Mini-Fecal Microbiota Transplantation for Treatment of Clostridium difficile Proctitis Following Total Colectomy

Orenstein, Robert; King, K L; Patron, Roberto L.; DiBaise, John K.; Etzioni, David A.

doi:10.1093/cid/cix736

Cited by 3 publications

(3 citation statements)

References 11 publications

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“…There was also significant heterogeneity in our cohort as the extent of colectomy and underlying disease leading up to colectomy was variable. There have been other reports of patients who have undergone FMT postcolectomy 15,16 including one with 13 patients. 3 The strength of our study is that it represents one of the largest cohort of patients with a history of colectomy and subsequent FMT and was able to describe outcomes from this procedure in this specific cohort.…”

Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplantation Is Effective for Postcolectomy Recurrent Clostridioides difficile Infection

Cho,

Roque,

Orenstein

et al. 2022

Journal of Gastrointestinal Infections

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Background The outcomes from fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) in patients after complete or partial colectomy are not well-defined. Objectives We sought to report our experience with FMT for rCDI in patients who have undergone colectomy. Methods Descriptive analyses of FMT outcomes from 2014 to 2020 were performed in patients who previously had undergone complete or partial colectomy. Results Twenty-nine patients with prior colectomy for inflammatory bowel disease, malignancy, slow-transit constipation refractory to medical therapy, or fulminant CDI underwent FMT for rCDI. Two patients (6.9%) had rCDI within 8 weeks post-FMT. Seven had CDI beyond 8 weeks (median 10 months) with 71% related to antibiotic exposure post-FMT, suggesting a 69% overall success. Conclusion FMT resolves rCDI in most patients after colectomy with subsequent antibiotic exposure predicting CDI after FMT.

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Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplantation Is Effective for Postcolectomy Recurrent Clostridioides difficile Infection

Cho,

Roque,

Orenstein

et al. 2022

Journal of Gastrointestinal Infections

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“…Microorganisms can survive gastric acid pH and bile in the gastrointestinal tract by adhering to the intestinal mucosa [70]. MTTs can be classified mainly into supplementation using probiotics and/or prebiotics; and fecal microbiota transplantation [71][72][73][74][75]. In this discussion, we summarize the former.…”

Section: Microbiome-targeted Therapy (Mtt)mentioning

confidence: 99%

The effects of microbiome-targeted therapy on cognitive impairment and postoperative cognitive dysfunction—A systematic review

2023

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Background The gut-brain axis involves bidirectional communication between the gut-microbiota and central nervous system. This study aimed to investigate whether probiotics and/or prebiotics, known as Microbiome-targeted Therapies (MTTs), improve cognition and prevent postoperative cognitive dysfunction (POCD). Methods Relevant animal and human studies were identified using a systematic database search (PubMed, EMBASE, Cochrane Library, and Web of Science), focusing on the effects of MTTs on inflammation, perioperative and non-perioperative cognitive impairment. Screening and data extraction were conducted by two independent reviewers. The Risk of bias was assessed using the SYRCLE’s risk of bias tool for animal studies. The revised Cochrane risk of bias tool (RoB 2) was used for human studies. Results A total of 24 articles were selected; 16 of these involved animal studies, and 8 described studies in humans. In these papers, the use of MTTs consistently resulted in decreased inflammation in perioperative and non-perioperative settings. Out of 16 animal studies, 5 studies (2 associated with delirium and 3 studies related to POCD) were conducted in a perioperative setting. MTTs improved perioperative cognitive behavior and reduced inflammation in all 5 animal studies. Eleven animal studies were conducted in a non-perioperative setting. In all of these studies, MTTs showed improvement in learning and memory function. MTTs showed a positive effect on levels of pro-inflammatory cytokines and biomarkers related to cognitive function. Among the 8 human studies, only one study examined the effects of perioperative MTTs on cognitive function. This study showed a reduced incidence of POCD along with improved cognitive function. Of the remaining 7 studies, 6 suggested that MTTs improved behavioral test results and cognition in non-perioperative environments. One study failed to show any significant differences in memory, biomarkers of inflammation, or oxidative factors. Conclusion In the studies we examined, most showed that MTTs decrease inflammation by down-regulating inflammatory cytokines and oxidative stress in both perioperative and non-perioperative settings. In general, MTTs also seem to have a positive effect on cognition through neural, immune, endocrine, and metabolic pathways. However, these effects have not yet resulted in a consensus regarding preventative strategies or treatments. Based on these current research results, MTTs could be a potential new preventative strategy for cognitive impairment after surgery.

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“…Role of FMT in post-colectomy CDI has been an area of ongoing research and some earlier reported studies highlight the potential benefits of FMT such as Orenstein et al in a case report described the successful FMT application for SFCDI remnant proctitis post-TAC with an excluded rectal stump with rectal swabs 9 and Lan et al subjected 13 patients with rCDI post-ileal pouch-anal anastomosis to 22 FMTs and their study showed the effectiveness of FMT in abolition of CDI in these patients. 10…”

mentioning

confidence: 99%

Editorial: Rejuvenating the Microbiome in Recurrent Clostridioides difficile Infection with Fecal Microbiota Transplant

Manrai,

Upreti

2022

Journal of Gastrointestinal Infections

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Mini-Fecal Microbiota Transplantation for Treatment of Clostridium difficile Proctitis Following Total Colectomy

Cited by 3 publications

References 11 publications

Fecal Microbiota Transplantation Is Effective for Postcolectomy Recurrent Clostridioides difficile Infection

Fecal Microbiota Transplantation Is Effective for Postcolectomy Recurrent Clostridioides difficile Infection

The effects of microbiome-targeted therapy on cognitive impairment and postoperative cognitive dysfunction—A systematic review

Editorial: Rejuvenating the Microbiome in Recurrent Clostridioides difficile Infection with Fecal Microbiota Transplant

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