Successful Fecal Microbiota Transplant Delivered by Foley Catheter Through a Loop Ileostomy in a Patient With Severe Complicated Clostridioides difficile Infection

Abstract

Clostridioides difficile infection (CDI) is a potentially life-threatening cause of diarrhea that can result in multiple complications. Fulminant CDI that is nonresponsive to antibiotics may require surgical ileostomy or fecal microbiota transplant (FMT). We present a case of a patient with fulminant CDI requiring surgical loop ileostomy who underwent a successful FMT delivered by Foley catheter through the ileostomy with symptom resolution. Delivery of FMT using a foley catheter in a patient with an ileostomy may be safe and effective for patients who are at a higher risk of complications associated with the instillation of FMT through colonoscopy with anesthesia.

Colonic Transendoscopic Enteral Tubing Is a New Pathway to Microbial Therapy, Colonic Drainage, and Host–Microbiota Interaction Research

“…The patient underwent rescue FMT, which was safely delivered by a Foley catheter through the ileostomy. The case highlighted the positive contribution of the Foley catheter in multiple FMTs, avoiding re-operation and unnecessary colonoscopy [30]. The role of the Foley catheter in this case was similar to colonic TET; however, it is not as stable as colonic TET because it is not fixed to the intestinal wall.…”

Understanding and treating diabetic foot ulcers: Insights into the role of cutaneous microbiota and innovative therapies

“…However, in chronic wounds this equilibrium is disrupted because of the underlying systemic disease of the patient, making it difficult to treat with commensal probiotics alone. Studies have shown the importance of maintaining healthy homoeostasis at sites of infection via microbiome transplantation, with the primary focus being on faecal transplantation for the treatment of Clostridium difficile infections and for surgical operations such as colostomy and ileostomy 116–120 . However, microbiota transplantation remains an underdeveloped area of research for the treatment of chronic wounds.…”

“…Studies have shown the importance of maintaining healthy homoeostasis at sites of infection via microbiome transplantation, with the primary focus being on faecal transplantation for the treatment of Clostridium difficile infections and for surgical operations such as colostomy and ileostomy. 116 , 117 , 118 , 119 , 120 However, microbiota transplantation remains an underdeveloped area of research for the treatment of chronic wounds. It is generally accepted that a diverse microbiome is considered the "right recipe".…”