Successful Therapy of Clostridium Difficile Infection with Fecal Microbiota Transplantation

Konturek, Peter C.; Dieterich, Walburga; Neurath, Markus F.; Zopf, Y

doi:10.1016/s0016-5085(17)31403-8

Cited by 50 publications

(63 citation statements)

References 22 publications

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“…Van Nood et al observed an increase in gut Bacteroidetes and Clostridium cluster IV and XIVa (Firmicutes), and a reduction in Proteobacteria post-FMT, suggesting the importance of Bacteroidetes and the non-pathogenic Clostridia member in suppressing C. difficile outgrowth [7]. Konturek et al also demonstrated a high curing rate (94%) of CDI after FMT application, presenting an increase in beneficial bacteria including Lactobacillaceae, Ruminococcaceae, Desulfovibrionaceae, Sutturellaceae, and Porhyromonadeacae, along with decrease in aggresive bacteria such as Enterobacteriaceae and Veillonellaceae [115].…”

Section: Restoration Of the Gut Microbiota As Therapeutic For CDImentioning

confidence: 99%

Insights into the Role of Human Gut Microbiota in Clostridioides difficile Infection

Kachrimanidou

Tsintarakis

2020

Microorganisms

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Clostridioides difficile infection (CDI) has emerged as a major health problem worldwide. A major risk factor for disease development is prior antibiotic use, which disrupts the normal gut microbiota by altering its composition and the gut’s metabolic functions, leading to the loss of colonization resistance and subsequent CDI. Data from human studies have shown that the presence of C. difficile, either as a colonizer or as a pathogen, is associated with a decreased level of gut microbiota diversity. The investigation of the gut’s microbial communities, in both healthy subjects and patients with CDI, elucidate the role of microbiota and improve the current biotherapeutics for patients with CDI. Fecal microbiota transplantation has a major role in managing CDI, aiming at re-establishing colonization resistance in the host gastrointestinal tract by replenishing the gut microbiota. New techniques, such as post-genomics, proteomics and metabolomics analyses, can possibly determine in the future the way in which C. difficile eradicates colonization resistance, paving the way for the development of new, more successful treatments and prevention. The aim of the present review is to present recent data concerning the human gut microbiota with a focus on its important role in health and disease.

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Section: Restoration Of the Gut Microbiota As Therapeutic For CDImentioning

confidence: 99%

Insights into the Role of Human Gut Microbiota in Clostridioides difficile Infection

Kachrimanidou

Tsintarakis

2020

Microorganisms

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“…Fecal microbiota transplantation aims to replace pathogenic bacteria, a role usually performed by the use of antibiotics. Restoration of the microbial balance can be realized by over-populating the colon with commensal bacteria using fecal microbiota transferred from a healthy donor [3]. FMT is a procedure in which fecal matter, or stool, is collected from a tested donor, mixed with saline or another solution, strained, and either placed in a bank or directly into a patient, by colonoscopy, endoscopy, nasogastric tube, or enema.…”

Section: Introductionmentioning

confidence: 99%

From Donor to Patient: Collection, Preparation and Cryopreservation of Fecal Samples for Fecal Microbiota Transplantation

