Fecal Microbiota Transplantation for Clostridium difficile Infection: A One-Center Experience

2019 ◽  
Vol 37 (6) ◽  
pp. 467-472 ◽  
Author(s):  
Shaina M. Lynch ◽  
Jinjian Mu ◽  
James J. Grady ◽  
Richard G. Stevens ◽  
Thomas J. Devers
Keyword(s):  
Clostridium Difficile ◽  
Fecal Microbiota Transplantation ◽  
Population Sample ◽  
Complete Recovery ◽  
Fecal Microbiota ◽  
Medical Chart Review ◽  
Antibiotic Associated Diarrhea ◽  
Close Relatives ◽  
Hospital Acquired

Background: Clostridium difficile is a gram-positive, anaerobic, and spore-forming bacillus, which is responsible for the majority of antibiotic-associated diarrhea and colitis. Objective: Determine if fecal microbiota transplantation (FMT) is effective in a population sample from Connecticut. Methods: We report the clinical experience of 92 consecutive patients from one gastroenterology practice in central Connecticut treated by colonoscopy with FMT for infection with Clostridium difficile from 2012 to 2017. The analyses are based on clinical follow-up up to 3 months after the FMT procedure and on medical chart review. Results: Overall, complete recovery occurred in 86% of patients. As previously reported in a limited number of previous studies, community-acquired cases were more common than hospital-acquired cases, and community-acquired cases were more likely to be female. Conclusions: Consistent with some previous reports, we found the following: the source of the donor for FMT did not make a difference in recovery: material from nonrelatives was as effective as from close relatives; and the presence of multiple comorbidities did not make a difference in recovery: patients with 2 or more comorbidities did as well as those with one or none.

scholarly journals Efficacy and Safety of, and Patient Satisfaction with, Colonoscopic-Administered Fecal Microbiota Transplantation in Relapsing and Refractory Community- and Hospital-Acquired Clostridium difficile Infection

2014 ◽  
Vol 28 (8) ◽  
pp. 434-438 ◽  
Author(s):  
Muhammad Ali Khan ◽  
Aijaz Ahmed Sofi ◽  
Usman Ahmad ◽  
Osama Alaradi ◽  
Abdur Rahman Khan ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Clostridium Difficile ◽  
Fecal Microbiota Transplantation ◽  
Bowel Function ◽  
Fecal Microbiota ◽  
Efficacy And Safety ◽  
Cure Rate ◽  
Symptomatic Infection ◽  
Telephone Surveys ◽  
Hospital Acquired

OBJECTIVE: To report the efficacy and safety of, and patient satisfaction with, colonoscopic fecal microbiota transplantation (FMT) for community- and hospital-acquired Clostridium difficile infection (CDI).METHODS: A retrospective medical records review of patients who underwent FMT between July 1, 2012 and August 31, 2013 was conducted. A total of 22 FMTs were performed on 20 patients via colonoscopy. The patients were divided into ‘community-acquired’ and ‘hospital-acquired’ CDI. Telephone surveys were conducted to determine procedure outcome and patient satisfaction. Primary cure rate was defined as resolution of diarrhea without recurrence within three months of FMT, whereas secondary cure rate described patients who experienced resolution of diarrhea and return of normal bowel function after a second course of FMT.RESULTS: Nine patients met the criteria for community-acquired CDI whereas 11 were categorized as hospital-acquired CDI. A female predominance in the community-acquired group (88.89% [eight of nine]) was found (P=0.048). The primary cure rate was 100% (nine of nine) and 81.8% (nine of 11 patients) in community- and hospital-acquired CDI groups, respectively (P=0.189). Two patients in the hospital-acquired group had to undergo a repeat FMT for persistent symptomatic infection; the secondary cure rate was 100%. During the six-month follow-up, all patients were extremely satisfied with the procedure and no complications or adverse events were reported.CONCLUSION: FMT was a highly successful and very acceptable treatment modality for treating both community- and hospital-acquired CDI.

scholarly journals Fecal microbiota transplant by push enteroscopy to treat diarrhea caused by Clostridium difficile

2015 ◽  
Vol 13 (2) ◽  
pp. 338-339 ◽  
Author(s):  
Arnaldo José Ganc ◽  
Ricardo Leite Ganc ◽  
Sílvia Mansur Reimão ◽  
Alberto Frisoli Junior ◽  
Jacyr Pasternak
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Clostridium Difficile ◽  
Pseudomembranous Colitis ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Push Enteroscopy ◽  
Fecal Microbiota Transplant ◽  
Recommended Treatment

