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Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease.


ABSTRACT: Purpose:Fecal microbiota transplantation (FMT) is an effective treatment option for patients with recurrent Clostridioides difficile infection (rCDI). However, there is a paucity of evidence regarding its efficacy and safety in patients with rCDI and concurrent inflammatory bowel disease (IBD). Here, we present a single-center experience of FMT for treatment of rCDI in Iranian patients with IBD. Patients and Methods:Eight patients with established IBD (7 with ulcerative colitis and 1 with Crohn's disease) who underwent at least one FMT via colonoscopy for treatment of rCDI were enrolled in this study. Demographics, pre-FMT and post-FMT IBD activity, efficacy for rCDI and adverse events (AEs) were assessed during a 6-month follow-up period. All patients had experienced 3 episodes of rCDI and were refractory to conventional therapies with metronidazole and vancomycin. Primary cure and secondary cure rates were assessed after FMT treatments. Results:A total of 10 FMTs were performed via colonoscopy in 8 patients (6/8; 75% men) with a median age of 35 years (range: 22-60). Two patients received a second FMT. Overall, the primary and secondary cure rates were 75% and 100%, respectively. Two patients developed CPE-producing C. perfringens diagnoses after second FMTs. There were no other AEs, and no patient experienced IBD flare. Conclusion:We demonstrated that FMT appears to be an effective, safe and rational therapeutic alternative for resolution of rCDI in patients with underlying IBD. Furthermore, we suggest implementing the CPE-producing C. perfringens testing in the screening of FMT donors.

SUBMITTER: Azimirad M 

PROVIDER: S-EPMC7509309 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Treatment of Recurrent <i>Clostridioides difficile</i> Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease.

Azimirad Masoumeh M   Yadegar Abbas A   Gholami Fatemeh F   Shahrokh Shabnam S   Asadzadeh Aghdaei Hamid H   Ianiro Gianluca G   Suzuki Hidekazu H   Cammarota Giovanni G   Zali Mohammad Reza MR  

Journal of inflammation research 20200918


<h4>Purpose</h4>Fecal microbiota transplantation (FMT) is an effective treatment option for patients with recurrent <i>Clostridioides difficile</i> infection (rCDI). However, there is a paucity of evidence regarding its efficacy and safety in patients with rCDI and concurrent inflammatory bowel disease (IBD). Here, we present a single-center experience of FMT for treatment of rCDI in Iranian patients with IBD.<h4>Patients and methods</h4>Eight patients with established IBD (7 with ulcerative col  ...[more]

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