"Allogenic Fecal Microbiota Transplantation in Clostridioides Difficile Infection: A Case Series in Mexico"

Abstract

BackgroundClostridioides difficile has become the major cause of health care-associated diarrhea and a recognized causal agent of pseudomembranous colitis [1,2]. It is a primary infection with major recurrence rate among hospitalized patients; spore renders Clostridioides difficile, highly transmissible and resistant to antimicrobial treatment [1,3,4]. Infection is characterized by toxin production leading to intestinal barrier line up areas of cell necrosis and an intense local and/or systemic inflammatory response ARTICLE INFO ABSTRACTClostridioides difficile is a gram-positive, spore-forming bacterium that produces toxins capable of causing severe infectious diarrhea and pseudomembranous colitis in humans. We reviewed eight cases of antimicrobial therapy-resistant C. difficile infection (CDI) in patients with various pathologies. The diagnosis was confirmed by toxin detection and colonoscopy. Stool for fecal microbiota transplantation (FMT) was prepared from healthy selected donors; all cases received the FMT through retention enema. In most of the patients, CDI symptoms decreased within the first 24h post-FMT. We carried out short-, medium-, and long-term follow-up post-FMT, which showed an 88% of efficacy. Observed efficacy is similar to the current 80-100% reported frequently, whereas the main difference with previous reports lays on the fact that half of our patients showed baseline affectations involving surgery, neurological conditions or immune system deficiency. This study provides examples for establishing solid criteria for the FMT among patients with recurrent CDI and baseline affectations. This is a small case series and results should be considered within limitations; however, it is relevant to add all experiences to build a better knowledge on this clinical tool.

Bacterial and Fungal Gut Dysbiosis and Clostridium difficile in COVID-19

“…FMT is now accepted in the treatment of severe or recurrent CDI, as a therapy to modulate the gut microbiota. 44 Therefore, it is plausible to consider the use of FMT in patients with COVID-19 to restore the gut microbiota and improve GI symptoms, and even for the treatment of CDI. Notwithstanding, FMT is currently limited due to concerns of potential transmission of SARS-CoV-2.…”