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

Olga C. Aroniadis, Lawrence J. Brandt, Adam Greenberg, Thomas Borody, Colleen R. Kelly, Mark Mellow, Christina Surawicz, Leslie Cagle, Leila Neshatian, Neil Stollman, Andrea Giovanelli, Arnab Ray, Robert Smith

Research output: Contribution to journalArticle

57 Citations (Scopus)

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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Clostridium Infections
Clostridium difficile
Fecal Microbiota Transplantation
Recurrence
Abdominal Pain
Inpatients
Diarrhea

Keywords

  • Clostridium difficile infection
  • Fecal microbiota transplantation
  • Infectious diarrhea

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Long-term follow-up study of fecal microbiota transplantation for severe and/or complicated clostridium difficile infection : A multicenter experience. / Aroniadis, Olga C.; Brandt, Lawrence J.; Greenberg, Adam; Borody, Thomas; Kelly, Colleen R.; Mellow, Mark; Surawicz, Christina; Cagle, Leslie; Neshatian, Leila; Stollman, Neil; Giovanelli, Andrea; Ray, Arnab; Smith, Robert.

In: Journal of Clinical Gastroenterology, Vol. 50, No. 5, 2016, p. 398-402.

Research output: Contribution to journalArticle

Aroniadis, OC, Brandt, LJ, Greenberg, A, Borody, T, Kelly, CR, 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, vol. 50, no. 5, pp. 398-402. https://doi.org/10.1097/MCG.0000000000000374
Aroniadis, Olga C. ; Brandt, Lawrence J. ; Greenberg, Adam ; Borody, Thomas ; Kelly, Colleen R. ; Mellow, Mark ; Surawicz, Christina ; Cagle, Leslie ; Neshatian, Leila ; Stollman, Neil ; Giovanelli, Andrea ; Ray, Arnab ; Smith, Robert. / Long-term follow-up study of fecal microbiota transplantation for severe and/or complicated clostridium difficile infection : A multicenter experience. In: Journal of Clinical Gastroenterology. 2016 ; Vol. 50, No. 5. pp. 398-402.
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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.",
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T1 - Long-term follow-up study of fecal microbiota transplantation for severe and/or complicated clostridium difficile infection

T2 - A multicenter experience

AU - Aroniadis, Olga C.

AU - Brandt, Lawrence J.

AU - Greenberg, Adam

AU - Borody, Thomas

AU - Kelly, Colleen R.

AU - Mellow, Mark

AU - Surawicz, Christina

AU - Cagle, Leslie

AU - Neshatian, Leila

AU - Stollman, Neil

AU - Giovanelli, Andrea

AU - Ray, Arnab

AU - Smith, Robert

PY - 2016

Y1 - 2016

N2 - 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.

AB - 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.

KW - Clostridium difficile infection

KW - Fecal microbiota transplantation

KW - Infectious diarrhea

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