Clinical outcomes after faecal microbiota transplant by retention enema in both immunocompetent and immunocompromised patients with recurrent Clostridioides difficile infections at an academic medical centre
| Autor: | Glenn S. Tillotson, Jordan Polistico, Bhagyashri Navalkele, Amar Krishna, Reda A. Awali, Suganya Chandramohan, Teena Chopra, Avnish Sandhu |
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| Rok vydání: | 2020 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Adverse outcomes medicine.medical_treatment Enema 030501 epidemiology Faecal microbiota transplantation Feces Immunocompromised Host 03 medical and health sciences Primary outcome Recurrence Internal medicine Humans Medicine Adverse effect Retrospective Studies Academic Medical Centers 0303 health sciences Retrospective review Clostridioides difficile 030306 microbiology business.industry Treatment options General Medicine Fecal Microbiota Transplantation Treatment Outcome Infectious Diseases Clostridium Infections 0305 other medical science business Clostridioides |
| Zdroj: | Journal of Hospital Infection. 106:643-648 |
| ISSN: | 0195-6701 |
| Popis: | Summary Background Recurrent Clostridioides difficile infection (CDI) is one of the most common and challenging infections to treat in healthcare facilities. Faecal microbiota transplantation (FMT) is recommended as a definitive treatment option. Methods We performed a retrospective review of 50 patients from January 2015 to December 2019 who underwent FMT for recurrent CDI. Primary outcome was recurrence of CDI within 12-weeks of FMT and secondary outcomes were the need for repeat FMT, serious adverse outcomes related to FMT and all-cause mortality. Results Fifty charts were reviewed, of which 47 cases comprising 17 immunocompromised patients treated with FMT via retention enema were included in the study. The majority of the patients had ≥3 recurrent CDIs (62%). Nine (19%) patients failed to respond to the first FMT and five underwent repeat FMT within four to 12 weeks. The cure rate was 81% after the first FMT (38/47) and 91% after the second FMT treatment (43/47). Serious adverse events occurred in 2% and all-cause mortality was 2% at 90-day follow up. Conclusion Our study demonstrated the safety and efficacy of FMT administered via retention enema, a simple bedside procedure, for the treatment and prevention of recurrent non-severe and severe CDI with an overall cure rate of 91%. |
| Databáze: | OpenAIRE |
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