Intestinal Microbiota Transplantation, a Simple and Effective Treatment for Severe and Refractory Clostridium Difficile Infection

Zainah, Hadeel; Hassan, Mona; Shiekh-Sroujieh, Laila; Hassan, Syed Adeel; Alangaden, George; Ramesh, Mayur

doi:10.1007/s10620-014-3296-y

Cited by 75 publications

(64 citation statements)

References 19 publications

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“…The majority of the studies evaluated FMT for patients with recurrent CDAD, and across all studies symptom resolution was seen reported in 85% of cases. Among the studies of patients with refractory CDAD (seven caseseries studies; n = 131) [19][20][21][22][23][24][25], symptom resolution ranged widely (0-100%; overall resolution rate, 55%). The authors concluded that low-strength evidence supports FMT as having a substantial effect for adults with recurrent CDAD; however, evidence supporting FMT for patients with refractory CDAD is insufficient [18].…”

Section: Discussionmentioning

confidence: 99%

Use of intravenous immunoglobulin in severeClostridium difficile-associated diarrhea

Shahani

Koirala

2015

Hospital Practice

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Section: Discussionmentioning

confidence: 99%

Use of intravenous immunoglobulin in severeClostridium difficile-associated diarrhea

Shahani

Koirala

2015

Hospital Practice

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“…Mortality in this situation is very high and varies between 10 and 80%, mainly depending on the point of time in the course of disease when the surgery is performed. Besides a number of case reports [9][10][11], smaller, retrospective, uncontrolled studies have already been published showing that FMT is also effective in treating CDI in this clinical situation [12][13][14][15][16] .…”

Section: Lessons Learned From Fmt In CDImentioning

confidence: 99%

Any Future for Fecal Microbiota Transplantation as Treatment Strategy for Inflammatory Bowel Diseases?

Kump

Högenauer²

2016

Dig Dis

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Fecal microbiota transplantation (FMT) is a novel therapeutic procedure aiming at restoring a normal intestinal microbiota by application of fecal microorganisms from a healthy subject into the gastrointestinal tract of a patient. FMT is the most effective treatment for recurrent Clostridium difficile infections (CDI). These infections also occur in patients with inflammatory bowel diseases (IBDs), where case series demonstrated a successful treatment of CDI by FMT in 83-92% of patients. The effect of FMT on the activity of IBD has mainly been investigated in ulcerative colitis (UC) patients, including 3 randomized controlled trials. So far, 2 randomized controlled trials showed a superiority of FMT compared to placebo in inducing remission in UC, while 1 study found no significant difference to placebo. The variation in response to FMT between these studies as well as in the uncontrolled trials might be explained by many differences in the way of FMT application, patient pretreatment and patient and donor selection. The data for the use of FMT in Crohn's disease and pouchitis are sparse; currently, no conclusion can be drawn regarding the effectiveness of FMT in these indications. It needs to be noted that cases of IBD activation after FMT have been reported. So far, FMT can only be recommended to be used for the treatment of concomitant CDI in IBD in clinical practice. For treating IBD irrespective of CDI, FMT should be only used in clinical trials. Current forms of FMT, especially protocols using repeated application, are very time and personnel consuming. Future trends are the use of defined stable microbiota preparations, in particular oral preparations, which will enable better and larger controlled trails for investigating FMT in IBD.

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“…Approximately 80 cases have been published of FMT in this patient population, demonstrating a high cure [9][10][11][12][13][14][15]. In a protocol consisting of sequential FMT and vancomycin administration developed by Fischer et al severe and severe/complicated CDI patients were administered FMT after 5 days of maximum medical therapy [11].…”

Section: Fmt Technologymentioning

confidence: 99%

Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

Borody

Fischer

Mitchell

et al. 2015

Expert Review of Gastroenterology & Hepatology

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At its height, the Clostridium difficile infection epidemic caused approximately 7000 infections and 300 deaths per day in the USA. Fecal microbiota transplantation (FMT) has demonstrated extraordinary clinical resolution, C. difficile infection cure rates of over 90%, and low recurrence. In tandem with the rise of FMT, the gastrointestinal microbiome has emerged as a 'vital' organ armed with a wealth of microbe 'soldiers' more powerful than known antibiotics. FMTs' reputation has diffused into many new 'indications' yet these appear to be merely the tip of the iceberg when considering its potential applications. FMT as a therapeutic tool has evolved from the original format of blended donor stool and moved towards a refined product comprising a myriad of microbial components, presented aesthetically as encapsulated lyophilized powder.

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Intestinal Microbiota Transplantation, a Simple and Effective Treatment for Severe and Refractory Clostridium Difficile Infection

Abstract: IMT performed at the bedside via NGT is effective and safe for the treatment of severe and refractory CDI, and prevents recurrence.

Cited by 75 publications

References 19 publications

Use of intravenous immunoglobulin in severeClostridium difficile-associated diarrhea

Use of intravenous immunoglobulin in severeClostridium difficile-associated diarrhea

Any Future for Fecal Microbiota Transplantation as Treatment Strategy for Inflammatory Bowel Diseases?

Fecal microbiota transplantation in gastrointestinal disease: 2015 update and the road ahead

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