Fecal bacteriotherapy in the treatment of recurrent Clostridium difficile infection
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| Year of publication | 2018 |
| Type | Conference abstract |
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| Description | Background: Disruption of the natural microbial ecosystem in the colon is one of the most clinically significant adverse effects of broad-spectrum antibiotic therapy. About 20% of post-antibiotic diarrhoea cases are caused by the proliferation of toxigenic Clostridium difficile strains. Current studies of Clostridium difficile infection (CDI) pathogenesis focus on the period of increased intestinal vulnerability after completed treatment of a colitis episode until full recovery of the intestinal microbiome (about eight weeks). Relapses, readily occurring during this period, can be prevented by faecal bacteriotherapy (FBT). This method consists in transplantation of gut flora from a healthy person to the patient’s intestine to promote the recovery of natural intestinal microbiome diversity. Materials/methods: Faecal bacteriotherapy has been established at the Department of Infectious Diseases of the University Hospital Brno, Czech Republic, as a method for treating recurrent Clostridium difficile colitis since 2010. The method was applied to 71 patients during the 2-year study period (2015–2016). After treatment, the patients were followed up by means of personal visits or by phone. If colitis did not recur within eight weeks, the treatment was considered successful. Results: Overall FBT success rate was 76%, with a very low, statistically insignificant decline in recurrences. Subgroup analysis did not show any statistically significant difference in success rate between administration via nasoenteral feeding tube and rectal enema. Likewise, there were no statistically significant differences due to prior antibiotic therapy type, nor between the use of fresh and cryo-stored stool suspension. No unexpected adverse events or lethality occurred in the study period. Conclusions: Fecal bacteriotherapy is a successful therapeutic alternative for recurrent Clostridium difficile infections, recommended by international professional organizations. |