Fecal Microbiota Transfer for Multidrug-Resistant Gram-Negatives: A Clinical Success Combined With Microbiological Failure

Stalenhoef, Janneke E.; Terveer, Elisabeth M.; Knetsch, Cornelis W.; Hof, Peter J. van‘t; Vlasveld, Imro N.; Keller, Josbert J.; Visser, Leo G.; Kuijper, Ed J.

doi:10.1093/ofid/ofx047

Cited by 37 publications

(30 citation statements)

References 15 publications

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“…A recent review found that FMT for recurrent Clostridium difficile infection (RCDI) was associated with decreased UTI frequency and improved antibiotic susceptibility profiles [ 7 ]. Case reports have also described interruption of recurrent UTIs with a Verona integron-encoded metallo-β-lactamase-positive MDR P. aeruginosa , recurrent renal allograft pyelonephritis with ESBL E. coli , and carbapenemase-producing K. pneumoniae osteomyelitis and sepsis [ 8–10 ].…”

Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplant for Refractory Clostridium difficile Infection Interrupts 25-Year History of Recurrent Urinary Tract Infections

Wang

Kraft

Woodworth

et al. 2018

Open Forum Infectious Diseases

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Section: Discussionmentioning

confidence: 99%

Fecal Microbiota Transplant for Refractory Clostridium difficile Infection Interrupts 25-Year History of Recurrent Urinary Tract Infections

Wang

Kraft

Woodworth

et al. 2018

Open Forum Infectious Diseases

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“…Subsequently, 6 articles were excluded after a full-text review. Finally, a total of 20 articles were selected: 10 single cases [25][26][27][28][29][30][31][32][33][34], 3 case series comprising 10 cases [35][36][37], and 7 prospective studies comprising 101 cases [38][39][40][41][42][43][44]. Of these articles, only one was a randomized controlled trial.…”

Section: Study Selection and Characteristics Of Included Studiesmentioning

confidence: 99%

Efficacy and safety of fecal microbiota transplantation for decolonization of intestinal multidrug-resistant microorganism carriage: beyond Clostridioides difficile infection

et al. 2019

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Persistent reservoirs of multidrug-resistant microorganisms (MDRO) that are prevalent in hospital settings and communities can lead to the spread of MDRO. Currently, there are no effective decolonization strategies, especially non-pharmacological strategies without antibiotic regimens. Our aim was to evaluate the efficacy and safety of fecal microbiota transplantation (FMT) for the eradication of MDRO. A systematic literature search was performed to identify studies on the use of FMT for the decolonization of MDRO. PubMed, EMBASE, Web of Science, and Cochrane Library were searched from inception through January 2019. Of the 1395 articles identified, 20 studies met the inclusion and exclusion criteria. Overall, the efficacy of FMT for the eradication of each MDRO was 70.3% (102/146) in 121 patients from the 20 articles. The efficacy rates were 68.2% (30/44) for gram-positive bacteria and 70.6% (72/102) for gram-negative bacteria. Minor adverse events, including vomiting, diarrhea, abdominal pain, and ileus, were reported in patients who received FMT. FMT could be a promising strategy to eradicate MDRO in patients. Further studies are needed to confirm these findings and establish a comprehensive FMT protocol for standardized treatment. KEY MESSAGES The development of new antibiotics lags behind the emergence of multidrug-resistant microorganisms (MDRO). New strategies are needed. Theoretically, fecal microbiota transplantation (FMT) might recover the diversity and function of commensal microbiota from dysbiosis in MDRO carriers and help restore colonization resistance to pathogens. A literature review indicated that FMT could be a promising strategy to eradicate MDRO in patients.

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“…We and others have previously shown that FMT can successfully treat recurrent Clostridium difficile infection (CDI), with an overall cure rate of more than 90% [ 6 , 7 ]. To date, over eight case reports and three case series have been published on successful FMT for MDRO decolonization, varying in treatment method, amount of feces administered, number of administrations, preparation (antibiotics and/or lavage) and targeted pathogen [ 8 , 9 ]. Currently several clinical trials are underway to evaluate effectivity of FMT against a range of MDRO ( https://clinicaltrials.gov ; NCT02312986, NCT02543866, NCT02461199, NCT02390622, NCT02472600).…”

Section: Introductionmentioning

confidence: 99%

Fecal microbiota transplantation against intestinal colonization by extended spectrum beta-lactamase producing Enterobacteriaceae: a proof of principle study

et al. 2018

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ObjectiveInfections with multidrug-resistant microorganisms are associated with increased hospitalization, medication costs and mortality. Based on our fecal microbiota transplantation (FMT) experience for Clostridium difficile infection, we treated 15 patients carrying ESBL-producing Enterobacteriaceae (ESBL-EB) with FMT. Seven patients underwent a second FMT after 4 weeks when ESBL-EB remained, amounting to a total number of 22 transplants. The objective was decolonization of ESBL-EB.ResultsThree out of fifteen (20%) patients were ESBL-negative at 1, 2 and 4 weeks after the first transplant, while six out of 15 (40%) were negative after the second transplant. Comparison of fecal microbiota at baseline and 4 weeks after FMT revealed restoration of microbial diversity after FMT and a microbial shift towards donor composition. Finally, we suggest several possible factors of response to therapy, such as donor-recipient microbiota match and number of FMTs. Therefore, FMT can be an effective treatment in patients carrying ESBL-EB. Response may be determined by microbiota composition and number of FMT procedures.Trial registration ISRCTN ISRCTN48328635 Registered 11 October 2017, retrospectively registeredElectronic supplementary materialThe online version of this article (10.1186/s13104-018-3293-x) contains supplementary material, which is available to authorized users.

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Fecal Microbiota Transfer for Multidrug-Resistant Gram-Negatives: A Clinical Success Combined With Microbiological Failure

Cited by 37 publications

References 15 publications

Fecal Microbiota Transplant for Refractory Clostridium difficile Infection Interrupts 25-Year History of Recurrent Urinary Tract Infections

Fecal Microbiota Transplant for Refractory Clostridium difficile Infection Interrupts 25-Year History of Recurrent Urinary Tract Infections

Efficacy and safety of fecal microbiota transplantation for decolonization of intestinal multidrug-resistant microorganism carriage: beyond Clostridioides difficile infection

Fecal microbiota transplantation against intestinal colonization by extended spectrum beta-lactamase producing Enterobacteriaceae: a proof of principle study

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