Fecal microbiota transplantation outcomes in immunocompetent and immunocompromised patients: A single-center experience

Transplant Infectious Disease : an Official Journal of the Transplantation Society
Sally AlrabaaJose Montero

Abstract

Clostridium difficile infection (CDI) is a major infectious disease focus for which fecal microbiota transplantation (FMT) has been used with success in various patient populations. We conducted a retrospective study of FMT in immunocompetent and immunocompromised patients to review outcomes at our center, with a focus on identifying risk factors for FMT failure in solid organ transplant (SOT) patients. FMT was conducted using universal banked frozen stool via naso-duodenal tube in patients with recurrent CDI of 3 or more episodes per our institutional protocol. Thirteen patients were included in the analysis, 6 who were immunocompetent and 7 who were immunocompromised. Of these, 6 patients had a history of SOT and were primarily abdominal organ recipients. All immunocompetent patients experienced success with FMT, while 3 immunocompromised SOT patients experienced failure. Two patients who failed FMT had a second FMT, which was successful in one patient and failed in the second patient. No adverse events were noted with FMT administration. A predictor of FMT failure was antimicrobial exposure pre-FMT. This study highlights the safe use of FMT for recurrent CDI with variable efficacy in immunocompromised patients. Antimicrobial...Continue Reading

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Citations

Jul 17, 2018·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Steven C LinAlan C Moss
Oct 4, 2018·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Sara Lynn Revolinski, L Silvia Munoz-Price
Dec 13, 2019·Journal of Gastroenterology and Hepatology·Annie S HongMahendran Jayaraj
Nov 6, 2020·United European Gastroenterology Journal·Josbert J KellerMaria J G T Vehreschild
Apr 9, 2021·Clinical Endoscopy·Seon-Young Park, Geom Seog Seo
May 28, 2019·Microbiology Spectrum·S MiletoD Lyras

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