Sa1844 - Factors Predicting Relapse of Clostridium Difficle Colitis Following Fecal Microbiota Transplantation (FMT)

Tiwari, Abhinav; Sharma, Himani; Qamar, Khola; Alastal, Yaseen; Abdelfattah, Thaer; Ammari, Zaid; Simo, Hermann; Khan, Mohammad Firoz; Nawras, Ali

doi:10.1016/s0016-5085(18)31667-6

Cited by 3 publications

(5 citation statements)

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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 4, respectively. We performed meta-analyses for 4 treatment-related factors including patient-directed donor (3 studies 14,26,29 ), inpatient status (7 studies 5,9,[11][12][13][14]30 ), poor quality of bowel preparation (3 studies), and peri-FMT use of non-CDI antibiotics (5 studies 12,14,16,25,31 ). Inpatient status (OR: 4.77, 95% CI: 3.02-7.53, P < 0.001, I 2 = 38.2%), poor quality of bowel preparation (OR: 3.1, 95% CI: 1.3-7.5, P = 0.01, I 2 = 46%), and peri-FMT use of non-CDI antibiotics (OR: 2.66, 95% CI: 1.22-5.79, P = 0.01, I 2 = 73.1%) were significantly associated with increased risk of FMT failure, whereas patient-directed donor was not.…”

Section: Treatment-related Risk Factorsmentioning

confidence: 99%

“…Various predictors have been associated with a greater risk of FMT failure in patients with CDI, including the severity of CDI, advanced age, female gender, inpatient status, CDI-related hospitalizations, and underlying inflammatory bowel disease (IBD) 5,9,10. Inpatient status is an obvious risk factor that predicts FMT failure in previous studies 5,9,11–13. However, many of these risk factors remain inconsistent.…”

mentioning

confidence: 99%

“…5,9,10 Inpatient status is an obvious risk factor that predicts FMT failure in previous studies. 5,9,[11][12][13] However, many of these risk factors remain inconsistent. Although several studies found that severe CDI is associated with a higher risk of FMT failure, 11,14 some studies found no significant association.…”

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confidence: 99%

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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%