ABSTRACT Clostridium difficile is the major etiological agent of pseudomembranous colitis and is found in up to 20% of adult inpatients. The recommended treatment is antibiotic therapy with metronidazole and/or vancomycin. However, the recurrence rate may reach up to 25% and it increases in each episode. The newest alternative to treat diarrhea due to recurrent Clostridium difficile is fecal microbiota transplantation. The procedure was performed in 12 patients, with a 6-month follow-up on 10 of them. Of the ten cases, bacterial recurrence was diagnosed in only one patient, after a course of antibiotic to treat urinary tract infection, without presenting with diarrhea. The particularity of our study, besides being an unprecedented event in South America, is the way to perform the infusion of fecal microbiota by enteroscopy.

scholarly journals Rescue fecal microbiota transplantation for antibiotic-associated diarrhea in critically ill patients

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Min Dai ◽  
Yafei Liu ◽  
Wei Chen ◽  
Heena Buch ◽  
Yi Shan ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Potential Benefit ◽  
Fecal Microbiota Transplantation ◽  
Case Series ◽  
Fecal Microbiota ◽  
Abdominal Symptoms ◽  
Antibiotic Associated Diarrhea

Abstract Background Antibiotic-associated diarrhea (AAD) is a risk factor for exacerbating the outcome of critically ill patients. Dysbiosis induced by the exposure to antibiotics reveals the potential therapeutic role of fecal microbiota transplantation (FMT) in these patients. Herein, we aimed to evaluate the safety and potential benefit of rescue FMT for AAD in critically ill patients. Methods A series of critically ill patients with AAD received rescue FMT from Chinese fmtBank, from September 2015 to February 2019. Adverse events (AEs) and rescue FMT success which focused on the improvement of abdominal symptoms and post-ICU survival rate during a minimum of 12 weeks follow-up were assessed. Results Twenty critically ill patients with AAD underwent rescue FMT, and 18 of them were included for analysis. The mean of Acute Physiology and Chronic Health Evaluation (APACHE) II scores at intensive care unit (ICU) admission was 21.7 ± 8.3 (range 11–37). Thirteen patients received FMT through nasojejunal tube, four through gastroscopy, and one through enema. Patients were treated with four (4.2 ± 2.1, range 2–9) types of antibiotics before and during the onset of AAD. 38.9% (7/18) of patients had FMT-related AEs during follow-up, including increased diarrhea frequency, abdominal pain, increased serum amylase, and fever. Eight deaths unrelated to FMT occurred during follow-up. One hundred percent (2/2) of abdominal pain, 86.7% (13/15) of diarrhea, 69.2% (9/13) of abdominal distention, and 50% (1/2) of hematochezia were improved after FMT. 44.4% (8/18) of patients recovered from abdominal symptoms without recurrence and survived for a minimum of 12 weeks after being discharged from ICU. Conclusion In this case series studying the use of FMT in critically ill patients with AAD, good clinical outcomes without infectious complications were observed. These findings could potentially encourage researchers to set up new clinical trials that will provide more insight into the potential benefit and safety of the procedure in the ICU. Trial registration ClinicalTrials.gov, Number NCT03895593. Registered 29 March 2019 (retrospectively registered).

scholarly journals Fecal Transplantation Treatment of Antibiotic-Induced, Noninfectious Colitis and Long-Term Microbiota Follow-Up

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Reetta Satokari ◽  
Susana Fuentes ◽  
Eero Mattila ◽  
Jonna Jalanka ◽  
Willem M. de Vos ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
High Throughput ◽  
Fecal Microbiota Transplantation ◽  
Rectal Mucosa ◽  
Fecal Microbiota ◽  
Associated Bacteria ◽  
Fecal Transplantation

Fecal microbiota transplantation (FMT) is an effective treatment for recurrentClostridium difficileinfection (CDI) and is considered as a treatment for other gastrointestinal (GI) diseases. We followed up the relief of symptoms and long-term, over-a-year microbiota stabilization in a 46-year-old man, who underwent FMT for antibiotic-induced, non-CDI colitis nine months after being treated for CDI by FMT. Fecal and mucosal microbiota was analyzed before the second FMT and during 14 months after FMT by using a high-throughput phylogenetic microarray. FMT resolved the symptoms and restored normal GI-function. Microbiota analysis revealed increased bacterial diversity in the rectal mucosa and a stable fecal microbiota up to three months after FMT. A number of mucosa-associated bacteria increased after FMT and some of these bacteria remained increased in feces up to 14 months. Notably, the increased bacteria includedBifidobacteriumspp. and various representatives ofClostridiumclusters IV and XIVa, such asClostridium leptum,Oscillospira guillermondii,Sporobacter termitidis,Anaerotruncus colihominis,Ruminococcus callidus,R. bromii,Lachnospira pectinoschiza, andC. colinum, which are presumed to be anti-inflammatory. The presented case suggests a possible role of microbiota in restoring and maintaining normal GI-functionality and improves our knowledge on the etiology of antibiotic-induced, noninfectious colitis.