Nicco

Paule²,

Konturek

et al. 2020

Diseases

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Fecal Microbiota Transplantation (FMT) is suggested as an efficacious therapeutic strategy for restoring intestinal microbial balance, and thus for treating disease associated with alteration of gut microbiota. FMT consists of the administration of fresh or frozen fecal microorganisms from a healthy donor into the intestinal tract of diseased patients. At this time, in according to healthcare authorities, FMT is mainly used to treat recurrent Clostridium difficile. Despite the existence of a few existing stool banks worldwide and many studies of the FMT, there is no standard method for producing material for FMT, and there are a multitude of factors that can vary between the institutions. The main constraints for the therapeutic uses of FMT are safety concerns and acceptability. Technical and logistical issues arise when establishing such a non-standardized treatment into clinical practice with safety and proper governance. In this context, our manuscript describes a process of donor safety screening for FMT compiling clinical and biological examinations, questionnaires and interviews of donors. The potential risk of transmission of SARS-CoV-2 virus by the use of fecal microbiota for transplantation must be taken urgently into consideration. We discuss a standardized procedure of collection, preparation and cryopreservation of fecal samples through to the administration of material to patients, and explore the risks and limits of this method of FMT. The future success of medicine employing microbiota transplantation will be tightly related to its modulation and manipulation to combat dysbiosis. To achieve this goal, standard and strict methods need to be established before performing any type of FMT.This procedure could be also indicated to treat other diseases associated with alteration of gut microbiota [5].The use of FMT was proposed from the 4th century AD and has been widely studied and documented since 2013, when the U.S. Food and Drug Administration approved FMT for the treatment of recurrent and refractory Clostridium difficile infections. In the 4th century yellow soup, as it was called in China, represented the feces used in patients with severe diarrhea. Accounts of treatment with fresh or fermented fecal suspensions applied in patients with gastrointestinal disorders, including diarrhea, constipation, and abdominal pain were described until the Chinese Ming Dynasty in the 16th century [6,7]. More recently, Eiseman and his colleagues successfully treated patients with FMT for Pseudomembranous colitis, in 1958, the first report in the medical literature [8]. With the increasing numbers of trials and the sharing of results around the world, mixed results have been observed, suggesting that heterogeneity in donor stool may play a role in patient response. Studies hypothesize that the microbiome is associated with a given indication [6][7][8]. Thus, fecal material collections should be informed by the health of the donors but also categorized to associate the donor with a recipient as part of a selection s...

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“…A recent systematic review emphasised that there is not enough consistency in the long‐term follow‐up of adverse events after FMT . In previous studies, the duration of the follow‐up period has ranged from 3 weeks to 8 years . However, the study with the longest follow‐up period only had 12 patients .…”

Section: Introductionmentioning

confidence: 99%

The long‐term effects of faecal microbiota transplantation for gastrointestinal symptoms and general health in patients with recurrent Clostridium difficile infection

Jalanka

Hillamaa

Satokari

et al. 2017

Aliment Pharmacol Ther

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Summary Background Faecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection. In short‐term the treatment has been shown to be safe, however, there are no large, long‐term follow‐up studies looking into the potential adverse effects. Aim To analyse the long‐term effect of FMT treatment in patients with recurrent C. difficile infection and to compare the outcome to antibiotic treated patients. Methods Altogether 84 patients of which 45 received a FMT treatment and 39 served as controls receiving antibiotics for the infection were followed on average for 3.8 years. Their recovery and medical status was evaluated using a retrospective questionnaire, determining their quality of life, gastrointestinal symptoms and new diseases potentially related to the FMT. Results There was no difference in the incidence of severe diseases (inflammatory bowel disease, cancer, autoimmune disease, allergy, neurological diseases) between the patient groups. In addition, weight gain did not differ between treatment groups. The FMT treated patients reported that their bowel habits improved significantly faster, they had less irregular bowel function and less symptoms of upper GI‐tract when compared to the patients treated with antibiotics. Significantly more patients in FMT‐group reported that their mental health improved after the treatment. The willingness to receive FMT treatment for potential new C. difficile infection was significantly higher in both treatment groups compared to other treatment options. Conclusion Our study highlights that FMT is a durable, safe and acceptable treatment option for patients with recurrent C. difficile infection also in long term, and it shows potential benefits over antimicrobial treatment.

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Successful Therapy of Clostridium Difficile Infection with Fecal Microbiota Transplantation

Cited by 50 publications

References 22 publications

Insights into the Role of Human Gut Microbiota in Clostridioides difficile Infection

Insights into the Role of Human Gut Microbiota in Clostridioides difficile Infection

From Donor to Patient: Collection, Preparation and Cryopreservation of Fecal Samples for Fecal Microbiota Transplantation

The long‐term effects of faecal microbiota transplantation for gastrointestinal symptoms and general health in patients with recurrent Clostridium difficile infection

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