Long-term follow-up study of fecal microbiota transplantation for severe and/or complicated clostridium difficile infection: A multicenter experience

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Abstract

Goal: Our aim was to investigate fecal microbiota transplantation (FMT) efficacy in patients with severe and/or complicated Clostridium difficile infection (CDI). Background: FMT is successful for recurrent CDI, although its benefit in severe or complicated CDI has not specifically been evaluated. Study Methods: A multicenter long-term follow-up study was performed in patients who received FMT for severe and/or complicated CDI (diagnosed using standard criteria). Pre-FMT and post-FMT questionnaires were completed. Study outcomes included cure rates and time to resolution of symptoms. Results: A total of 17 patients (82% inpatients, 18% outpatients) were included (76.4% women; mean age, 66.4 y; mean follow-up, 11.4 mo). Patients had severe and complicated (76.4%) or either severe or complicated (23.6%) CDI. Sixteen patients (94.1%) had diarrhea, which resolved in 12 (75%; mean time to resolution, 5.7 d) and improved in 4 (25%) after FMT. Eleven patients (64.7%) had abdominal pain, which resolved in 8 (72.7%; mean time to resolution, 9.6 d) and improved in 3 (27.3%) after FMT. Two of 17 patients experienced early CDI recurrence (≤90 d) after FMT (primary cure rate, 88.2%); and in 1 patient, a second FMT resulted in cure (secondary cure rate, 94.1%). Late CDI recurrence (≥90 d) was seen in 1 of 17 patients (5.9%) in association with antibiotics and was successfully treated with a repeat FMT. No adverse effects directly related to FMT occurred. Conclusions: FMT was successful and safe in this cohort of patients with severe or complicated CDI. Primary and secondary cure rates were 88.2% and 94.1%, respectively.

Original languageEnglish (US)
Pages (from-to)398-402
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume50
Issue number5
DOIs
StatePublished - 2016

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Keywords

  • Clostridium difficile infection
  • Fecal microbiota transplantation
  • Infectious diarrhea

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Aroniadis, O. C., Brandt, L. J., Greenberg, A., Borody, T., Kelly, C. R., Mellow, M., Surawicz, C., Cagle, L., Neshatian, L., Stollman, N., Giovanelli, A., Ray, A., & Smith, R. (2016). Long-term follow-up study of fecal microbiota transplantation for severe and/or complicated clostridium difficile infection: A multicenter experience. Journal of Clinical Gastroenterology, 50(5), 398-402. https://doi.org/10.1097/MCG.0000000000000374