Fecal microbiota transplantation for management of Clostridium difficile infection

Abstract

The widespread use of antibiotics has led Clostridium difficile infection (CDI) to become a common problem with pronounced medical and economic effects. The recurrence of CDI after treatment with standard antibiotics is becoming more common with the emergence of more resistant strains of C. difficile. As CDI is an antibiotic-associated disease, further treatment with antibiotic is best avoided. As the gut flora is severely disturbed in CDI, approaches that restore the gut microbiota may become good alternative modes of CDI therapies. Fecal microbiota transplantation (FMT) is the procedure of transplantation of fecal bacteria from a healthy donor individual into a patient for restoration of the normal colonic flora. Thus, FMT helps in the eradication of C. difficile and resolution of clinical symptoms such as diarrhea, cramping, and urgency. Though this approach to treatment is not new, presently, it has become an alternative and promising way of combating infections. The procedure is not in regular use because of the time required to identify a suitable donor, the risk of introducing opportunistic pathogens, and a general patient aversion to the transplant. However, FMT is gaining popularity because of its success rate as a panacea for recurrent attacks of CDI and is being increasingly used in clinical practice. This review describes the rationale, the indications, the results, the techniques, the potential donors, the benefits as well as the complications of fecal microbiota instillation to CDI patients in order to restore the normal gut flora.

Expression of Toll-like Receptors, Pro-, and Anti-inflammatory Cytokines in Relation to Gut Microbiota in Irritable Bowel Syndrome: The Evidence for Its Micro-organic Basis

“…Manipulation of gut microbiota using probiotic, antibiotics, and fecal transplantation may be useful in IBS and IBD patients, further proving the role of dysbiosis and inflammation in the pathogenesis of a subset of patients. [52][53][54] In conclusion, up-regulation of TLR-4 and TLR-5 suggest that the innate immune system may play an important role in the pathophysiology of IBS. The up-regulation of pro-inflammatory cytokines (IL-6, CXCL-11, and CXCR-3) and down-regulation of the anti-inflammatory cytokine (IL-10) in patients with IBS-D than controls suggest the presence of low-grade intestinal inflammation in a subgroup of IBS patients.…”

Correlation of liver function with intestinal flora, vitamin deficiency and IL-17A in patients with liver cirrhosis

“…Studies have shown that the bacteria content in sigmoid colon and anal canal can be up to 1,011 g wet weight, accounting for 20% of the stool weight. In healthy people, the Bacteroides and Bifidobacterium in intestinal tract account for about 50% of the total bacteria, but Escherichia coli and Enterococci are no more than 1% ( 14 ). Bifidobacterium and Lactobacillus are the intestinal symbiotic dominant bacterial communities, which form the bacterial flora, acidify the intestinal tract, inhibit the spoilage and pathogens, constitute the intestinal barrier, reduce toxins into the blood, produce the organic acids, stimulate the peristalsis, prevent constipation, synthesize the vitamins and amino acids, stimulate the body's immune system, decompose carcinogenic substances and reduce the occurrence of colon cancer ( 15 , 16 ).…”

Fecal Microbial Transplant- A New Hope of Treatment for Ulcerative Colitis

“…FMT may be administered to the proximal colon via colonoscope, the distal lower gastrointestinal tract via enema, rectal catheter, and the upper GI tract through a nasogastric tube, a nasoduodenal tube or a gastroscope. 14 We are hereby reporting our findings in a child with ulcerative colitis who was treated with fecal microbial transplantation at our institute. To the best of our knowledge, the use of FMT for the treatment of ulcerative colitis is being reported for the first time in India.…”