Efficacy of Fecal Microbiota Transplantation for Clostridium difficile Infection in Children
| Autor: | Jeffery D. Lewis, Elizabeth D. Knackstedt, Erin Alexander, George Russell, Mark Bartlett, Michael Dole, David L. Suskind, Judith R. Kelsen, Stacy A. Kahn, Maria Oliva-Hemker, Michael Docktor, Aliza Solomon, Zev Davidovics, Jonathan Gisser, Grace Felix, Namita Singh, Sahil Khanna, Richard Kellermayer, Karen Queliza, Melissa Kennedy, Maribeth R Nicholson, Penny Becker, Sonia Arora Ballal, Paul Mitchell, Steven L. Werlin, Suchitra K. Hourigan, Ashley Lodarek, McKenzie Leier, Sonia Michail, Tiffany Patton, M. Kyle Jensen, Jess L. Kaplan |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Colonoscopy Inflammatory bowel disease Article Feces Young Adult 03 medical and health sciences 0302 clinical medicine Recurrence Internal medicine medicine Humans Young adult Child Adverse effect Feeding tube Retrospective Studies Hepatology medicine.diagnostic_test Clostridioides difficile business.industry Gastroenterology Retrospective cohort study Odds ratio Fecal Microbiota Transplantation Clostridium difficile medicine.disease Treatment Outcome 030220 oncology & carcinogenesis Clostridium Infections 030211 gastroenterology & hepatology business |
| Zdroj: | Clin Gastroenterol Hepatol |
| ISSN: | 1542-3565 |
| DOI: | 10.1016/j.cgh.2019.04.037 |
| Popis: | Background & Aims Fecal microbiota transplantation (FMT) is commonly used to treat Clostridium difficile infection (CDI). CDI is an increasing cause of diarrheal illness in pediatric patients, but the effects of FMT have not been well studied in children. We performed a multi-center retrospective cohort study of pediatric and young adult patients to evaluate the efficacy, safety, and factors associated with a successful FMT for the treatment of CDI. Methods We performed a retrospective study of 372 patients, 11 months to 23 years old, who underwent FMT at 18 pediatric centers, from February 1, 2004, to February 28, 2017; 2-month outcome data were available from 335 patients. Successful FMT was defined as no recurrence of CDI in the 2 months following FMT. We performed stepwise logistic regression to identify factors associated with successful FMT. Results Of 335 patients who underwent FMT and were followed for 2 months or more, 271 (81%) had a successful outcome following a single FMT and 86.6% had a successful outcome following a first or repeated FMT. Patients who received FMT with fresh donor stool (odds ratio [OR], 2.66; 95% CI, 1.39–5.08), underwent FMT via colonoscopy (OR, 2.41; 95% CI, 1.26–4.61), did not have a feeding tube (OR, 2.08; 95% CI, 1.05–4.11), or had 1 less episode of CDI before FMT (OR, 1.20; 95% CI, 1.04–1.39) had increased odds for successful FMT. Seventeen patients (4.7%) had a severe adverse event during the 3-month follow-up period, including 10 hospitalizations. Conclusions Based on the findings from a large multi-center retrospective cohort, FMT is effective and safe for the treatment of CDI in children and young adults. Further studies are required to optimize the timing and method of FMT for pediatric patients—factors associated with success differ from those of adult patients. |
| Databáze: | OpenAIRE |
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