Fecal Microbiota Transplantation for Refractory and Recurrent Clostridium difficile Infection: A Case Series of Nine Patients

Korean J Gastroenterol. 2017 Apr 25;69(4):226-231. doi: 10.4166/kjg.2017.69.4.226.

Abstract

Background/aims: Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI.

Methods: We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission.

Results: FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics.

Conclusions: FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.

Keywords: Clostridium difficile; Colonoscopy; Fecal microbiota transplantation; Gastrointestinal microbiome.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Clostridium Infections / diagnosis
  • Clostridium Infections / drug therapy
  • Clostridium Infections / therapy*
  • Colonoscopy
  • Duodenoscopy
  • Enterocolitis, Pseudomembranous / diagnosis
  • Enterocolitis, Pseudomembranous / drug therapy
  • Enterocolitis, Pseudomembranous / therapy*
  • Fecal Microbiota Transplantation* / adverse effects
  • Feces / microbiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pneumonia, Aspiration / etiology
  • Recurrence

Substances

  • Anti-Bacterial Agents