Fecal microbiota transplantation in the treatment of Clostridium difficile infection: state of the art and literature review

Abstract

Clostridium difficile infection is a common complication following intestinal dysbiosis caused by abusive antibiotic use. It presents medical importance due to the high rates of recurrence and morbidity. Fecal microbiota transplantation is an effective alternative for the treatment of recurrent and refractory C. difficile infection and consists of introducing the intestinal microbiota from a healthy donor into a patient with this infection. The exact physiological mechanism by which fecal microbiota transplantation alters the intestinal microbiota is not well established, but it is clear that it restores the diversity and structure of the microbiota by promoting increased resistance to colonization by C. difficile. Several routes of transplant administration are being studied and used according to the advantages presented. All forms of application had a high cure rate, and the colonoscopic route was the most used. No relevant complications and adverse events have been documented, and the cost-effectiveness over conventional treatment has proven advantageous. Despite its efficacy, it is not commonly used as initial therapy, and more studies are needed to establish this therapy as the first option in case of refractory and recurrent Clostridium difficileinfection.

Fecal Microbiota Transplantation in Recurrent Clostridium Difficile Infection: Is it Superior to Other Conventional Methods?

“…Other serious complications include toxic megacolon, intestinal perforation and ileus, renal failure, systemic inflammatory response syndrome, septicemia, and death [22]. [24].…”

“…3. Severe C. difficile infection (including fulminant) with no response to standard treatment after two days [ 24 ].…”

Role of Surgery in Clostridium difficile Infection

“…[26][27][28] Fecal transplant could be a consideration before reanastomosis in these patients to help prevent recurrence. [29][30][31]…”

Infecção Por Clostridium Difficile: O Transplante Fecal Como Tratamento Em Casos De Recidiva

“…O Transplante de Microbiota Fecal (TMF) é um tratamento alternativo em casos de diarreia recorrente por C. difficile, tratado previamente com vancomicina. O procedimento ocorre com a introdução de bactérias intestinais de um doador saudável no sistema gastrointestinal, a fim de estabilizar a microbiota do paciente portador de infecção por C. difficile (MESSIAS et al, 2018).…”