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World J Gastroenterol. 2017 Oct 21;23(39):7174-7184. doi: 10.3748/wjg.v23.i39.7174.

Faecal microbiota transplantation in patients with Clostridium difficile and significant comorbidities as well as in patients with new indications: A case series.

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Department of Gastroenterology, Päijät-Häme Central Hospital, Lahti 15850, Finland.
Department of Infectious Diseases, Helsinki University Hospital, Helsinki 00029, Finland.
Department of Gastroenterology, Päijät-Häme Central Hospital, Lahti 15850, Finland.
Department of Medicine, Hyvinkää Hospital 05850, Hyvinkää, Finland.
Department of Medicine, Tampere University Hospital 33521, Tampere, Finland.
Functional Foods Forum, University of Turku, Turku 20014, Finland.
Immunobiology Research Program, Faculty of Medicine, University of Helsinki, Helsinki 00014, Finland.
Department of Gastroenterology, Helsinki University Hospital, Helsinki 00029, Finland.


Fecal microbiota transplantation (FMT) is effective in recurrent Clostridium difficile infection (rCDI). Knowledge of the safety and efficacy of FMT treatment in immune deficient patients is scarce. FMT has been suggested as a potential method for an increasing number of new indications besides rCDI. Among our FMT-treated rCDI patients, we reviewed those with major comorbidities: two human immunodeficiency virus patients, six haemodialysis patients, two kidney transplant patients, two liver transplant patients and a patient with chronic lymphatic leukaemia. We also reviewed those treated with FMT for indications other than rCDI: Salmonella carriage (two patients), trimethylaminuria (two patients), small intestinal bacterial overgrowth (SIBO; one patient), and lymphocytic colitis (one patient), as well as a common variable immunodeficiency patient with chronic norovirus infection and ESBL-producing Escherichia coli (E. coli) carriage. Of the thirteen rCDI patients treated with FMT, eleven cleared the CDI. The observed adverse events were not directly attributable to FMT. Concerning the special indications, both Salmonellas and ESBL-producing E. coli were eradicated. One trimethylaminuria patient and one SIBO-patient reported a reduction of symptoms. Three patients did not experience a benefit from FMT: chronic norovirus, lymphocytic colitis and the other fish malodour syndrome. There were no reported side effects in this group. FMT appeared to be safe and effective for immunocompromised patients with rCDI. FMT showed promise for the eradication of antibiotic-resistant bacteria, but further research is warranted.


Antibiotic resistance; Clostridium difficile infection; Faecal microbiota transplantation; Immunodeficiency; Microbiota; Salmonella infection

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