Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study
Background. Patients with recurrent Clostridium difficile infections (CDIs) constitute an increasing treatment problem. Fecal microbiota transplantation (FMT) has shown promising results of treating recurrent CDI, where treatment with antibiotics fails repeatedly. Our study describes retrospective c...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | International Journal of Microbiology |
| Online Access: | http://dx.doi.org/10.1155/2019/7395127 |
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| _version_ | 1849398929891786752 |
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| author | Alexandra Nowak Magnus Hedenstierna Johan Ursing Christer Lidman Piotr Nowak |
| author_facet | Alexandra Nowak Magnus Hedenstierna Johan Ursing Christer Lidman Piotr Nowak |
| author_sort | Alexandra Nowak |
| collection | DOAJ |
| description | Background. Patients with recurrent Clostridium difficile infections (CDIs) constitute an increasing treatment problem. Fecal microbiota transplantation (FMT) has shown promising results of treating recurrent CDI, where treatment with antibiotics fails repeatedly. Our study describes retrospective cohort treated with FMT at two major hospitals in Stockholm. Methods. Medical records of all patients with recurrent CDI treated with FMT during the period 2013–2017 were reviewed. We evaluated cure of CDI-related diarrhea without relapse 10 weeks after FMT. Results. 47 patients were included. One treatment cured 25 patients (53%), and more than one treatment cured 32 patients (68%). Treatment outcome did not vary significantly with treatment with fresh donor feces or frozen fecal culture, days of use of antibiotics or days of hospitalization prior to CDI, and renal function or time from the first CDI to therapy. Treatment failure was associated with a significantly lower Karnofsky performance status score (70 points vs 90, p=0.02). Conclusion. Fecal instillation, for the treatment of relapsing CDI, is a promising approach, with 68% success rate reported in this study. The success rate of FMT is high, regardless of multiple comorbidities, extended use of antibiotics, or long time hospitalization. Although generally FMT is performed with fresh donor feces, our data show that the usage of frozen fecal culture could be an effective treatment alternative in recurrent CDI. |
| format | Article |
| id | doaj-art-9fa526db3e5f4ca88ac0593de331ba1a |
| institution | Kabale University |
| issn | 1687-918X 1687-9198 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | International Journal of Microbiology |
| spelling | doaj-art-9fa526db3e5f4ca88ac0593de331ba1a2025-08-20T03:38:27ZengWileyInternational Journal of Microbiology1687-918X1687-91982019-01-01201910.1155/2019/73951277395127Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort StudyAlexandra Nowak0Magnus Hedenstierna1Johan Ursing2Christer Lidman3Piotr Nowak4Department of Nephrology, Karolinska University Hospital Huddinge, Huddinge, SwedenDepartment of Infectious Diseases, Danderyds Hospital, Danderyd, SwedenDepartment of Infectious Diseases, Danderyds Hospital, Danderyd, SwedenDepartment of Medicin Huddinge, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Huddinge, SwedenDepartment of Medicin Huddinge, Unit of Infectious Diseases, Karolinska Institutet, Karolinska University Hospital, Huddinge, SwedenBackground. Patients with recurrent Clostridium difficile infections (CDIs) constitute an increasing treatment problem. Fecal microbiota transplantation (FMT) has shown promising results of treating recurrent CDI, where treatment with antibiotics fails repeatedly. Our study describes retrospective cohort treated with FMT at two major hospitals in Stockholm. Methods. Medical records of all patients with recurrent CDI treated with FMT during the period 2013–2017 were reviewed. We evaluated cure of CDI-related diarrhea without relapse 10 weeks after FMT. Results. 47 patients were included. One treatment cured 25 patients (53%), and more than one treatment cured 32 patients (68%). Treatment outcome did not vary significantly with treatment with fresh donor feces or frozen fecal culture, days of use of antibiotics or days of hospitalization prior to CDI, and renal function or time from the first CDI to therapy. Treatment failure was associated with a significantly lower Karnofsky performance status score (70 points vs 90, p=0.02). Conclusion. Fecal instillation, for the treatment of relapsing CDI, is a promising approach, with 68% success rate reported in this study. The success rate of FMT is high, regardless of multiple comorbidities, extended use of antibiotics, or long time hospitalization. Although generally FMT is performed with fresh donor feces, our data show that the usage of frozen fecal culture could be an effective treatment alternative in recurrent CDI.http://dx.doi.org/10.1155/2019/7395127 |
| spellingShingle | Alexandra Nowak Magnus Hedenstierna Johan Ursing Christer Lidman Piotr Nowak Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study International Journal of Microbiology |
| title | Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study |
| title_full | Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study |
| title_fullStr | Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study |
| title_full_unstemmed | Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study |
| title_short | Efficacy of Routine Fecal Microbiota Transplantation for Treatment of Recurrent Clostridium difficile Infection: A Retrospective Cohort Study |
| title_sort | efficacy of routine fecal microbiota transplantation for treatment of recurrent clostridium difficile infection a retrospective cohort study |
| url | http://dx.doi.org/10.1155/2019/7395127 |
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