Fecal Microbiota Transplantation for <i>Clostridium difficile</i> Infection

Drekonja, Dimitri; Reich, Jon; Gezahegn, Selome; Greer, Nancy; Shaukat, Aasma; MacDonald, Roderick; Rutks, Indulis; Wilt, Timothy J

doi:10.7326/m14-2693

Cited by 327 publications

(251 citation statements)

References 50 publications

Supporting

Mentioning

235

Contrasting

Unclassified

Order By: Relevance

“…Numerous authors joint on the imt, drekonia confirms positive results [10] and showed a pair of randomized controls. studying series of 28 and 5 cases, detected a recurrence in 2 patients, it concludes that imt may have a significant effect with a few short-term adverse effects for recurrent CDI.…”

Section: Discussionmentioning

confidence: 83%

“…since them, numerous cases have been described in the world literature, many doctors performed imt successfully, broody [3][4][5][6][7][8] observed that a second or in needed third transplantation is necessary to get good results, just as happened in our patient. Broody not only directed his attention to C. difficile, goes a little further and used imt in irritable bowel syndrome, myoclonusdystonia, ulcerative colitis and chronic fatigue syndrome [9].Numerous authors joint on the imt, drekonia confirms positive results [10] and showed a pair of randomized controls. studying series of 28 and 5 cases, detected a recurrence in 2 patients, it concludes that imt may have a significant effect with a few short-term adverse effects for recurrent CDI.…”

mentioning

confidence: 65%

See 1 more Smart Citation

Pseudomembranous enterocolitis cured with three intestinal microbiota transplantations

Zamudio-Tiburcio¹,

Bermúdez-Ruiz²,

Reyes-López³

et al. 2018

Gastroenterol Hepatol Endosc

View full text Add to dashboard Cite

SummaryWe present a unique case of a 82 years old women, with this newly described condition called "pseudomembranous enterocolitis cured with three transplants of intestinal microbi0ta (imt)." We evaluated the case of gaw, who had a perforates sigmoid diverticulum 10m days ago and had surgery with sigmoid resection, colostomy and hartmann's pouch. Her progress was good. However, she was given metronidazole and vancomycin, antibiotics that caused severe diarrhea and toxic state, a week postoperatively. Histopathological study of surgical specimen showed colonic mucosa extensively ulcerated and granulation tissue, fibrin and abundant neutrophils. Submucosal edema and acute periserositis. The muscular and mucosal layer had not alterations. A diagnosis of pseudomembranous enterocolitis (pm) was made. The patient had a toxic state, semi-conscious, diaphoretic and extensive erythema in the right forearm, with minor erythema at the left forearm and face, as well as perineal erythema, third degree edema in lower limbs, dehydrated and chest x-ray showed interstitial pneumonitis. She had a typical case of pm, and proceeded to perform an intestinal microbiota transplantation (imt) from healthy donors at clinical and laboratory studies. After that imt we performed colonoscopy, which showed at the course of transverse and right colon multiple plaques of whitish, cotton-like appearance, which protuded on the mucosal surface. This appearance were also seen at the left colon. We applied 400 ml. Of imt in the right colon and 100 ml at the hartmann's pouch of rectum. At the colonoscopy we placed a foley's catheter with an inflated balloon 20 ml. Also, solid petroleum jelly was left to prevent imt elimination. We removed all antibiotic treatment and replaced with probiotics, through the nasogastric tube.Three day later the patient had a better general condition, was conscious, with erythema limited to forearms, face and perineum, the lowers limb had no edema and she was better hydrated.The second imt was performed with another 400 ml. Of microbiota in right colon and 100 ml. At the hartmann's pouch. To prevent imt a 20 ml. Inflated balloon colostomy (foley's catheter) sealed with solid petroleum jelly.Three days later, a new imt was required under the same conditions as the former two imt. On this occasion the patient was fully aware, speaking and responded correctly to our questions. She had no erythema in her body, no edema at her legs and her chest x-ray had no pneumonitis, and showed only a small leak at the base of right lung.Further treatment without antibiotics, was with symbiotic by mouth and was under another treating team.We reviewed the literature, and we hope to encourage colleagues to use this procedure, which had similar results in the world. Presentation of the caseGaw, female, 82 years old with a history of sigmoid diverticulum perforation, peritonitis treated with sigmoid resection, colostomy and hartmann's pouch were given the following antibiotics: metronidazole, vancomycin which caused pseudomembranous enteroc...

show abstract

Section: Discussionmentioning

confidence: 83%

mentioning

confidence: 65%

Pseudomembranous enterocolitis cured with three intestinal microbiota transplantations

Zamudio-Tiburcio¹,

Bermúdez-Ruiz²,

Reyes-López³

et al. 2018

Gastroenterol Hepatol Endosc

View full text Add to dashboard Cite

show abstract

“…As the disrupted gut microbiota is a key factor in the pathogenesis of C. difficile infection (CDI), FMT is increasingly used for recurrent or severe CDI. [105][106][107] In a recent systemic review involving 516 patients with recurrent CDI, 108 the overall success rate of FMT was reported as 85% for recurrent CDI and 55% for refractory cases. Although the evidence for such is limited, FMT for CDI seems safe.…”

Section: Fecal Microbiota Transplantationmentioning

confidence: 99%

Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders

Lee

Choi

Ryu

et al. 2017

J Neurogastroenterol Motil

View full text Add to dashboard Cite

Functional bowel disorders (FBDs) are functional gastrointestinal disorders with symptoms attributable to the middle or lower gastrointestinal tract. These include irritable bowel syndrome, functional bloating, functional constipation, functional diarrhea, and unspecified FBD. Increasing evidence has emerged of late that intestinal microbiota is involved in the pathogenesis of FBDs. In this review, the therapeutic benefits and future perspectives of the currently available strategies for modifying the gut microbiota in FBDs are described, focusing primarily on irritable bowel syndrome and functional constipation.

show abstract

“…Still, the relative merits of selecting donors known or unknown to patients, though a subject of much speculation, are largely undefined. [22][23][24] Further research on the relative merits of donor selection and screening is needed.…”

Section: Current Donor Selection and Screening Guidancementioning

confidence: 99%

Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review

et al. 2017

View full text Add to dashboard Cite

Fecal microbiota transplantation is best understood as an effective and inexpensive therapy for recurrent Clostridium difficile infection but fecal donor selection and screening should be periodically revised. Here, we review current recommendations for selection and screening of fecal donors for fecal microbiota transplantation. We recommend considering diabetes mellitus, prior cardiovascular events, and clinical healthcare exposure as fecal donor exclusion criteria until more is known about the association of these conditions with the human gut microbiome. We review the non-bacterial members of the human gut microbiome, associations of the gut microbiome with colorectal malignancies, the human gut resistome and how these may impact future donor screening recommendations. Collaboration between clinicians, clinical laboratory scientists, industry and regulatory agencies will be critically important for continued improvement in donor selection and screening.

show abstract

Fecal Microbiota Transplantation for Clostridium difficile Infection

Abstract: U.S. Department of Veterans Affairs.

Cited by 327 publications

References 50 publications

Pseudomembranous enterocolitis cured with three intestinal microbiota transplantations

Pseudomembranous enterocolitis cured with three intestinal microbiota transplantations

Therapeutic Modulation of Gut Microbiota in Functional Bowel Disorders

Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review

Contact Info

Product

Resources

About