Article
Medicine, General & Internal
Daniel Popa, Bogdan Neamtu, Manuela Mihalache, Adrian Boicean, Adela Banciu, Daniel Dumitru Banciu, Doru Florian Cornel Moga, Victoria Birlutiu
Summary: Faecal microbiota transplant (FMT) is highly effective for recurrent Clostridioides difficile infection (rCDI) with a cure rate of 85-92%, but its role in primary CDI is still uncertain. This study shows FMT's effectiveness in primary severe CDI and the risk of recurrence is related to the number of CDI episodes. Further research on larger cohorts is needed.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Kelsey E. Huus, Marcin Frankowski, Maja Pucic-Bakovic, Frano Vuckovic, Gordan Lauc, Benjamin H. Mullish, Julian R. Marchesi, Tanya M. Monaghan, Dina Kao, B. Brett Finlay
Summary: This study found that IgA-bacterial interactions are reestablished in human FMT recipients to resemble that of the healthy fecal donor. The data suggests that the IgA-bacterial interactions are influenced by the bacterial species and the fecal donor identity in the FMT recipients.
Article
Biotechnology & Applied Microbiology
Qiaomai Xu, Shumeng Zhang, Jiazheng Quan, Zhengjie Wu, Silan Gu, Yunbo Chen, Beiwen Zheng, Longxian Lv, Lanjuan Li
Summary: Vancomycin is the preferred treatment for CDI but has a high recurrence rate. FMT has emerged as a successful treatment for recurrent CDI. Our study suggests that FMT can better restore gut microbiota and metabolites, promoting the recovery of colonization resistance in mice compared to vancomycin.
APPLIED MICROBIOLOGY AND BIOTECHNOLOGY
(2022)
Article
Public, Environmental & Occupational Health
Krishna Vedala, Philip Sobash, Parth Shah, Gilbert-Roy Kamoga
Summary: Clostridioides difficile infection imposes a significant economic burden in inpatient and rural settings. Fecal Microbiota Transplant, although limited by guidelines and resources, has been shown to save an average of $11,603.49 per patient after the first recurrence of CDI. Our study suggests that utilizing FMT in rural hospitals for recurrent CDI treatment could be economically beneficial.
FRONTIERS IN PUBLIC HEALTH
(2021)
Article
Immunology
Elizabeth S. Aby, Byron P. Vaughn, Eva A. Enns, Radha Rajasingham
Summary: This study assessed the cost-effectiveness of fecal microbiota transplantation (FMT) for first recurrent Clostridioides difficile infection (CDI). The findings indicate that FMT is a cost-effective treatment strategy for first recurrent CDI.
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Gastroenterology & Hepatology
Maribeth R. Nicholson, Suchitra K. Hourigan, Maire Conrad, Alka Goyal, Kyle Jensen, Judith Kelsen, Melissa Kennedy, Madison Weatherly, Stacy A. Kahn
Summary: The impact of the 2019 US FDA safety alert and the COVID-19 pandemic on the use of FMT in children has led to changes in practices for many pediatric gastroenterologists, with a majority of programs being halted as a result.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Shaodong Wei, Martin Iain Bahl, Simon Mark Dahl Baunwall, Jens Frederik Dahlerup, Christian Lodberg Hvas, Tine Rask Licht
Summary: This study aimed to explore the relationship between early changes in the intestinal microbiota and clinical outcomes following fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (CDI). The results showed that patients with sustained resolution after FMT had different microbial diversity, abundance, and gut microbiota dysbiosis compared to non-responders. Additionally, a constructed index based on clinically feasible methods successfully predicted treatment failure. It was also found that FMT had a more pronounced impact on the gut microbiota compared to antibiotic monotherapy. Therefore, early identification of microbial community structures after FMT is clinically valuable for predicting treatment response.
Review
Medicine, General & Internal
S. Khanna
Summary: Clostridioides difficile infection (CDI) is a common healthcare-associated infection, with management difficulties and high rates of recurrence. Microbiota restoration therapies, such as faecal microbiota transplantation, are the cornerstone for preventing recurrent CDI, with success rates over 90%. Developments in standardized microbiota restoration therapies, such as capsule-based and enema-based therapies, are emerging to improve management of CDI.
