Hospitalized Older Patients with <i>Clostridioides difficile</i> Infection Refractory to Conventional Antibiotic Therapy Benefit from Fecal Microbiota Transplant-Advances in Geriatric Medicine and Research-CSCIED科技核心评价数据库-手机版

Hospitalized Older Patients with Clostridioides difficile Infection Refractory to Conventional Antibiotic Therapy Benefit from Fecal Microbiota Transplant

Hospitalized Older Patients with Clostridioides difficile Infection Refractory to Conventional Antibiotic Therapy Benefit from Fecal Microbiota Transplant

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DOI	10.20900/agmr20210012
刊名	Advances in Geriatric Medicine and Research AGMR
年，卷(期)	2021, 3(2)
作者	Jae Hyun Shin*,Rachel Ann Hays,Cirle Alcantara Warren,
作者单位	Division of Infectious Diseases and International Health, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA ; Division of Gastroenterology and Hepatology, Department of Medicine, School of Medicine, University of Virginia, Charlottesville, VA 22903, USA ;
Abstract	Background: Options for Clostridioides difficile infection (CDI) refractory to conventional therapy are limited. Fecal microbiota transplant (FMT) is considered safe and effective treatment for recurrent CDI and could be a treatment option for refractory CDI. We investigated the efficacy and safety of FMT in hospitalized patients who were not responding to standard treatments for CDI.Methods: Electronic medical records of patients who received FMT inpatient for refractory CDI were reviewed as part of quality improvement efforts to evaluate safety and efficacy of FMT in inpatient setting.Results: Between July 2014 and December 2019, 9 patients (age 60–96) received FMT for CDI as inpatient for refractory or fulminant CDI. Most (7 of 9) of these patients had pseudomembranous colitis and underwent multiple FMTs (mean 2.15, range 1 to 3). Five patients had complete resolution and one patient had diarrhea that was C. difficile-negative. There was one recurrent CDI and two deaths, one of which may have been related to FMT or CDI. Compared to recurrent CDI at diagnosis, patients with refractory CDI had higher WBC and neutrophil counts, which decreased after FMT. The overall cure rate of FMT in refractory cases was 66.7%.Conclusions: This study shows moderate efficacy of FMT for treatment of refractory CDI although multiple FMT treatment may need to be administered in the presence of pseudomembranous colitis. Inpatient FMT may be an alternative strategy for managing refractory CDI in this population of patients who may not have any effective medical treatment available.
KeyWord	fecal microbiota transplant; Clostridioides difficile; refractory C. difficile; fulminant C. difficile
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Jae Hyun Shin*,Rachel Ann Hays,Cirle Alcantara Warren. Hospitalized Older Patients with Clostridioides difficile Infection Refractory to Conventional Antibiotic Therapy Benefit from Fecal Microbiota Transplant, Advances in Geriatric Medicine and Research. 2021; 3; (2). https://doi.org/10.20900/agmr20210012.

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