Fecal Microbiota Transplant for Recurrent Clostridium difficile Infection in Pediatric Inflammatory Bowel Disease
| Autor: | Robert Hirten, Marla Dubinsky, Elizabeth A. Spencer, Stanley Cho, Ari Grinspan |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Adolescent Severity of Illness Index digestive system Gastroenterology Inflammatory bowel disease 03 medical and health sciences 0302 clinical medicine Recurrence Vancomycin 030225 pediatrics Internal medicine Severity of illness medicine Humans In patient Longitudinal Studies Child Retrospective Studies business.industry Retrospective cohort study Fecal bacteriotherapy Fecal Microbiota Transplantation Clostridium difficile Inflammatory Bowel Diseases medicine.disease digestive system diseases Anti-Bacterial Agents Pediatrics Perinatology and Child Health Clostridium Infections Female 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Pediatric Gastroenterology & Nutrition. 68:343-347 |
| ISSN: | 1536-4801 0277-2116 |
| Popis: | Recurrent Clostridium difficile infection (RCDI) increases morbidity and mortality in patients with inflammatory bowel disease (IBD). Fecal microbiota transplant (FMT) is known to be very effective for RCDI in non-IBD patients with cure rates up to 91%. The same success rates of FMT have not been reported in patients with IBD with RCDI, and the data in pediatrics are limited. We aimed to determine the effectiveness of FMT for RCDI in established pediatric patients with IBD.We performed a retrospective chart review of pediatric patients with IBD and RCDI (≥3 episodes) who underwent FMT via colonoscopy at a tertiary care IBD center. The primary outcome was the rate of RCDI within 60 days post-FMT. The secondary outcomes were recurrence rate by 6 months, rate of colectomy, and time to recurrence.Of the 8 eligible patients, 6 had ulcerative colitis, 1 had IBD-unspecified, and 1 had Crohn disease. Median (interquartile range) age was 13 (11-14) years. All patients were on vancomycin at FMT. Two patients (25%) had RCDI by 60 days post-FMT and another 3 patients had RCDI between 60 days and 6 months. The median time to recurrence was 101 (40-139) days. Two patients (25%) who developed recurrence went to colectomy after FMT.With a cure rate of 75% at 60 days, FMT administered for the treatment of RCDI may be an effective treatment option in pediatric IBD. However, there appears to be a significant rate of late recurrence of C difficile infection after 60 days in these patients. |
| Databáze: | OpenAIRE |
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