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Rev Esp Quimioter. 2018 Oct;31(5):411-418. Epub 2018 Sep 14.

Fecal microbiota transplantation for recurrent Clostridium difficile infection: Experience, protocol, and results.

Author information

1
Elena Reigadas Ramírez, Servicio de Microbiología Clínica y Enfermedades Infecciosas, Hospital General Universitario "Gregorio Marañón" C/ Dr. Esquerdo, 46, 28007 Madrid, Spain. helenrei@hotmail.com.
2
Emilio Bouza Santiago, Instituto de Investigación Sanitaria Gregorio Marañón, C/ Dr. Esquerdo, 46,28007 Madrid, Spain. emilio.bouza@gmail.com.

Abstract

OBJECTIVE:

Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection (R-CDI). Despite its excellent efficacy, it is still not a routine procedure in most European centers. FMT has not been widely used in Spain to date. We describe our experience with FMT, including a novel approach based on oral fecal capsules.

METHODS:

We analyzed a prospectively recorded case series of patients with R-CDI treated with FMT at a single center (June 2014-July 2017). Primary outcome was defined as resolution of CDI without recurrence in a two-month period. FMT was administered via colonoscopy, nasojejunal tube, or oral capsules. All stool donors were rigorously screened.

RESULTS:

FMT was performed in 13 patients with R-CDI. Median age was 75.0 years and 76.9% were females. Six FMT were performed via nasojejunal tube, 5 via oral capsules, and 2 by colonoscopy. There were no procedure-related adverse events, except for bacteremia in one patient. During follow-up, R- CDI was observed in one patient at one month after FMT. The primary resolution rate was 83.3% and the overall resolution rate was 91.7%. FMT by capsules achieved a 100% resolution rate, colonoscopy 100%, and nasojejunal tube 80.0%.

CONCLUSIONS:

In our cohort, FMT proved to be safe and effective, even in high risk patients. Oral administration in capsules also proved to be safe, well-tolerated, and highly effective for R-CDI. In our experience, the FMT capsule formulation seems feasible in the routine of a hospital. This administration method will allow FMT to be more widely used.

PMID:
30221898
PMCID:
PMC6194865
[Indexed for MEDLINE]
Free PMC Article

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