Successful Fecal Transplantation by Enema for Recurrent and Refractory <i>Clostridium difficile</i> Infection

Moon, Kang Ryun; Sohn, Kyung Mok; Park, Bo Mi; Kim, So Hyun; Chun, Shinhye; Jung, Hyeon; Song, Chnag Hun

doi:10.4235/jkgs.2013.17.3.152

Cited by 3 publications

(5 citation statements)

References 20 publications

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“…In Korea, the incidence of CDI is also increasing; FMT has been introduced to treat recurrent and refractory CDI [15]. However, there is a lack of research studying the gut microbiota of healthy people and patients with CDI in Korea.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea

et al. 2019

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BackgroundThe intestinal microbiota plays an important role in the pathogenesis of Clostridioides difficile-associated diarrhea, and regional and racial characteristics influence the microbiome composition and diversity. We investigated the intestinal microbiome characteristics of patients with C. difficile colitis (CD+) compared to those of patients with colitis not due to C. difficile (CD−), patients with vancomycin-resistant enterococci (VRE) colonization, and healthy controls, in Korea.Materials and MethodsWe collected stool samples from 24, 18, 11 and 13 subjects within CD+, CD−, VRE and healthy control groups, respectively. The microbial communities were evaluated by 454-pyrosequencing of bacterial 16s rRNA.ResultsThe species richness and microbial diversity were significantly lower in the CD+ group compared to those in healthy controls, but not compared to those in CD− and VRE groups. Phylum-level analysis showed that the proportion of Actinobacteria in the CD+ group was significantly lower than in the healthy control, but was unchanged compared to that in CD− and VRE groups. At the genus level, compared to the healthy group, the CD+ group showed significantly lower proportions of Blautia, Bifidobacterium, Faecalibacterium et al. Compared to the VRE group, the CD+ group showed a significantly higher proportion of Anaerostipes.ConclusionsWe could identify the intestinal microbiome characteristics of Koreans with C. difficile colitis. It might help to develop microbiome based diagnostic and treatment modalities.

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Section: Introductionmentioning

confidence: 99%

Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea

et al. 2019

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“…New therapeutic approaches have been investigated for the treatment of recurrent and refractory PMC, and a large number of recent studies have explored the use of FMT. 8 9 10 11 12 13 14 15 The concept of an FMT was first reported in 1958 by Eiseman et al 9 for the treatment of fulminant PMC. Since then, a considerable number of case reports and studies on the treatment's effects and methodologies have been performed worldwide.…”

Section: Discussionmentioning

confidence: 99%

“…In a recent randomized control trial, FMT had a better outcome than the use of vancomycin in patients with recurrent and refractory PMC. 8 A domestic study also reported a successful case of treating recurrent and refractory PMC via enema 11 and upper GI endoscopy. 12 This case report was meaningful in that it compared clinical data and colonoscopic findings from follow-up colonoscopies in cases where PMC was managed with colonoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…Fecal microbiota transplant (FMT) has emerged in recent years as a treatment option for patients with recurrent and antibiotic-refractory PMC, and many studies have achieved favorable results with this procedure. 8 9 10 11 12 13 14 15 Here we report a case of refractory PMC which was successfully resolved without recurrence after performing FMT using a colonoscope.…”

Section: Introductionmentioning

confidence: 86%

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Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation

Shin

Lee

et al. 2016

Intest Res

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Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%–30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.

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“…In Korea, two cases of severe refractory C. difficile infection treated with fecal transplantation during an initial episode have been reported. One case used esophagogastroduodenoscopy (EGD) while the other case used enema [ 9 10 ]. Here, we report the first case of severe initial C. difficile infection, refractory to antibiotics, that was treated with fecal transplantation using a nasoenteric tube in Korea.…”

Section: Introductionmentioning

confidence: 99%

Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection

et al. 2016

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The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. Furthermore, antibiotic therapy results in recurrence rates of at least 20%. Fecal transplantation may be a feasible treatment option for recurrent C. difficile infection; moreover, it may be an early treatment option for severe C. difficile infection. We report a case of severe C. difficile infection treated with fecal transplantation using a nasoenteric tube during an initial episode. This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea.

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Successful Fecal Transplantation by Enema for Recurrent and Refractory Clostridium difficile Infection

Cited by 3 publications

References 20 publications

Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea

Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea

Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation

Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection

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