Faecal microbiota transplantation for Clostridioides difficile infection:Four years’ experience of the Netherlands Donor Feces Bank

Autor: Abraham Goorhuis, Elisabeth M. Terveer, Rogier E. Ooijevaar, Ed J. Kuijper, Josbert J. Keller, Hein W. Verspaget, Joffrey van Prehn, Marcel G. W. Dijkgraaf, Emilie van Lingen, Yvette H. van Beurden, Jos F.M.L. Seegers, Christina M. J. E. Vandenbroucke-Grauls, Chris J. J. Mulder, Karuna E. W. Vendrik, Els van Nood, Martijn P. Bauer, Eline Boeije-Koppenol
Přispěvatelé: Infectious diseases, AII - Infectious diseases, APH - Aging & Later Life, APH - Global Health, Epidemiology and Data Science, APH - Methodology, Gastroenterology and hepatology, AGEM - Digestive immunity, Medical Microbiology and Infection Prevention, Amsterdam Gastroenterology Endocrinology Metabolism, Internal Medicine
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Terveer, E M, Vendrik, K E W, Ooijevaar, R E, Lingen, E V, Boeije-Koppenol, E, Nood, E V, Goorhuis, A, Bauer, M P, van Beurden, Y H, Dijkgraaf, M G W, Mulder, C J J, Vandenbroucke-Grauls, C M J E, Seegers, J F M L, van Prehn, J, Verspaget, H W, Kuijper, E J & Keller, J J 2020, ' Faecal microbiota transplantation for Clostridioides difficile infection : Four years’ experience of the Netherlands Donor Feces Bank ', United European Gastroenterology Journal, vol. 8, no. 10, pp. 1236-1247 . https://doi.org/10.1177/2050640620957765
United European gastroenterology journal, 8(10), 1236-1247. SAGE Publications Inc.
United European Gastroenterology Journal, 8(10), 1236-1247. SAGE Publications Inc.
United European Gastroenterology Journal, 8(10), 1236-1247. SAGE Publishing
United European Gastroenterology Journal
United European Gastroenterology Journal, 8(10), 1236-1247. SAGE PUBLICATIONS INC
ISSN: 2050-6406
DOI: 10.1177/2050640620957765
Popis: Background: The Netherlands Donor Feces Bank provides standardized ready-to-use donor faecal suspensions for faecal microbiota transplantation treatment of patients with recurrent Clostridioides difficile infection. Objective: The purpose of this study was evaluation of safety, feasibility and outcome of faecal microbiota transplantation facilitated by a national stool bank. Methods: The methods used included: observational cohort study of donors and recipients of faecal suspensions; assessment of donor screening and patient selection performed by an expert panel of medical microbiologists, gastroenterologists and infectious disease specialists; and patient outcome evaluated at different timepoints after faecal microbiota transplantation. Results: Of 871 volunteers who registered as a potential faeces donor, 16 (2%) became active donors. Nine donors stopped or were excluded after a mean donation period of 5.7 months. In 2016–2019, 47 (27%) of 176 requests for faecal microbiota transplantations were deemed not indicated by the expert panel. In total, 129 patients with recurrent C. difficile infection were treated with 143 faecal suspensions in 40 different hospitals. The cure rate at two months after a single infusion was 89% (107/120). Of 84 patients, long-term follow-up (median 42 weeks) was available and sustained cure was achieved in 61 (73%). Early C. difficile infection relapses (within two months after faecal microbiota transplantation) and late recurrences (after more than two months) occurred more frequently in patients who received non-C. difficile antibiotics within three weeks after faecal microbiota transplantation and in moderately to severely immunocompromised patients. Of 21 patients with C. difficile infection after faecal microbiota transplantation, 14 were cured with anti-C. difficile antibiotics and seven with a second transplantation. No faecal microbiota transplantation-related serious adverse events were observed, but gastro-intestinal complaints (nausea, abdominal pain or diarrhoea) persisted in 32% of the treated patients at long-term follow-up. Conclusion: Faecal suspensions provided by a centralized stool bank, supported by a multidisciplinary expert team, resulted in effective, appropriate and safe application of faecal microbiota transplantation for recurrent C. difficile infection. Level of evidence: Level II, prospective cohort study.
Databáze: OpenAIRE
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