Faecal microbiota transplantation in the treatment of Clostridioides difficile infection

Stebel, Roman; Vojtilová, Lenka; Svačinka, Radek; Husa, Petr

doi:10.1016/j.humic.2020.100070

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…Twenty-two studies were excluded (1 study did not assess risk factors of FMT failure, 1 reported risk factors in hazard ratio, and 20 did not report risk factors that underwent multivariate analysis. Eventually, 20 studies met our inclusion criteria and were included in the meta-analysis 4,5,9–17,25–33 Figure 1. shows the PRISMA flow chart that illustrates how the final studies were selected.…”

Section: Resultsmentioning

confidence: 99%

“…Eventually, 20 studies met our inclusion criteria and were included in the meta-analysis. 4,5,[9][10][11][12][13][14][15][16][17][25][26][27][28][29][30][31][32][33] Figure 1 shows the PRISMA flow chart that illustrates how the final studies were selected.…”

Section: Study Selectionmentioning

confidence: 99%

“…The effect estimate and forest plot of each risk factor are shown in Table 2 and Figure 2, respectively. We performed meta-analyses for 5 patient-related factors including advanced age (6 studies 10,15,[26][27][28]31 ), female gender (4 studies 10,16,26,31 ), IBD (3 studies 4,10,31 ), immunosuppressed status (4 studies 9,10,30,31 ), and increased CCI (3 studies 16,27,28 ). Advanced age (OR: 1.03, 95% CI: 1.004-1.051, P = 0.02, I 2 = 36.1%) and IBD (OR: 4.89, 95% CI: 2.21-10.83, P < 0.001, I 2 = 0.00%) were significantly associated with increased risk of FMT failure.…”

Section: Patient-related Risk Factorsmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of Fecal Microbiota Transplant Failure in Clostridioides difficile Infection

Beran¹,

Sharma

Ghazaleh³

et al. 2022

Journal of Clinical Gastroenterology

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Introduction and Aim: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent/refractory Clostridioides difficile infection (CDI) with a 10% to 20% risk of recurrence after a single FMT. In this meta-analysis, we aimed to evaluate the predictors of FMT failure. Methods: A comprehensive search of MEDLINE, Embase, Cochrane, and Web of Science databases through July 2021 was performed. All studies that evaluated risk factors associated with FMT failure in a multivariate model were included. We calculated pooled odds ratios with 95% confidence intervals for risk factors reported in ≥3 studies using a random-effects model. Results: Twenty studies involving 4327 patients (63.6% females) with recurrent/refractory CDI who underwent FMT were included. FMT failed in 705 patients (16.3%) with 2 to 3 months of follow-up in most studies. A total of 12 different risk factors were reported in a multivariate model in ≥3 studies. Meta-analysis showed that advanced age, severe CDI, inflammatory bowel disease, peri-FMT use of non-CDI antibiotics, prior CDI-related hospitalizations, inpatient status, and poor quality of bowel preparation were significant predictors of FMT failure. Charlson Comorbidity Index, female gender, immunosuppressed status, patient-directed donor, and number of CDI recurrences were not associated with FMT failure. Conclusions: Adequate bowel preparation at the time of FMT and optimizing antibiotic stewardship practices in the peri-FMT period can improve the success of FMT. Patients with nonmodifiable risk factors should be counseled about the risk of FMT failure. Our results may help develop a risk stratification model to predict FMT failure in CDI patients.

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Section: Resultsmentioning

confidence: 99%