Treatment of Recurrent Clostridium difficile Infection With Fecal Transplantation

Abstract

Clostridium difficile infection is an increasingly common clinical challenge in hospitals and healthcare facilities. The infection often results in severe complications for the infected individual including relentless diarrhea, abdominal pain, dehydration, and mortality. Currently, there is a significant gap between research and practice in the management of recurrent Clostridium difficile infection, and treatment guidelines are limited. Numerous attempts at treating this infection have been made including the practice of fecal transplantation. A comprehensive literature search was conducted and 6 studies were reviewed to evaluate the safety and effectiveness of fecal transplantation as a modality in treating recurrent Clostridium difficile infection refractory to other treatment methodologies. The implementation of fecal transplantation is suggested to restore normal bowel flora in individuals with Clostridium difficile and rid patients of the infection. Additional studies have since revealed perceived barriers toward the implementation of this treatment modality, although it has shown promising results with success rates of 83%-100%. Further efficacy testing validation is needed in larger, prospective controlled trials to guide healthcare providers in the direction of a reliable, standardized treatment protocol for recurrent Clostridium difficile infection.

Changes of the intestinal microbiome—host homeostasis in HIV-infected individuals — a focus on the bacterial gut microbiome

“…Fecal transplantation should also be taken into account as a possible adjunct therapy in the future. This approach has already been successfully applied in treating recurrent and refractory Clostridium difficile infections, for instance, and could therefore be used to modify gut microbiome composition towards a beneficial (i.e., health-promoting) direction and to treat infectious diarrhea in the late stages of HIV infection [ 41 , 42 ].…”

Gut Microbial Metabolites Associated With HIV Infection

“…Deeper insights gained from integrated multiomics studies would presumably open the door to novel therapeutic approaches including probiotics, tailoring diet modulations and fecal microbiota transplantation, which hold the potential to modify gut microbiome composition toward a beneficial direction and to treat infectious diarrhea in the late stages of HIV infection [120,121]. For the known beneficial microbial metabolites, there will be more options such as selectively increasing the abundance of the specific gut microbiota that can produce beneficial metabolites, or by engineering endogenous gut microbiota to produce metabolites in high levels.…”