JOURNAL OF INTERNAL MEDICINE
(2021)
Article
Biochemistry & Molecular Biology
Adrian Boicean, Bogdan Neamtu, Sabrina Birsan, Florina Batar, Ciprian Tanasescu, Horatiu Dura, Mihai Dan Roman, Adrian Hasegan, Dan Bratu, Alin Mihetiu, Calin Ilie Mohor, Cosmin Mohor, Ciprian Bacila, Mihai Octavian Negrea, Sorin Radu Fleaca
Summary: In this comparative study on 86 patients with co-infection of COVID-19 and Clostridioides Difficile, fecal microbiota transplantation (FMT) showed better results in terms of inflammatory markers, relapse rate, and symptom relief compared to antibiotic treatment alone. Therefore, FMT may be an effective treatment for improving patients' quality of life and inflammatory syndrome.
Article
Cell Biology
Tanya M. Monaghan, Niharika A. Duggal, Elisa Rosati, Ruth Griffin, Jamie Hughes, Brandi Roach, David Y. Yang, Christopher Wang, Karen Wong, Lynora Saxinger, Maja Pucic-Bakovic, Frano Vuckovic, Filip Klicek, Gordan Lauc, Paddy Tighe, Benjamin H. Mullish, Jesus Miguens Blanco, Julie A. K. McDonald, Julian R. Marchesi, Ning Xue, Tania Dottorini, Animesh Acharjee, Andre Franke, Yingrui Li, Gane Ka-Shu Wong, Christos Polytarchou, Tung On Yau, Niki Christodoulou, Maria Hatziapostolou, Minkun Wang, Lindsey A. Russell, Dina H. Kao
Summary: Fecal microbiota transplantation (FMT) is effective in treating recurrent Clostridioides difficile infection, and new evidence suggests its potential in severe cases. A deep phenomics study conducted on four adults undergoing sequential FMT for severe infection revealed differences in host responses, suggesting immunosenescent signals in non-responders. Further research with larger sample sizes is needed to validate these preliminary findings on the mechanisms of successful FMT.
Article
Multidisciplinary Sciences
Mao Hagihara, Tadashi Ariyoshi, Yasutoshi Kuroki, Shuhei Eguchi, Seiya Higashi, Takeshi Mori, Tsunemasa Nonogaki, Kenta Iwasaki, Makoto Yamashita, Nobuhiro Asai, Yusuke Koizumi, Kentaro Oka, Motomichi Takahashi, Yuka Yamagishi, Hiroshige Mikamo
Summary: CBM 588 enhances the antibacterial activity against C. difficile, reduces colon epithelial damage, and improves immunity through upregulating pathogen specific immunoglobulin A and enhancing gut epithelial barrier function to protect colon tissue from CDI.
SCIENTIFIC REPORTS
(2021)
Article
Multidisciplinary Sciences
Olle Bjorkqvist, Ignacio Rangel, Lena Serrander, Cecilia Magnusson, Jonas Halfvarson, Torbjorn Noren, Malin Bergman-Jungestrom
Summary: The study found that FMT can increase the relative abundance of Faecalibacterium prausnitzii in patients with recurrent CDI, and this microbial shift persists for several months later. Further research is needed to determine whether Faecalibacterium prausnitzii actively contributes to the resolution of CDI.
Letter
Medicine, General & Internal
Nicolas Benech, Tatiana Galperine, Harry Sokol
Summary: This article compares the efficacy of SER-109 and fecal microbiota transplantation (FMT) in preventing recurrent Clostridioides difficile infection. The recurrence rate was lower than expected in the placebo group, while FMT showed benefits in preventing recurrent C. difficile infection among patients with a history of multiple cases.
