Effect of Faecal Microbiota Transplantation for Treatment of Clostridium difficile Infection in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Cohort Studies

Chen, Tuo; Zhou, Qun; Zhang, Dan; Jiang, Feng; Wu, Jing; Zhou, Jin‐Yong; Zheng, Xiaoya; Chen, Yugen

doi:10.1093/ecco-jcc/jjy031

Cited by 55 publications

(42 citation statements)

References 45 publications

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“…CDI is more prevalent in patients with IBD123 and is associated with disease recurrence, more severe disease course, longer duration of hospitalisation and higher rates of colectomy and mortality 123 124. Although FMT effectively treats CDI in patients with IBD, efficacy may be lower than in patients without IBD, and independent of immunosuppressive therapy 125 126. FMT was strongly recommended in recurrent CDI complicating IBD and repeated FMT may be necessary 125 127.…”

Section: Resultsmentioning

confidence: 99%

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Haifer

Kelly

Paramsothy

et al. 2020

Gut

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ObjectiveFaecal microbiota transplantation (FMT) has proved to be an extremely effective treatment for recurrent Clostridioides difficile infection, and there is interest in its potential application in other gastrointestinal and systemic diseases. However, the recent death and episode of septicaemia following FMT highlights the need for further appraisal and guidelines on donor evaluation, production standards, treatment facilities and acceptable clinical indications.DesignFor these consensus statements, a 24-member multidisciplinary working group voted online and then convened in-person, using a modified Delphi approach to formulate and refine a series of recommendations based on best evidence and expert opinion. Invitations to participate were directed to Australian experts, with an international delegate assisting the development. The following issues regarding the use of FMT in clinical practice were addressed: donor selection and screening, clinical indications, requirements of FMT centres and future directions. Evidence was rated using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system.ResultsConsensus was reached on 27 statements to provide guidance on best practice in FMT. These include: (1) minimum standards for donor screening with recommended clinical selection criteria, blood and stool testing; (2) accepted routes of administration; (3) clinical indications; (4) minimum standards for FMT production and requirements for treatment facilities acknowledging distinction between single-site centres (eg, hospital-based) and stool banks; and (5) recommendations on future research and product development.ConclusionsThese FMT consensus statements provide comprehensive recommendations around the production and use of FMT in clinical practice with relevance to clinicians, researchers and policy makers.

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Section: Resultsmentioning

confidence: 99%

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Haifer

Kelly

Paramsothy

et al. 2020

Gut

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“…In relation to treating rCDI with FMT in IBD patients, a meta-analysis showed that FMT is equally effective for treating rCDI in patients with IBD (initial cure rate of 81%) when compared with those without IBD (55). FMT was equally efficacious in treating rCDI for CD and UC patients.…”

Section: Inflammatory Bowel Diseasementioning

confidence: 99%

Clinical Application and Potential of Fecal Microbiota Transplantation

et al. 2019

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Fecal microbiota transplantation (FMT) is a well-established treatment for recurrent Clostridioides difficile infection. FMT has become a more readily available and useful new treatment option as a result of stool banks. The current state of knowledge indicates that dysbiosis of the gut microbiota is implicated in several disorders in addition to C. difficile infection. Randomized controlled studies have shown FMT to be somewhat effective in treating ulcerative colitis, irritable bowel syndrome, and hepatic encephalopathy. In addition, FMT has been beneficial in treating several other conditions, such as the eradication of multidrug-resistant organisms and graft-versus-host disease. We expect that FMT will soon be implemented as a treatment strategy for several new indications, although further studies are needed.

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“…Faecal microbiota transplantation has also been adopted in human and mouse models [ 479 ] and has been shown to be effective in dealing with Clostridium difficile infect in IBD [ 480 , 481 , 482 ].…”

Section: Aberrant Mucin Glycosylation and Disease In The Gastroinmentioning

confidence: 99%

The Interaction of the Gut Microbiota with the Mucus Barrier in Health and Disease in Human

Corfield

2018

Microorganisms

101

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Glycoproteins are major players in the mucus protective barrier in the gastrointestinal and other mucosal surfaces. In particular the mucus glycoproteins, or mucins, are responsible for the protective gel barrier. They are characterized by their high carbohydrate content, present in their variable number, tandem repeat domains. Throughout evolution the mucins have been maintained as integral components of the mucosal barrier, emphasizing their essential biological status. The glycosylation of the mucins is achieved through a series of biosynthetic pathways processes, which generate the wide range of glycans found in these molecules. Thus mucins are decorated with molecules having information in the form of a glycocode. The enteric microbiota interacts with the mucosal mucus barrier in a variety of ways in order to fulfill its many normal processes. How bacteria read the glycocode and link to normal and pathological processes is outlined in the review.

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Effect of Faecal Microbiota Transplantation for Treatment of Clostridium difficile Infection in Patients With Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis of Cohort Studies

Abstract: FMT is an effective therapy for CDI in patients with IBD. Well-designed randomised controlled trials and well-conducted microbiological studies are needed to validate its efficacy and safety.

Cited by 55 publications

References 45 publications

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Australian consensus statements for the regulation, production and use of faecal microbiota transplantation in clinical practice

Clinical Application and Potential of Fecal Microbiota Transplantation

The Interaction of the Gut Microbiota with the Mucus Barrier in Health and Disease in Human

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