Efficacy of Fecal Microbiota Transplantation for Clostridium difficile Infection in Children

Nicholson, Maribeth R; Mitchell, Paul D.; Alexander, Erin; Ballal, Sonia A.; Bartlett, Mark; Becker, Penny; Davidovics, Zev; Docktor, Michael; Dole, Michael; Felix, Grace; Gisser, Jonathan M.; Hourigan, Suchitra K.; Jensen, M. Kyle; Kaplan, Jess L.; Kelsen, Judith R.; Kennedy, Melissa; Khanna, Sahil; Knackstedt, Elizabeth D.; Leier, McKenzie; Lewis, Jeffery D.; Lodarek, Ashley; Michail, Sonia; Oliva‐Hemker, Maria; Patton, Tiffany; Queliza, Karen; Russell, George H.; Singh, Namita; Solomon, Aliza; Suskind, David L.; Werlin, Steven L.; Kellermayer, Richárd; Kahn, Stacy A.

doi:10.1016/j.cgh.2019.04.037

Cited by 91 publications

(88 citation statements)

References 39 publications

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“…Therefore, it is important to collect real-world evidence for the short- and long-term safety of the procedure. In the USA and Europe, FMT recipient registries have been launched to track efficacy and safety outcomes in adult and paediatric patients after FMT 17 76 77. In addition to infections, the possibility that gut microbiota associated with a disease phenotype (eg, obesity) will be transplanted and the risk for these chronic disorders in recipients must be assessed.…”

Section: Resultsmentioning

confidence: 99%

“…Comment: There is sufficient evidence to support the safety and efficacy of FMT in children with CDI 110 111. CDI presents a growing health concern in young patients who are also more likely to have community-acquired CDI.…”

Section: Resultsmentioning

confidence: 99%

“…Faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent Clostridioides difficile infection (CDI) 1–13. FMT working protocols have undergone considerable advancements in recent years, including the use of frozen faeces,2 capsules6 and the release of guidelines to provide methodological guidance 14–17…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Cammarota

Ianiro

Kelly

et al. 2019

Gut

336

375

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Although faecal microbiota transplantation (FMT) has a well-established role in the treatment of recurrent Clostridioides difficile infection (CDI), its widespread dissemination is limited by several obstacles, including lack of dedicated centres, difficulties with donor recruitment and complexities related to regulation and safety monitoring. Given the considerable burden of CDI on global healthcare systems, FMT should be widely available to most centres.Stool banks may guarantee reliable, timely and equitable access to FMT for patients and a traceable workflow that ensures safety and quality of procedures. In this consensus project, FMT experts from Europe, North America and Australia gathered and released statements on the following issues related to the stool banking: general principles, objectives and organisation of the stool bank; selection and screening of donors; collection, preparation and storage of faeces; services and clients; registries, monitoring of outcomes and ethical issues; and the evolving role of FMT in clinical practice,Consensus on each statement was achieved through a Delphi process and then in a plenary face-to-face meeting. For each key issue, the best available evidence was assessed, with the aim of providing guidance for the development of stool banks in order to promote accessibility to FMT in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

International consensus conference on stool banking for faecal microbiota transplantation in clinical practice

Cammarota

Ianiro

Kelly

et al. 2019

Gut

336

375

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show abstract

“…Our results suggest an intriguing opportunity to test causality by using fecal microbiota transplant (FMT) or defined symbiotic consortia to treat patients with PTLDS. FMT has been successfully used to treat Clostridium difficile infection in patients ( 63 – 65 ). Furthermore, FMT or the administration of symbiotic bacteria has also been shown to be efficacious in treating multiple sclerosis ( 34 ), Parkinson’s disease ( 66 ), Alzheimer’s disease ( 67 ), and rheumatoid arthritis ( 68 ) in animal models of disease.…”

Section: Discussionmentioning

confidence: 99%

A Distinct Microbiome Signature in Posttreatment Lyme Disease Patients

Morrissette

Pitt

González

et al. 2020

mBio

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Lyme disease is the most common vector-borne disease in the United States, with an estimated incidence of 300,000 infections annually. Antibiotic intervention cures Lyme disease in the majority of cases; however, 10 to 20% of patients develop posttreatment Lyme disease syndrome (PTLDS), a debilitating condition characterized by chronic fatigue, pain, and cognitive difficulties. The underlying mechanism responsible for PTLDS symptoms, as well as a reliable diagnostic tool, has remained elusive. We reasoned that the gut microbiome may play an important role in PTLDS given that the symptoms overlap considerably with conditions in which a dysbiotic microbiome has been observed, including mood, cognition, and autoimmune disorders. Analysis of sequencing data from a rigorously curated cohort of patients with PTLDS revealed a gut microbiome signature distinct from that of healthy control subjects, as well as from that of intensive care unit (ICU) patients. Notably, microbiome sequencing data alone were indicative of PTLDS, which presents a potential, novel diagnostic tool for PTLDS. IMPORTANCE Most patients with acute Lyme disease are cured with antibiotic intervention, but 10 to 20% endure debilitating symptoms such as fatigue, neurological complications, and myalgias after treatment, a condition known as posttreatment Lyme disease syndrome (PTLDS). The etiology of PTLDS is not understood, and objective diagnostic tools are lacking. PTLDS symptoms overlap several diseases in which patients exhibit alterations in their microbiome. We found that patients with PTLDS have a distinct microbiome signature, allowing for an accurate classification of over 80% of analyzed cases. The signature is characterized by an increase in Blautia, a decrease in Bacteroides, and other changes. Importantly, this signature supports the validity of PTLDS and is the first potential biological diagnostic tool for the disease.

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“…This is a rapidly evolving field; the offending organism has been renamed Clostridioides difficile and an ever‐greater understanding of the biology of CDAD gained. The promise of the pioneering studies of Cammarota and others has been upheld in well‐conducted studies in adults and children and insights gained on determinants of response . Consensus protocols for the preparation and delivery of donor material and management of the recipient have been developed and less invasive and cumbersome delivery systems evaluated.…”

mentioning

confidence: 99%