While fecal microbiota transplantation is historically known to be an effective means to treat recurrent Clostridium difficile infection (CDI) refractory to standard antibiotic therapies, the procedure is rarely performed.
At least some of the reasons for limited availability are those of practicality, including aesthetic concerns and costs of donor screening.
Dr Alexander Khoruts and colleagues from Minnesota, USA overcame these barriers in their clinical fecal microbiota transplantation program.
|30% of the patients had underlying inflammatory bowel disease|
|American Journal of Gastroenterology|
The research team report clinical experience with 43 consecutive patients who were treated with fecal microbiota transplantation for recurrent Clostridium difficile infection since inception of this program at the University of Minnesota.
During this time, the team simplified donor identification and screening by moving from patient-identified individual donors to standard volunteer donors.
Material preparation shifted from the endoscopy suite to a standardized process in the laboratory, and ultimately to banking frozen processed fecal material that is ready to use when needed.
The team noted that standardization of material preparation significantly simplified the practical aspects of fecal microbiota transplantation without loss of apparent efficacy in clearing recurrent Clostridium difficile infection.
The researchers found that approximately 30% of the patients had underlying inflammatory bowel disease, and fecal microbiota transplantation was equally effective in this group.
Dr Khoruts' team commented, "Several key steps in the standardization of donor material preparation significantly simplified the clinical practice of fecal microbiota transplantation for recurrent Clostridium difficile infection in patients failing antibiotic therapy."