scholarly journals Fecal microbiota transplantation in recurrent Clostridium difficile infection: the first prospective study of 30 patients in Romania

2018 ◽  
Vol 26 (2) ◽  
pp. 201-210
Author(s):  
Laszlo Mihaela ◽  
Oliviu Pascu ◽  
Daniel-Corneliu Leucuta ◽  
Vasile Andreica
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Fecal Microbiota Transplantation ◽  
Therapy Resistance ◽  
Fecal Microbiota ◽  
Post Transplantation ◽  
Fecal Matter ◽  
Efficient Treatment ◽  
Recurrent Clostridium Difficile Infection

Abstract Introduction: The infection with Clostridium difficile has increased in incidence worldwide and it raises many problems with regard to therapy, resistance to treatment and especially recurrence. Recurrence is frequent in patients treated for Clostridium difficile infection, requiring vancomycin by mouth, with limited alternatives. The literature shows that one of the most efficient treatment methods in Clostridium difficile infection is the transplantation of gut microbiota, also known as fecal microbiota transplantation. Aim: We present our results following FMT performed in patients with recurrent Clostridium difficile infection, and propose a simple and effective protocol for fecal microbiota transplantation. Study design: The study was prospective. The phases of the FMT procedure: assessment of patient eligibility, patient’s consent, identification and screening of donors, discontinuation of antibiotics (vancomycin, metronidazole) 3 days prior to the procedure. Methods: Between 2013 and 2015, FMT was performed in 30 patients with recurrent Clostridium difficile infection, by direct infusion of extensively processed donor fecal matter via colonoscopy. We followed up the patients for 12 months. Results: Immediate post-transplantation outcome in what concerns stool frequency during the follow-up period (7 days) was encouraging in 93.33% of patients. The donors were healthy individuals (53% 1st degree relatives), previously screened for possible infections and infestations. This result was sustained at 6-month and 12-month follow-up. Post-transplantation recurrence occurred in 6.67% (2 patients), which responded well to treatment and did not require a new vancomycin course. Conclusions: Fecal microbiota transplantation via colonoscopy is effective, safe, easy to perform, it yields lasting results and is therefore a good option for recurrent or treatment-resistant Clostridium difficile infection.

998 Long-Term Follow-up Study of Fecal Microbiota Transplantation (FMT) for Severe or Complicated Clostridium difficile Infection (CDI)

2013 ◽  
Vol 144 (5) ◽  
pp. S-185 ◽  
Author(s):  
Olga C. Aroniadis ◽  
Lawrence J. Brandt ◽  
Adam Greenberg ◽  
Thomas J. Borody ◽  
Colleen Kelly ◽  
...  
Keyword(s):  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Follow Up Study ◽  
Long Term Follow Up

scholarly journals Clostridium difficile infection in patients after solid organ transplantations

2020 ◽  
Vol 74 ◽  
pp. 198-204
Author(s):  
Sylwia Dudzicz ◽  
Marcin Adamczak ◽  
Andrzej Więcek
Keyword(s):  
Clostridium Difficile ◽  
General Population ◽  
Immunosuppressive Therapy ◽  
Clostridium Difficile Infection ◽  
Fecal Microbiota Transplantation ◽  
Fecal Microbiota ◽  
Solid Organ ◽  
Proper Treatment ◽  
Efficacy And Safety ◽  
Antibiotic Associated Diarrhea

Clostridium difficile is the most common identified pathogen causing nosocomial and antibiotic-associated diarrhea. The incidence of Clostridium difficile infection (CDI) has increased over the last decades. The occurrence of severe and recurrent CDI is also more often recently observed. Patients after solid organs transplantation are more prone to Clostridium difficile infection that the general population. This is associated mainly with immunosuppressive therapy, more frequent hospitalizations and frequent antibiotic therapy. Due to the growing number of CDI, it is important to correctly diagnose this infection and to implement the proper treatment. The main drugs used to treat CDI are vancomycin and fidaxomicin. In the case of CDI recurrence, fecal microbiota transplantation remains to be considered. The rationale use of antibiotics and avoiding proton pump inhibitors may also prevent CDI. Results of recent observational study suggest that one of the probiotics – Lactobacillus plantarum 299v prevents CDI in patients during immunosuppressive therapy. The efficacy and safety of using probiotics in CDI prophylaxis in this group of patients requires, however, further studies.

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