Fecal Microbiota Transplantation for the Management of<i>Clostridium difficile</i>Infection

Paknikar, Raghavendra; Pekow, Joel

doi:10.1089/sur.2018.221

Cited by 7 publications

(4 citation statements)

References 80 publications

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“…[5] The study has shown that there is a higher recurrence rate of diarrhea within the control group compared to the fresh FMT group (24.6% vs. 11.0%, p = 0.05), which leads to the presumption that, despite the difficulty involved with its fresh FMT is more efficacious in preventing recurrent bouts of diarrhea associated with rCDI. Although frozen FMT has been known to decrease the number and frequency of donor screenings and expenses with application in healthcare settings [16] , the study could not detect a significant clinical difference with frozen FMT compared to its counterparts, including antibiotic treatment (p = 0.79) and capsule forms (p = 0.45). Although the ideal form of FMT remains unknown, one may still argue that both fresh and frozen FMT serve as beneficial alternatives to antimicrobial therapies in the prevention of recurrent bouts of CDI, especially following the initial clinical resolution of CDI with typical mainstays of treatment.…”

Section: Fresh Vs Frozen Fmtmentioning

confidence: 63%

A Narrative Review of the Current Evidence of Fecal Microbiota Transplant as Curative Therapy for Recurrent Clostridioides difficile Infection

Yerramsetty¹,

Pandeya²

2021

MSRJ

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Hypothesis: Compared to the flawed antimicrobial interventions, fecal microbiota transplantation (FMT) is more efficacious and safer in offering a significant clinical resolution of recurrent Clostridioides difficile (rCDI) – the world's leading hospital-acquired infection. Methods: An electronic search using Medscape, PubMed, and Google Scholar databases, limited only to articles published in academic journals with full-text access within the past ten years (2010-2020). Selection criteria consisted of quality research studies with relevant findings from patient follow-up post-FMT, considering both primary and secondary endpoints of the investigations. An evidence table was created to organize and evaluate the notable features of each source. Results: Three RCTs, two retrospective cohort studies, and two systematic reviews and meta-analyses have established that FMT is an effective alternative to standard care in treating rCDI. Multiple infusions of FMT as a monotherapy and rescue treatment demonstrated near-complete clinical resolution in patients with rCDI. Further management of rCDI with the recommended first-line agents (e.g., vancomycin and fidaxomicin) proved counterproductive to FMT in comparative studies. Conclusions: With its unappealing aesthetics and under-researched long-term implications, there is increased reluctance to FMT's regular use. Before declaring the novel procedure as the best form of medical practice, future studies should have a stronger emphasis on vancomycin and fidaxomicin to allow for the effective comparison of FMT to non-FMT treatments. Despite the existing limitations, including insufficient sample sizes, FMT has still shown overwhelming promise as a curative treatment for rCDI.

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Section: Fresh Vs Frozen Fmtmentioning

confidence: 63%

A Narrative Review of the Current Evidence of Fecal Microbiota Transplant as Curative Therapy for Recurrent Clostridioides difficile Infection

Yerramsetty¹,

Pandeya²

2021

MSRJ

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“…There are many different methods to detect the three different targets: C. difficile toxin (EIA, cytotoxin), C. difficile (GDH, cytotoxin culture) and toxin B gene (PCR) [ 8 , 11 ]. In this case, we used several methods to detect the microbial isolate.…”

Section: Discussionmentioning

confidence: 99%

Extraintestinal Clostridioides difficile infection

Zhen

Juan

Yang

et al. 2020

IDCases

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Clostridioides (Clostridium) difficile is the major cause of healthcare antibiotic-associated diarrhoea. However, extra-intestinal manifestations of Clostridioides (Clostridium) difficile infection (CDI) (including bacteremia and tissue infection) are extremely rare. We report a case of extraintestinal CDI after surgery. The isolate of C. difficile was not the PCR ribotype 027. However, this isolate produced toxins A and B. The patient underwent a follow-up examination 30 days after discharge, which showed complete recovery. This case report adds to existing knowledge of CDI.

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“…In recent years, with the deepening understanding of the pathogenesis of CDI in the medical community, great changes have been implemented in the management of CDI. Initially, metronidazole was mainly used as a first-line management[10]. Data before 2000 demonstrated that the proportion of patients receiving metronidazole to achieve a clinical cure was similar to the group of receiving vancomycin.…”

Section: Discussionmentioning

confidence: 99%

Fecal microbiota transplantation as an effective initial therapy for pancreatitis complicated with severe Clostridium difficile infection: A case report

Xiao

et al. 2019

WJCC

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BACKGROUNDModerately severe acute pancreatitis (MSAP) is a critical form of acute pancreatitis that is related with high morbidity and mortality. Severe Clostridium difficile infection (sCDI) is a serious and rare nosocomial diarrheal complication, especially in MSAP patients. Fecal microbiota transplantation (FMT) is a highly effective treatment for refractory and recurrent CDI (rCDI). However, knowledge regarding the initial use of FMT in patients suffering from sCDI is limited.CASE SUMMARYHere, we report an MSAP patient complicated with sCDI who was treated by FMT as a first-line therapy. The patient was a 51-year-old man who suffered from diarrhea in his course of acute pancreatitis. An enzyme immunoassay was performed to detect toxins, and the result was positive for toxin-producing C. difficile and toxin B and negative for C. difficile ribotype 027. The colonoscopy revealed pseudomembranous colitis. Due to these findings, sCDI was our primary consideration. Because the patient provided informed consent for FMT treatment, we initially treated the patient by FMT rather than metronidazole. Diarrhea resolved within 5 d after FMT. The patient remained asymptomatic, and the follow-up colonoscopy performed 40 d after discharge showed a complete recovery. Our case is the first reported in China.CONCLUSIONThis case explores the possibilities of initially using FMT to treat severe CDI. Moreover, FMT may become a critical component of the treatment for severe CDI in MSAP patients.

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Fecal Microbiota Transplantation for the Management ofClostridium difficileInfection

Cited by 7 publications

References 80 publications

A Narrative Review of the Current Evidence of Fecal Microbiota Transplant as Curative Therapy for Recurrent Clostridioides difficile Infection

A Narrative Review of the Current Evidence of Fecal Microbiota Transplant as Curative Therapy for Recurrent Clostridioides difficile Infection

Extraintestinal Clostridioides difficile infection

Fecal microbiota transplantation as an effective initial therapy for pancreatitis complicated with severe Clostridium difficile infection: A case report

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