NEW ENGLAND JOURNAL OF MEDICINE
(2022)
Article
Gastroenterology & Hepatology
Kelly Suchman, Yuying Luo, Ari Grinspan
Summary: This study supports the efficacy and safety of fecal microbiota transplant (FMT) for Clostridioides difficile infection (CDI) in immunocompromised patients. The primary cure rate was 85.1% and the overall cure rate was 86.5%. Serious adverse events were experienced by 11.7% of patients following FMT.
DIGESTIVE DISEASES AND SCIENCES
(2022)
Article
Multidisciplinary Sciences
Alexander B. Smith, Matthew L. Jenior, Orlaith Keenan, Jessica L. Hart, Jonathan Specker, Arwa Abbas, Paula C. Rangel, Chao Di, Jamal Green, Katelyn A. Bustin, Jennifer A. Gaddy, Maribeth R. Nicholson, Clare Laut, Brendan J. Kelly, Megan L. Matthews, Daniel R. Evans, Daria Van Tyne, Emma E. Furth, Jason A. Papin, Frederic D. Bushman, Jessi Erlichman, Robert N. Baldassano, Michael A. Silverman, Gary M. Dunny, Boone M. Prentice, Eric P. Skaar, Joseph P. Zackular
Summary: Enterococci can shape the metabolic environment in the gut and enhance the fitness and pathogenesis of Clostridioides difficile through nutrient restriction and cross-feeding. This microbial interaction plays a role in the susceptibility to and the severity of C. difficile infection.
Review
Public, Environmental & Occupational Health
Lynne McFarland, Stuart B. Johnson, Charlesnika T. Evans
Summary: The review examined quasi-experimental studies adding probiotics to infection control protocols to reduce CDI rates, finding that certain probiotics showed promise in reducing infections. However, the study design was influenced by various factors that must be carefully considered.
AMERICAN JOURNAL OF INFECTION CONTROL
(2021)
Article
Microbiology
D. R. Snydman, L. A. McDermott, S. G. Jenkins, E. J. C. Goldstein, R. Patel, B. A. Forbes, S. Johnson, D. N. Gerding, C. M. Thorpe, S. T. Walk
Article
Immunology
Stuart Johnson, Diane M. Citron, Dale N. Gerding, Mark H. Wilcox, Ellie J. C. Goldstein, Susan P. Sambol, Emma L. Best, Karen Eves, Erin Jensen, Mary Beth Dorr
Summary: In the MODIFY I/II trials, infection with BI strains of C. difficile was associated with poor outcomes. Bezlotoxumab treatment was effective in both BI and non-BI subpopulations.
CLINICAL INFECTIOUS DISEASES
(2021)
Article
Public, Environmental & Occupational Health
Andrew M. Skinner, Brian Yu, Adam Cheknis, Susan M. Pacheco, Dale N. Gerding, Stuart Johnson
INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY
(2020)
Article
Medicine, General & Internal
Andrew M. Skinner, S. Tyler Phillips, Michelle M. Merrigan, Kevin J. O'Leary, Susan P. Sambol, Farida Siddiqui, Lance R. Peterson, Dale N. Gerding, Stuart Johnson
Summary: Most pathogenic strains of C. difficile possess two large molecular weight single unit toxins that disrupt the actin cytoskeleton of intestinal epithelial cells, leading to diarrhea. While TcdB alone can cause disease, TcdA-/TcdB+ mutant strains have been shown to be responsible for C. difficile infection, which are typically mild in nature.
JOURNAL OF CLINICAL MEDICINE
(2021)
Article
Immunology
Andrew M. Skinner, Xing Tan, Benjamin D. Sirbu, Larry H. Danziger, Dale N. Gerding, Stuart Johnson
Summary: The tapered-pulsed fidaxomicin regimen shows promising results in managing multiple recurrent Clostridioides difficile infections (mrCDI), with sustained clinical response rates of 74% at 30 days and 61% at 90 days.
CLINICAL INFECTIOUS DISEASES
(2021)
Review
Infectious Diseases
Ravina Kullar, Stuart Johnson, Lynne V. McFarland, Ellie J. C. Goldstein
Summary: Medical care for hospitalized COVID-19 patients is constantly evolving, with a majority receiving empiric antibiotics which can lead to antibiotic-related diarrhea. Strategies such as antimicrobial stewardship programs and specific probiotic strains have shown promise in reducing these adverse effects and are currently being studied in trials for COVID-19 patients.
