Help
Subscribe


Submit Videos to GastroHep Read For FREE - Our full range of review articles
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Guido Tytgat Profile of Pete Peterson Profile of Peter Cotton Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Fecal microbiota transplant treats C. difficile in immunocompromised patients

A study in this month's issue of the American Journal of Gastroenterology examines fecal microbiota transplant for the treatment of Clostridium difficile infection in immunocompromised patients.

News image

Patients who are immunocompromised are at increased risk of Clostridium difficile infection (CDI), which has increased to epidemic proportions over the past decade.

Fecal microbiota transplantation (FMT) appears effective for the treatment of Clostridium difficile, although there is concern that immunocompromised patients may be at increased risk of having adverse events related to FMT.

Dr Colleen Kelly and colleagues from Rhode Island, USA describe the multicenter experience of FMT in immunocompromised patients.

A multicenter retrospective series was performed on the use of FMT in immunocompromised patients with Clostridium difficile that was recurrent, refractory, or severe.

The research team described rates of Clostridium difficile cure after FMT as well as adverse events experienced by immunocompromised patients after FMT.

79% were outpatients at the time of FMT
American Journal of Gastroenterology

A 32-item questionnaire soliciting demographic and pre- and post-FMT data was completed for 99 patients at 16 centers, of whom 80 were eligible for inclusion.

Outcomes included rates of Clostridium difficile cure after FMT, serious adverse events such as death or hospitalization within 12 weeks of FMT, infection within 12 weeks of FMT, and adverse events.

Cases included 75 adult and 5 pediatric patients treated with FMT for recurrent, refractory, and severe and/or overlap of recurrent/refractory and severe Clostridium difficile.
 
The team noted that in all, 79% were outpatients at the time of FMT.

The mean follow-up period between FMT and data collection was 11 months.

Reasons for immunocompromise included HIV/AIDS, solid organ transplant, oncologic condition, immunosuppressive therapy for inflammatory bowel disease, and other medical conditions/medications.

The research team found that the Clostridium difficile cure rate after a single FMT was 78%, with 62 patients suffering no recurrence at least 12 weeks post FMT.

The team identified 12 patients who underwent repeat FMT, of whom 8 had no further Clostridium difficile.

Thus, the overall cure rate was 89%.

The researchers found that 15% had any serious adverse event within 12 weeks post FMT, of which 10 were hospitalizations.

The team observed 2 deaths occurred within 12 weeks of FMT, one of which was the result of aspiration during sedation for FMT administered via colonoscopy, and the other was unrelated to FMT.

None suffered infections definitely related to FMT, but 2 patients developed unrelated infections and 5 had self-limited diarrheal illness in which no causal organism was identified.

The team found 1 patient had a superficial mucosal tear caused by the colonoscopy performed for the FMT, and 3 patients reported mild, self-limited abdominal discomfort post FMT.

About 14% of patients experienced disease flare post FMT.

The research team noted 3 ulcerative colitis patients that underwent colectomy related to course of UC >100 days after FMT.

Dr Kelly's team concludes, "This series demonstrates the effective use of FMT for Clostridium difficile in immunocompromized patients with few serious adverse events or related adverse events."

"Importantly, there were no related infectious complications in these high-risk patients."

Am J Gastroenterol 2014; 109:1065–1071
11 July 2014

Go to top of page Email this page Email this page to a colleague

 20 December 2014

Advanced search
 19 December 2014 
Idiopathic inflammatory demyelinating disease in IBD
 19 December 2014 
Colorectal cancer risk for first-degree relatives
 19 December 2014 
Thiopurine treatment and colectomy in ulcerative colitis
 18 December 2014 
Assessment of Crohn's disease activity
 18 December 2014 
Vitamin D and sustained virologic response in HCV
 18 December 2014 
Factor for treatment in IBS
 17 December 2014 
Non-invasive measures of fatty liver
 17 December 2014 
Remission from hepatic encephalopathy with rifaximin
 17 December 2014 
Colonic adenoma recurrence after endoscopic resection
 16 December 2014 
Screening esophagus during routine US
 16 December 2014 
Therapeutic targets in IBD
 16 December 2014 
Diagnostic tool for dysplasia in Barrett's
 15 December 2014 
Esophageal adenocarcinoma and Barrett's
 15 December 2014 
Outcomes of mildly abnormal liver function tests
 15 December 2014 
Food allergy and food intolerances
 12 December 2014 
Hospital readmission after colorectal resection
 12 December 2014 
Detecting intestingal damage in Crohn's
 12 December 2014 
SSRIs for noncardiac chest pain
 11 December 2014 
Hep C and post-liver transplant diabetes
 11 December 2014 
Antiviral therapy and post-hepatectomy survival
 11 December 2014 
Barrett’s risk factors in African Americans vs Non-Hispanic Whites
 10 December 2014 
Prompt endoscopy for uninvestigated dyspepsia
 10 December 2014 
Microbiota composition on gluten-free diet in celiac disease
 10 December 2014 
Utilization of health care resources in ileostomy patients
 09 December 2014 
Diverticular disease and irritable bowel syndrome
 09 December 2014 
Management of acute colonic diverticulitis
 09 December 2014 
Food intolerance
 08 December 2014 
Portal vein obstruction
 08 December 2014 
Readmission after restorative proctocolectomy with IPAA
 08 December 2014 
Metachronous colorectal cancer
 05 December 2014 
Esophageal cancer in Veterans with Barrett’s esophagus
 05 December 2014 
Clinical outcome in pediatric Crohn's
 05 December 2014 
Hepatocellular carcinoma surveillance survey
 04 December 2014 
Diagnosis of NAFLD and NASH
 04 December 2014 
Ethnic disparities in gastric cancer
 04 December 2014 
Gilbert's syndrome and respiratory health
 03 December 2014 
Unmet treatment needs of GERD
 03 December 2014 
Finding sessile serrated adenomas during colonoscopy
 03 December 2014 
Antibiotics in acute uncomplicated diverticulitis
 02 December 2014 
Vit D and sustained virologic response in Hep C
 02 December 2014 
Severe esophagitis and upper GI bleeding
 02 December 2014 
Critical illness in patients with IBD
 01 December 2014 
Algorithms for the diagnosis of Lynch syndrome
 01 December 2014 
Differentiates inflammatory from functional intestinal disorders
 01 December 2014 
Racial disparities in colorectal cancer survival
 28 November 2014 
C. diff and pediatric IBD
 28 November 2014 
Fruit and vegetable consumption and esophageal cancer
 28 November 2014 
IBD and students' adjustment to college
 27 November 2014 
Prediction of functional GI disorders later in life
 27 November 2014 
Differences in the incidence of esophageal adenocarcinoma
 27 November 2014 
End points of outcomes in primary biliary cirrhosis
 26 November 2014 
Detection of gastric precancerous conditions
 26 November 2014 
Vegetables and garlic and colorectal cancer risk
 26 November 2014 
Fertility in women with celiac disease
 25 November 2014 
Esophagogastric junction of children with GERD
 25 November 2014 
Symptom activity index for eosinophilic esophagitis
 25 November 2014 
Placebo response rate in fistulizing Crohn's
 24 November 2014 
Nasoenteric tube feeding in acute pancreatitis
 24 November 2014 
Corticosteroids and infections in elderly-onset IBD
 24 November 2014 
Adhesions in abdominal and pelvic surgery

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2014 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us