Going to the Bank: Fecal Microbiota Transplantation in Pediatrics

Barfield, Elaine; Small, Lesley; Navallo, Lauren; Solomon, Aliza

doi:10.1177/0009922817721159

Cited by 4 publications

(4 citation statements)

References 7 publications

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“…In general, resorting to a universal donor may have some advantages, as families or close acquaintances of children with C difficile may have a higher risk of exposure and infection with C difficile and confidentiality (such as Health Insurance Portability and Accountability Act of 1996) concerns may exist during screening (107,108). Therefore, the donor gut microbiome may potentially be impacted by prior infection, colonization, or therapy that may render a suboptimal microbiome for transfer.…”

Section: Universal Donors and Stool Banksmentioning

confidence: 99%

Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children

Davidovics

Michail

Nicholson

et al. 2019

J. pediatr. gastroenterol. nutr.

102

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Fecal microbiota transplantation (FMT) is becoming part of the treatment algorithms against recurrent Clostridium difficile infection (rCDI) both in adult and pediatric gastroenterology practice. With our increasing recognition of the critical role the microbiome plays in human health and disease, FMT is also being considered as a potential therapy for other disorders, including inflammatory bowel disease (Crohn disease, ulcerative colitis), graft versus host disease, neuropsychiatric diseases, and metabolic syndrome. Controlled trials with FMT for rCDI have not been performed in children, and numerous clinical and regulatory considerations have to be considered when using this untraditional therapy. This report is intended to provide guidance for FMT in the treatment of rCDI in pediatric patients.

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Section: Universal Donors and Stool Banksmentioning

confidence: 99%

Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children

Davidovics

Michail

Nicholson

et al. 2019

J. pediatr. gastroenterol. nutr.

102

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show abstract

“…The following supporting information can be downloaded at: https: //www.mdpi.com/article/10.3390/microorganisms10122450/s1, Table S1: Search terms used to identify and filter studies from literature, Table S2: List of studies for which full articles were retrieved and reviewed, Table S3: Risk of bias assessment for observational cohort studies with Newcastle-Ottawa Scale, and Table S4: Risk of bias assessment for case series with NIH quality assessment tool. References [1][2][3][4][5]7,9,10,[25][26][27][28][29][30][43][44][45][46][47][48] are cited in the supplementary materials. Institutional Review Board Statement: Ethical review and approval were waived for this study since this is a systematic review and meta-analysis based on the data that have already been published in the literature.…”

Section: Supplementary Materialsmentioning

confidence: 99%

Efficacy and Safety of Fecal Microbiota Transplantation in Treatment of Clostridioides difficile Infection among Pediatric Patients: A Systematic Review and Meta-Analysis

et al. 2022

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Background and Aims: Cases of Clostridioides difficile infection have been rising among the pediatric and adolescent population. Fecal microbiota transplantation (FMT) has emerged as an alternative therapy for recurrent C. difficile infection. We aim to perform the first systematic review and meta-analysis investigating the safety and efficacy of fecal microbiota transplantation for C. difficile infection in children and adolescents. Methods: A literature search was performed using variations of the keywords “pediatrics”, “C. difficile infection”, and “fecal microbiota transplantation” in PubMed, EMBASE, CINAHL, Cochrane, and Google Scholar from inception to 30 June 2022. The resulting 575 articles were independently screened by three authors. Fourteen studies that satisfied the eligibility criteria were included in the meta-analysis. Results: The pooled success rate of FMT in the overall cohort was 86% (95% confidence interval: 77–95%; p < 0.001; I2 = 70%). There were 38 serious adverse events in 36 patients with a pooled rate of 2.0% (95% confidence interval: 0.0–3.0%; p = 0.1; I2 = 0.0%) and 47 adverse events in 45 patients with a pooled rate of 15% (95% confidence interval: 5.0–25.0%; p = 0.02; I2 = 54.0%). There was no death associated with FMT. Conclusions: FMT was concluded to be an effective and safe therapy in pediatric and adolescent patients with C. difficile infection. Underlying comorbidities may impede the efficacy. A rigorous screening process of the donors is recommended prior to embarking on FMT. There is no universal and cost-effective way to monitor the long-term outcomes of FMT. While promising, metagenomic sequencing may not be available in settings with limited resources. Robust data from randomized clinical trials is warranted.

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“…Clinical remission is seen in 28.8% of patients and a clinical response is seen in 53% during follow-up, according to a recent systematic review and meta-analysis of 459 IBD patients (Fang et al, 2018). In pediatrics, several case series on FMT for IBDs have also been published (De Leon et al, 2013; Barfield et al, 2018); Fang et al (2018) reported a total of 67 pediatric patients, which will need to be updated with the rising use of FMT in this field. The currently published data show a clinical response rate ranging between 56 and 100% (Kunde et al, 2013; Wang A.Y.…”

Section: Conveying the Present To The Future For Fighting Against Antmentioning

confidence: 99%

“…This wide variability may be due to the different locations of disease in Crohn’s disease and ulcerative colitis, as well as the different routes of FMT administration used in the published studies (Hourigan and Oliva-Hemker, 2016; Wang A.Y. et al, 2016; Barfield et al, 2018). Side effects in both populations have been confirmed to be modest and transient, involving the GI tract (Hourigan and Oliva-Hemker, 2016; Wang A.Y.…”

Section: Conveying the Present To The Future For Fighting Against Antmentioning

confidence: 99%

Gut Microbiota Modulation for Multidrug-Resistant Organism Decolonization: Present and Future Perspectives

et al. 2019

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The emergence of antimicrobial resistance (AMR) is of great concern to global public health. Treatment of multi-drug resistant (MDR) infections is a major clinical challenge: the increase in antibiotic resistance leads to a greater risk of therapeutic failure, relapses, longer hospitalizations, and worse clinical outcomes. Currently, there are no validated treatments for many MDR or pandrug-resistant (PDR) infections, and preventing the spread of these pathogens through hospital infection control procedures and antimicrobial stewardship programs is often the only tool available to healthcare providers. Therefore, new solutions to control the colonization of MDR pathogens are urgently needed. In this narrative review, we discuss current knowledge of microbiota-mediated mechanisms of AMR and strategies for MDR colonization control. We focus particularly on fecal microbiota transplantation for MDR intestinal decolonization and report updated literature on its current clinical use.

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Going to the Bank: Fecal Microbiota Transplantation in Pediatrics

Cited by 4 publications

References 7 publications

Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children

Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection and Other Conditions in Children

Efficacy and Safety of Fecal Microbiota Transplantation in Treatment of Clostridioides difficile Infection among Pediatric Patients: A Systematic Review and Meta-Analysis

Gut Microbiota Modulation for Multidrug-Resistant Organism Decolonization: Present and Future Perspectives

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