Clostridium difficile Infection and Fecal Bacteriotherapy

Mitchell, I.deG.; Shropshire, KaSheena; Ruel, Jennifer

doi:10.1097/sga.0b013e318280f817

Cited by 3 publications

(4 citation statements)

References 9 publications

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“…3,4,7,13,14,38 Although fecal transplants have been used since the 4th century in China, they are now becoming more widely accepted as a safe and effective method of treating RCDI. 4,13,[38][39][40][41][42][43][44][45][46] Traditional pharmacological treatment of CDI should be started only after testing for C difficile is completed.…”

Section: Fecal Microbiota Transplantmentioning

confidence: 99%

“…[38][39][40][41][42][43][44][45][46][47] Although early on the most common method of administration was retention enema, 17 more recently the donor fecal material has been administered via nasogastric tube, [47][48][49] nasoduodenal tube, 50,51 colonoscopy, 52 oral fecal capsules, 45 and self-administered enemas. 50, [53][54][55] Instilling the fecal material via colonoscopy has many advantages.…”

Section: Fecal Microbiota Transplantmentioning

confidence: 99%

“…For example, if FMT is performed via a nasogastric tube, a proton pump inhibitor is usually administered the night before the procedure, whereas, if the fecal material is transfused via a colonoscopy, a bowel preparation with polyethylene glycol orally may be administered the evening before the transplant. 30,37,40,42 Other times loperamide may be administered either before or after FMT. All pharmacological therapy for CDI is discontinued 24 to 48 hours before FMT.…”

Section: Recognizing Fmt As An Option For Patients With CDImentioning

confidence: 99%

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Fecal Microbiota Transplant to Treat Recurrent Clostridium difficile Infections

Boyle

Ruth-Sahd

Zhou

2015

Critical Care Nurse

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C lostridium difficile infections (CDIs) are some of the most common health care-associated infections in hospitalized patients 1-8 and in patients residing in nursing homes. 9-11 According to estimates, the diagnosis and treatment of CDIs cost more than $3.2 billion annually in the United States, 2,4,11,12 with approximately 333 000 cases and 15 000 to 20 000 deaths per year. 2,4,[13][14][15] When the diarrhea associated with CDIs becomes severe and causes complications, the infections become life-threatening and are a marked cause of morbidity and death in hospitalized patients. [1][2][3][4] The incidence of severe and recurrent CDIs (RCDIs) has increased because of a new hypervirulent strain of C difficile that is less responsive to traditional medications. Patients with RCDI often are treated in an intensive care unit. Fecal microbiota transplant (FMT), also called fecal bacteriotherapy, is an adjunctive, costeffective treatment for patients with RCDI. 2,[12][13][14][15][16][17][18][19] Critical care nurses must understand the importance of a balanced gut microbiome 20,21 and how CDIs disrupt that balance. [22][23][24][25] Furthermore, the nurses must recognize the role of FMT in order to provide appropriate care, educate patients, and collaborate with health care professionals on the latest treatment options for patients with RCDI. Feature The prevalence of recurrent or refractory Clostridium difficile infection has been steadily increasing since 2000. Consequently, alternative treatments to the standard antibiotic therapies are now being considered. One alternative treatment is fecal microbiota transplant. Although fecal microbiota transplant is relatively new-and not appealing to most people-it has been around for many years and has great promise as an inexpensive, safe, and efficient treatment of refractory and recurrent C difficile infection. With a better understanding of the intricacies of the colonic microbiome and its role in colonic physiology and pathophysiology, critical care nurses will recognize that fecal microbiota transplant has the potential to become the standard of care for treatment of recurrent or refractory C difficile infection. The American College of Gastroenterology and the Infectious Diseases Society of America provide the latest treatment guidelines for care of patients with these clostridial infections. (Critical Care Nurse. 2015;35[2]:51-65) Fecal Microbiota Transplant to Treat Recurrent

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Section: Fecal Microbiota Transplantmentioning

confidence: 99%

Section: Fecal Microbiota Transplantmentioning

confidence: 99%

Section: Recognizing Fmt As An Option For Patients With CDImentioning

confidence: 99%

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Fecal Microbiota Transplant to Treat Recurrent Clostridium difficile Infections

Boyle

Ruth-Sahd

Zhou

2015

Critical Care Nurse

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“…Clostridium difficile infection (CDI) has doubled in occurrence during the period from 1996 to 2003 and is still steadily expanding in the following years in western countries with the development of antibiotic resistance [80][81][82]. CDI may lead to colectomy and lethality, and has become more severe due to the emergence of B1/NAP1/027, a more virulent strain characterized by enhanced fluoroquinolone resistance, and higher levels of toxins A and B, and binary toxin [83].…”

Section: Pathogenic Bacteria Associated With Ibdmentioning

confidence: 99%

Manipulation of Microbiome, a Promising Therapy for Inflammatory Bowel Diseases

Jin¹,

Zhang²,

Sun³

2014

J Clin Cell Immunol

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Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are featured by chronic intestinal inflammation, which is becoming increasingly prevalent in Western societies, and is spreading to the rest of the world. Although the etiology of IBD is poorly understood, it is widely accepted that several factors may be crucial, which includes genetics, diet and lifestyle, immunity, environment, and microbiota. In the past decade, huge advances have been made toward a better understanding of IBD, epitomized by far-reaching progress in the field of microbiome. In this review, we summarize the current knowledge of how changes in microbiota may affect the pathogenesis of IBD. Commensal bacteria, benign normally, are essentially opportunists that may readily take over, and potentially contributes to dysbiosis, which, in turn, promotes pathogenesis. Several pathogens, mainly Mycobacterium avium paratuberculosis, adherent invasive Escherichia coli, Clostridium difficile, Campylobacter, and Salmonella, have been shown to be associated with IBD, but the causality remains unproven. The microbiome comprises of not only bacteria, but also viruses, bacteriophages, and fungi. However, little is known as per the role of the latter. We highlight recent research on viruses, bacteriophages, and fungi in IBD. We also discuss the progress on manipulating the microflora to serve therapeutic purposes. The methodology for manipulating the microbiota covers fecal transplantation, pre-, pro-, syn-and post-biotics, helminth therapy, bacteriocins, bacteriophage, etc., which greatly enriches the arsenal against IBD. Manipulation of intestinal microbiome represents a promising type of therapy for IBD.

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