Article
Immunology
Stuart Johnson, Valery Lavergne, Andrew M. Skinner, Anne J. Gonzales-Luna, Kevin W. Garey, Ciaran P. Kelly, Mark H. Wilcox
Summary: This guideline offers focused updates on the management of Clostridioides difficile infection (CDI) in adults, specifically addressing the use of fidaxomicin and bezlotoxumab. Recommendations are based on evidence from systematic literature reviews and rated using the GRADE approach.
CLINICAL INFECTIOUS DISEASES
(2021)
Letter
Gastroenterology & Hepatology
Lynne V. McFarland, Ravina Kullar, Stuart Johnson, Jason C. Sniffen, Kristin Woolard, Ellie J. C. Goldstein
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2022)
Article
Infectious Diseases
Robert Orenstein, Erik R. Dubberke, Sahil Khanna, Christine H. Lee, David Yoho, Stuart Johnson, Gail Hecht, Herbert L. DuPont, Dale N. Gerding, Ken F. Blount, Sarah Mische, Adam Harvey
Summary: In this Phase 2 trial, RBX2660 was found to be safe and effective in reducing the recurrence of rCDI compared to a historical control group. Microbiome changes in participants treated with RBX2660 were consistent with protective changes against C. difficile recurrence.
BMC INFECTIOUS DISEASES
(2022)
Letter
Immunology
Andrew M. Skinner, Laurica Petrella, Stacey Spandoni, Fidel Serna-Perez, Stuart Johnson
CLINICAL INFECTIOUS DISEASES
(2022)
Article
Medicine, Research & Experimental
Stuart Johnson, Dale N. Gerding, Xue Li, Domenic J. Reda, Curtis J. Donskey, Kalpana Gupta, Matthew Bidwell Goetz, Michael W. Climo, Fred M. Gordin, Robert Ringer, Neil Johnson, Michelle Johnson, Lawrence A. Calais, Alexa M. Goldberg, Ling Ge, Tamara Haegerich
Summary: This study aims to compare three antibiotic treatments for patients with recurrent CDI and determine the optimal treatment. The study is designed as a prospective, double-blind, multi-center clinical trial, and includes protocol modifications based on early trial experience and clinical realities.
CONTEMPORARY CLINICAL TRIALS
(2022)
Article
Multidisciplinary Sciences
Susan P. Sambol, Stuart Johnson, Adam Cheknis, Dale N. Gerding
Summary: This study successfully transferred the pathogenicity locus (PaLoc) from toxigenic Clostridioides difficile strain to a nontoxigenic strain CD37 but not to the nontoxigenic strain NTCD-M3r. This finding provides important insights into the mechanism of toxin transfer in Clostridioides difficile.
Article
Infectious Diseases
Andrew M. Skinner, Laurica A. Petrella, Adam Cheknis, Stuart Johnson
Summary: Omadacycline has demonstrated a high level of activity towards C. difficile compared to commonly used antimicrobials for CABP and ABSSSI. The study results show that there were no notable elevations in the in vitro omadacycline MIC among contemporary C. difficile isolates.
JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY
(2023)
Article
Microbiology
Susan P. Sambol, Andrew M. Skinner, Fidel Serna-Perez, Benjamin Owen, Dale N. Gerding, Stuart Johnson
Summary: This study aimed to investigate the colonization of NTCD-M3 after treatment with fidaxomicin, an alternative antibiotic to vancomycin, in a hamster model of C. difficile infection (CDI). The results showed that NTCD-M3 successfully colonized all hamsters treated with fidaxomicin, similar to those treated with vancomycin. The presence of high levels of OP-1118 and vancomycin in feces during treatment suggests the potential effectiveness of NTCD-M3 for preventing recurrent CDI.
MICROBIOLOGY SPECTRUM
(2023)