Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection: Mayo Clinic in Arizona Experience

Patel, Niren; Griesbach, Cheryl L.; DiBaise, John K.; Orenstein, Robert

doi:10.1016/j.mayocp.2013.04.022

Cited by 55 publications

(50 citation statements)

References 23 publications

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“…Issue of Mayo Clinic Proceedings, Patel et al [12] presented their results on the use of FMT to treat RCDI using a standardized evaluation process and protocol. Over a 2-year period, 31 patients were treated.…”

Section: How Successful Is It?mentioning

confidence: 99%

“…However, FMT has recently experienced a potential setback at most institutions since the US Food and Drug Administration (FDA) convened a public workshop on May 2-3, 2013, that addressed FMT, i.e. after acceptance of the article by Patel et al [12] for publication in the proceedings is an unapproved new drug for which an investigational new drug (IND) application is required. For most institutions, obtaining an IND will be too cumbersome and time consuming.…”

Section: Future Of Fmtmentioning

confidence: 99%

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Gut microbiota and its role in cancer patients

Purkite

2018

Int J Mol Immuno Oncol.

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Chemotherapy and allogeneic stem cell transplant suppress the body’s immunity making them more prone to neutropenic sepsis, for which the patients have to be given broad-spectrum antibiotics. These antibiotics disrupt the well-organized colony of our intestinal microbiome creating dysbiosis. Dysbiosis makes the intestine a favorable platform for certain Gram-positive bacilli to proliferate which is Clostridium difficile. Traditional treatment requires the patient to take metronidazole, vancomycin, and probiotics. Recurrent C. difficile infection makes the traditional treatment a failure. Thus, fecal microbial transplant is the answer to recurrent C. difficile.

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Section: How Successful Is It?mentioning

confidence: 99%

Section: Future Of Fmtmentioning

confidence: 99%

Gut microbiota and its role in cancer patients

Purkite

2018

Int J Mol Immuno Oncol.

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“…Because of their durability and strength, spores germinate, and organisms rapidly outgrow the normal intestinal flora. 1,3,8,9,[12][13][14][15][16][17] Although C difficile flourishes in anaerobic conditions such as the gut, it can survive on a variety of surfaces for more than 3 months. [1][2][3][4][5][6][7]31 The spores are difficult to eradicate from surfaces, creating an easy way to 138/min with sinus tachycardia, respirations 18/min, and oxygen saturation 96% on room air as measured by pulse oximetry.…”

Section: The Role Of the Gut Floramentioning

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%

“…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.…”

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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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