The impact of technical and clinical factors on fecal microbiota transfer outcomes for the treatment of recurrent Clostridioides difficile infections in Germany
| Autor: | Philipp Solbach, Rosemarie Peri, Wolfgang Angeli, Maria J G T Vehreschild, Frank Tacke, Andreas Sturm, Philipp Ehlermann, Ulrich Rosien, Oliver Bachmann, Alexander Link, Thorsten Frank, F Goeser, Andreas Erhardt, Kester Tüffers, Andreas Stallmach, Martin Storr, Rebeca Cruz Aguilar, Thomas Glück |
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| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Secondary Prevention Medicine Humans Treatment Failure Aged Retrospective Studies Aged 80 and over business.industry Clostridioides difficile Gastroenterology Age Factors Original Articles Fecal microbiota Fecal Microbiota Transplantation Middle Aged Oncology 030220 oncology & carcinogenesis Clostridium Infections 030211 gastroenterology & hepatology Female business Clostridioides |
| Popis: | INTRODUCTION: Fecal microbiota transfer (FMT) is highly effective in the treatment and prevention of recurrent Clostridioides difficile infection (rCDI) with cure rates of about 80% after a single treatment. Nevertheless, the reasons for failure in the remaining 20% remain largely elusive. The aim of the present study was to investigate different potential clinical predictors of response to FMT in Germany. METHODS: Information was extracted from the MicroTrans Registry (NCT02681068), a retrospective observational multicenter study, collecting data from patients undergoing FMT for recurrent or refractory CDI in Germany. We performed binary logistic regression with the following covariates: age, gender, ribotype 027, Eastern Co-operative Oncology Group score, immunosuppression, preparation for FMT by use of proton pump inhibitor, antimotility agents and bowel lavage, previous recurrences, severity of CDI, antibiotic induction treatment, fresh or frozen FMT preparation, and route of application. RESULTS: Treatment response was achieved in 191/240 evaluable cases (79.6%) at day 30 (D30) post FMT and 78.1% at day 90 (D90) post FMT. Assessment of clinical predictors for FMT failure by forward and confirmatory backward-stepwise regression analysis yielded higher age as an independent predictor of FMT failure (p = 0.001; OR 1.060; 95%CI 1.025–1.097). CONCLUSION: FMT in Germany is associated with high cure rates at D30 and D90. No specific pre-treatment, preparation or application strategy had an impact on FMT success. Only higher age was identified as an independent risk factor for treatment failure. Based on these and external findings, future studies should focus on the assessment of microbiota and microbiota-associated metabolites as factors determining FMT success. |
| Databáze: | OpenAIRE |
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