Øines, Håvard Wiig, Øystein Rose, Birgitte Seip, J. Thomas Lamont, Tore Midtvedt, Jørgen Valeur, Mette Kalager, Øyvind Holme, Lise Helsingen, Magnus Løberg, Hans-Olov Adami. Fecal Microbiota Transplantation for Primary Clostridium difficile Infection.
The New England Journal of Medicine June2018. DOI: 10.1056/NEJMc1803103

From IBS to DBS: The Dysbiotic Bowel Syndrome.
Benno P, Dahlgren AL, Befrits R, Norin E, Hellström PM, Midtvedt T
J Investig Med High Impact Case Rep ;4(2):2324709616648458

A Role for Bacteria in Celiac Disease?
Tjellström B, Högberg L, Stenhammar L, Magnusson KE, Midtvedt T, Norin E, et al
Dig. Dis. Sci. 2016 07;61(7):2140-1

[Underlying dysbiosis may be the cause of some forms of IBS. Patients were free of symptoms after the administration of microbiota].
Benno P, Befrits R, Berstad A, Dahlgren AL, Norin E, Midtvedt T
Lakartidningen 2015 Jun;112():

Experience with cultivated microbiota transplant: ongoing treatment of Clostridium difficile patients in Sweden.
Norin E
Microb. Ecol. Health Dis. 2015 ;26():27638

Is irritable bowel syndrome a dysbiotic bowel syndrome?
Benno P, Befrits R, Norin E, Berstad A, Dahlgren AL, Midtvedt T, et al
Microb. Ecol. Health Dis. 2015 ;26():27637

Exclusive Enteral Nutrition Does Not Normalize Gut Microflora Function in Pediatric Perianal Crohn Disease.
Tjellström B, Stenhammar L, Magnusson KE, Midtvedt T, Norin E, Sundqvist T, et al
J. Pediatr. Gastroenterol. Nutr. 2015 Jul;61(1):e4

The effects of oats on the function of gut microflora in children with coeliac disease.
Tjellström B, Stenhammar L, Sundqvist T, Fälth-Magnusson K, Hollén E, Magnusson KE, et al
Aliment. Pharmacol. Ther. 2014 May;39(10):1156-60

Response to Surawicz et al.
Midtvedt T, Norin E, Benno P, Dahlgren AL
Am. J. Gastroenterol. 2013 Dec;108(12):1931-2

Faecal short-chain fatty acid pattern in childhood coeliac disease is normalised after more than one year's gluten-free diet.
Tjellström B, Högberg L, Stenhammar L, Fälth-Magnusson K, Magnusson KE, Norin E, et al
Microb. Ecol. Health Dis. 2013 ;24():

Increase of faecal tryptic activity relates to changes in the intestinal microbiome: analysis of Crohn's disease with a multidisciplinary platform.
Midtvedt T, Zabarovsky E, Norin E, Bark J, Gizatullin R, Kashuba V, et al
PLoS ONE 2013 ;8(6):e66074

Effect of exclusive enteral nutrition on gut microflora function in children with Crohn's disease.
Tjellström B, Högberg L, Stenhammar L, Magnusson KE, Midtvedt T, Norin E, et al
Scand. J. Gastroenterol. 2012 Dec;47(12):1454-9

Fecal transplant against relapsing Clostridium difficile-associated diarrhea in 32 patients.
Jorup-Rönström C, Håkanson A, Sandell S, Edvinsson O, Midtvedt T, Persson AK, et al
Scand. J. Gastroenterol. 2012 May;47(5):548-52

Major alterations in metabolic activity of intestinal microflora in Crohn's disease.
Benno P, Bark J, Collinder E, Hellström PM, Midtvedt T, Norin E
Scand. J. Gastroenterol. 2012 Feb;47(2):251-2

Determinants of the human infant intestinal microbiota after the introduction of first complementary foods in infant samples from five European centres.
Fallani M, Amarri S, Uusijarvi A, Adam R, Khanna S, Aguilera M, et al
Microbiology (Reading, Engl.) 2011 May;157(Pt 5):1385-1392

Assessment of microbial fermentation products in fecal samples.
Valeur J, Norin E, Midtvedt T, Berstad A
Neurogastroenterol. Motil. 2010 Oct;22(10):1147

Screening-detected and symptomatic untreated celiac children show similar gut microflora-associated characteristics.
Tjellström B, Stenhammar L, Högberg L, Fälth-Magnusson K, Magnusson KE, Midtvedt T, et al
Scand. J. Gastroenterol. 2010 Sep;45(9):1059-62

Intestinal microbiota of 6-week-old infants across Europe: geographic influence beyond delivery mode, breast-feeding, and antibiotics.
Fallani M, Young D, Scott J, Norin E, Amarri S, Adam R, et al
J. Pediatr. Gastroenterol. Nutr. 2010 Jul;51(1):77-84

Sara Lidman