Department of Gastroenterology, Päijät-Häme Central Hospital, Lahti 15850, Finland.
Department of Infectious Diseases, Helsinki University Hospital, Helsinki 00029, Finland.
World J Gastroenterol. 2017 Oct 21;23(39):7174-7184. doi: 10.3748/wjg.v23.i39.7174.
Fecal microbiota transplantation (FMT) is effective in recurrent infection (rCDI). Knowledge of the safety and efficacy of FMT treatment in immune deficient patients is scarce. FMT has been suggested as a potential method for an increasing number of new indications besides rCDI. Among our FMT-treated rCDI patients, we reviewed those with major comorbidities: two human immunodeficiency virus patients, six haemodialysis patients, two kidney transplant patients, two liver transplant patients and a patient with chronic lymphatic leukaemia. We also reviewed those treated with FMT for indications other than rCDI: carriage (two patients), trimethylaminuria (two patients), small intestinal bacterial overgrowth (SIBO; one patient), and lymphocytic colitis (one patient), as well as a common variable immunodeficiency patient with chronic norovirus infection and ESBL-producing () carriage. Of the thirteen rCDI patients treated with FMT, eleven cleared the CDI. The observed adverse events were not directly attributable to FMT. Concerning the special indications, both and ESBL-producing were eradicated. One trimethylaminuria patient and one SIBO-patient reported a reduction of symptoms. Three patients did not experience a benefit from FMT: chronic norovirus, lymphocytic colitis and the other fish malodour syndrome. There were no reported side effects in this group. FMT appeared to be safe and effective for immunocompromised patients with rCDI. FMT showed promise for the eradication of antibiotic-resistant bacteria, but further research is warranted.
粪便微生物群移植(FMT)在复发性感染(rCDI)中有效。关于免疫功能低下患者 FMT 治疗的安全性和有效性的知识很少。除 rCDI 外,FMT 已被提议作为越来越多新适应症的潜在方法。在我们接受 FMT 治疗的 rCDI 患者中,我们回顾了那些患有主要合并症的患者:两名艾滋病毒患者、六名血液透析患者、两名肾移植患者、两名肝移植患者和一名慢性淋巴细胞白血病患者。我们还回顾了那些接受 FMT 治疗 rCDI 以外适应症的患者:携带(两名患者)、三甲胺尿症(两名患者)、小肠细菌过度生长(SIBO;一名患者)和淋巴细胞性结肠炎(一名患者),以及一名患有慢性诺如病毒感染和产 ESBL 的 携带的常见可变免疫缺陷患者。在接受 FMT 治疗的 13 名 rCDI 患者中,有 11 名清除了 CDI。观察到的不良事件与 FMT 无关。关于特殊适应症,均根除了 和产 ESBL 的 。一名三甲胺尿症患者和一名 SIBO 患者报告症状减轻。三名患者未从 FMT 中获益:慢性诺如病毒、淋巴细胞性结肠炎和另一种鱼臭味综合征。该组未报告任何副作用。FMT 似乎对患有 rCDI 的免疫功能低下患者是安全且有效的。FMT 显示出根除抗生素耐药菌的潜力,但需要进一步研究。