Fecal microbiota transplantation for recurrent Clostridium difficile infection: Experience, protocol, and results.

Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent Clostridium difficile infection (R-CDI). Despite its excellent efficacy, it is still not a routine procedure in most European centers. FMT has not been widely used in Spain to date. We describe our experience with FMT, including a novel approach based on oral fecal capsules. We analyzed a prospectively recorded case series of patients with R-CDI treated with FMT at a single center (June 2014-July 2017). Primary outcome was defined as resolution of CDI without recurrence in a two-month period. FMT was administered via colonoscopy, nasojejunal tube, or oral capsules. All stool donors were rigorously screened. FMT was performed in 13 patients with R-CDI. Median age was 75.0 years and 76.9% were females. Six FMT were performed via nasojejunal tube, 5 via oral capsules, and 2 by colonoscopy. There were no procedure-related adverse events, except for bacteremia in one patient. During follow-up, R- CDI was observed in one patient at one month after FMT. The primary resolution rate was 83.3% and the overall resolution rate was 91.7%. FMT by capsules achieved a 100% resolution rate, colonoscopy 100%, and nasojejunal tube 80.0%. In our cohort, FMT proved to be safe and effective, even in high risk patients. Oral administration in capsules also proved to be safe, well-tolerated, and highly effective for R-CDI. In our experience, the FMT capsule formulation seems feasible in the routine of a hospital. This administration method will allow FMT to be more widely used.

Reigadas E ，Olmedo M ，Valerio M ，Vázquez-Cuesta S ，Alcalá L ，Marín M ，Muñoz P ，Bouza E ... -  《-》

Faecal microbiota transplantation for recurrent Clostridioides difficile infection: experience with lyophilized oral capsules.

Faecal microbiota transplantation (FMT) is a highly effective approach for refractory and recurrent Clostridioides difficile infection (CDI). Despite its excellent efficacy, FMT is not yet a routine procedure in most centres. There is very little experience with FMT based on lyophilized capsules, and data from European institutions are lacking. This article describes our experience with FMT to treat recurrent CDI using lyophilized oral capsules. A prospectively recorded single-centre case series of patients with recurrent CDI who underwent FMT between January 2018 and May 2019 were analysed. The primary outcome was defined as resolution of CDI without recurrences over a two-month period. Overall resolution was defined as resolution of diarrhoea without recurrence of CDI within two months after a further cycle of FMT. The FMT process involved oral ingestion of four or five lyophilized capsules in a single dose. All stool donors were rigorously screened. FMT was performed in 32 patients. Primary cure was achieved in 81.3% of patients, and the overall cure rate was 87.5%. FMT via lyophilized capsules was well tolerated. No FMT procedure-related adverse events and no further complications were observed for lyophilized-capsule FMT. This initial clinical experience suggests that FMT based on oral lyophilized preparations is a safe, well-tolerated, and highly effective treatment for recurrent CDI. Administration of oral lyophilized capsules seems feasible in hospital routine and will enable FMT to be more widely used.

Reigadas E ，Bouza E ，Olmedo M ，Vázquez-Cuesta S ，Villar-Gómara L ，Alcalá L ，Marín M ，Rodríguez-Fernández S ，Valerio M ，Muñoz P ... -  《-》

Oral, frozen fecal microbiota transplant (FMT) capsules for recurrent Clostridium difficile infection.

Youngster I ，Mahabamunuge J ，Systrom HK ，Sauk J ，Khalili H ，Levin J ，Kaplan JL ，Hohmann EL ... -  《BMC Medicine》

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

Bang BW ，Park JS ，Kim HK ，Shin YW ，Kwon KS ，Kwon HY ，Baek JH ，Lee JS ... -  《-》

Five years of fecal microbiota transplantation - an update of the Israeli experience.

Greenberg SA ，Youngster I ，Cohen NA ，Livovsky DM ，Strahilevitz J ，Israeli E ，Melzer E ，Paz K ，Fliss-Isakov N ，Maharshak N ... -  《-》