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Clin Gastroenterol Hepatol. 2014 Sep;12(9):1572-6. doi: 10.1016/j.cgh.2013.12.032. Epub 2014 Jan 16.

Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile Infection.

Author information

1
University of Maryland School of Medicine and Department of Gastroenterology, Sinai Hospital of Baltimore, Baltimore, Maryland. Electronic address: sdutta@gmail.com.
2
Division of Gastroenterology, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland. Electronic address: girotra.mohit@gmail.com.
3
Department of Medicine, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland.
4
Division of Gastroenterology, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland.
5
University of Maryland School of Medicine and Department of Gastroenterology, VA Maryland Health Care System, Baltimore, Maryland.
6
Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
7
Johns Hopkins University School of Medicine and Division of Infectious Diseases, Johns Hopkins Hospital, Baltimore, Maryland.
8
Department of Hepatology, Sinai Hospital of Baltimore, Baltimore, Maryland.
9
Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland.

Abstract

The prevalence of recurrent Clostridium difficile infection (RCDI) is increasing; fecal microbiota transplantation (FMT) is an effective therapy. However, there have been no studies of the efficacy of a single session of combined enteral and colonic FMT or characterizations of changes in the microbiota between donors and recipients. We performed a study of 27 patients with RCDI who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. Patients were closely monitored, and fecal samples were collected from 2 patient-donor pairs for 16S rRNA analysis. All patients had reduced stool frequency, abdominal pain, white blood cell counts, and elimination of fecal C difficile toxin (P < .05). FMT increased microbial diversity, increasing proportions of Lachnospiraceae (phylum Firmicutes) and reducing proportions of Enterobacteriaceae. FMT was associated with marked changes in the composition of fecal microbiota in 2 patients with RCDI.

KEYWORDS:

16s rRNA Analysis; Clostridium difficile; Colonic; FMT; Fecal Microbiota Transplantation; Jejunal; Lachnospiraceae; Microbiota; RCDI; Recurrent

PMID:
24440222
DOI:
10.1016/j.cgh.2013.12.032
[Indexed for MEDLINE]

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