Review
Infectious Diseases
Raseen Tariq, Maham Hayat, Darrell Pardi, Sahil Khanna
Summary: Fecal microbiota transplantation (FMT) is an effective therapy for CDI, but has a failure rate of around 15%. Factors such as use of non-CDI antibiotics, presence of inflammatory bowel disease, poor bowel preparation, CDI-related hospitalization before FMT, inpatient FMT, and severe CDI are associated with increased risk of FMT failure. Modifiable factors like antibiotic use post-FMT and good bowel preparation can lower the risk of failure. Patients with non-modifiable risk factors should be more vigilant for recurrent symptoms after FMT.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(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
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.
Article
Gastroenterology & Hepatology
Azizullah Beran, Sachit Sharma, Sami Ghazaleh, Wade Lee-Smith, Muhammad Aziz, Faisal Kamal, Ashu Acharya, Douglas G. Adler
Summary: This meta-analysis explored the predictors of fecal microbiota transplantation (FMT) failure in patients with recurrent/refractory Clostridioides difficile infection (CDI). The study included 20 studies with a total of 4327 patients and found that FMT failed in 16.3% of the patients. Advanced age, severe CDI, inflammatory bowel disease, peri-FMT use of non-CDI antibiotics, prior CDI-related hospitalizations, inpatient status, and poor quality of bowel preparation were significant predictors of FMT failure.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2023)
Review
Microbiology
Kyaw Min Tun, Mark Hsu, Kavita Batra, Chun-Han Lo, Tooba Laeeq, Tahne Vongsavath, Salman Mohammed, Annie S. Hong
Summary: This study conducted a systematic review and meta-analysis on the safety and efficacy of FMT for C. difficile infection in pediatric and adolescent patients. The success rate of FMT was 86% in the overall cohort, with low rates of adverse events. Therefore, FMT is considered an effective and safe therapy, but caution should be taken when selecting donors.
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
Surgery
Liping Yang, Wenrui Li, Xianzhuo Zhang, Jinhui Tian, Xiaojia Ma, Lulu Han, Huaping Wei, Wenbo Meng
Summary: This study evaluated the efficacy of different types of fecal microbiota transplantation for the treatment of RCDAD. The results showed that fresh fecal bacteria were the best treatment option, while frozen and lyophilized fecal bacteria had similar effects. Fecal microbiota transplantation is a promising approach for clinical and commercial application.
FRONTIERS IN SURGERY
(2022)
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
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)
Review
Gastroenterology & Hepatology
Anna Maria Seekatz, Nasia Safdar, Sahil Khanna
Summary: The composition of the human gut microbiota is important for overall health, and disruptions in this microbiome can lead to various diseases. In the case of Clostridioides difficile infection, standard treatments and monoclonal antibodies do not address the underlying dysbiosis. Fecal microbiota transplantation (FMT) is an effective strategy in preventing recurrent infections, but there are challenges in screening and standardizing the acquisition and processing of donor stool. Newer biotherapeutic formulations are being developed to improve gut microbiome restoration and prevent CDI recurrence.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Raseen Tariq, Darrell S. S. Pardi, Sahil Khanna
Summary: Microbiota restoration shows higher efficacy in observational studies compared to randomized controlled trials (RCTs) for treating recurrent Clostridioides difficile infection (CDI), likely due to stricter definitions and inclusion criteria in RCTs. The results from observational studies and open-label trials are similar.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2023)
Article
Oncology
Hiba Ali, Shruti Khurana, Weijie Ma, Yuanzun Peng, Zhi-Dong Jiang, Herbert DuPont, Hao Chi Zhang, Anusha S. Thomas, Pablo Okhuysen, Yinghong Wang
Summary: Patients with cancer who underwent FMT for rCDI showed a high response rate and no serious adverse events or mortality within 30 days. However, additional antibiotic use for complications from chemotherapy or immunosuppression may negatively affect the efficacy of FMT in this population with advanced cancer.
Article
Infectious Diseases
Raseen Tariq, Pritish. K. K. Tosh, Darrell. S. S. Pardi, Sahil Khanna
Summary: We conducted an updated study to examine the occurrence of urinary tract infections (UTIs) in patients with recurrent Clostridioides difficile infection (CDI) who underwent fecal microbiota transplantation (FMT) for CDI treatment. Our findings revealed a significant decrease in the incidence of UTIs following FMT compared to patients treated with antibiotics for CDI. Furthermore, there was a trend towards reduced antibiotic resistance in UTI-causing organisms after FMT.
EUROPEAN JOURNAL OF CLINICAL MICROBIOLOGY & INFECTIOUS DISEASES
(2023)
Review
Gastroenterology & Hepatology
Avnish Sandhu, Teena Chopra
Summary: Clostridioides difficile infection (CDI) is a major cause of hospital-acquired infections, with recurrent CDI (rCDI) posing a challenge in treatment. Fecal microbiota transplantation (FMT) is suggested for second episodes of rCDI, showing promise compared to traditional treatments like vancomycin or fidaxomicin. However, concerns over infections, adverse events, and new diagnoses remain, requiring further study for long-term safety and efficacy of FMT in clinical practice.
THERAPEUTIC ADVANCES IN GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Gianluca Ianiro, Stefano Bibbo, Serena Porcari, Carlo Romano Settanni, Federica Giambo, Andreea Roxana Curta, Gianluca Quaranta, Franco Scaldaferri, Luca Masucci, Maurizio Sanguinetti, Antonio Gasbarrini, Giovanni Cammarota
Summary: Inflammatory bowel disease (IBD) is a risk factor for C. difficile infection (CDI), and fecal microbiota transplantation (FMT) appears to be highly effective and safe in treating both CDI and improving disease activity of IBD.