Clearance of carbapenem-resistant Enterobacteriaceae vs vancomycin-resistant enterococci carriage after faecal microbiota transplant: a prospective comparative study.

Autor: Dinh A; Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France. Electronic address: aurelien.dinh@aphp.fr., Fessi H; Nephrology Unit, Tenon Teaching Hospital, APHP, Pierre et Marie Curie University, Paris, France., Duran C; Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France., Batista R; Pharmacy Department, Cochin Teaching Hospital, APHP, Paris Descartes University, Paris, France., Michelon H; Pharmacy Department, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France., Bouchand F; Pharmacy Department, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France., Lepeule R; Antimicrobial Stewardship Unit, Henri Mondor Teaching Hospital, APHP, Paris-Est Créteil-Est University, Créteil, France., Vittecoq D; Infectious Diseases Unit, Bicêtre Teaching Hospital, APHP, Paris-Sud University, Kremlin-Bicêtre, France., Escaut L; Infectious Diseases Unit, Bicêtre Teaching Hospital, APHP, Paris-Sud University, Kremlin-Bicêtre, France., Sobhani I; Gastro-enterology Department, Henri Mondor Teaching Hospital, APHP, Paris-Est Créteil-Est University, Créteil, France., Lawrence C; Microbiology Laboratory, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France., Chast F; Pharmacy Department, Cochin Teaching Hospital, APHP, Paris Descartes University, Paris, France., Ronco P; Nephrology Unit, Tenon Teaching Hospital, APHP, Pierre et Marie Curie University, Paris, France., Davido B; Infectious Diseases Unit, Raymond Poincaré Teaching Hospital, APHP, Versailles Saint-Quentin University, Garches, France.
Jazyk: angličtina
Zdroj: The Journal of hospital infection [J Hosp Infect] 2018 Aug; Vol. 99 (4), pp. 481-486. Date of Electronic Publication: 2018 Mar 02.
DOI: 10.1016/j.jhin.2018.02.018
Abstrakt: Background: Carbapenem-resistant Enterobacteriaceae (CRE) and vancomycin-resistant enterococci (VRE) carriage are increasing worldwide. Faecal microbiota transplantation (FMT) appears to be an attractive option for decolonization. This study aimed to evaluate CRE vs VRE clearance by FMT among carriers.
Methods: A multi-centre trial was undertaken on patients with CRE or VRE digestive tract colonization who received FMT between January 2015 and April 2017. Adult patients with CRE or VRE colonization, confirmed by three consecutive rectal swabs at weekly intervals, including one in the week prior to FMT, were included in the study. Patients with immunosuppression or concomitant antibiotic prescription at the time of FMT were excluded. Successful decolonization was determined by at least two consecutive negative rectal swabs [polymerase chain reaction (PCR) and culture] on Days 7, 14, 21 and 28, and monthly for three months following FMT.
Results: Seventeen patients were included, with a median age of 73 years [interquartile range (IQR) 64.3-79.0]. Median duration of carriage of CRE or VRE before FMT was 62.5 days (IQR 57.0-77.5). One week after FMT, three of eight patients were free of CRE colonization and three of nine patients were free of VRE colonization. After three months, four of eight patients were free of CRE colonization and seven of eight patients were free of VRE colonization. Qualitative PCR results were concordant with culture. Six patients received antibiotics during follow-up, three in each group. No adverse events were reported.
Conclusion: CRE and VRE clearance rates were not significantly different in this study, possibly due to the small sample size, but a trend was observed. These data should be confirmed by larger cohorts and randomized trials.
(Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: