Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong.
Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.
Hong Kong Med J. 2019 Jun;25(3):178-182. doi: 10.12809/hkmj197855. Epub 2019 May 29.
infection (CDI) is a leading cause of healthcare-associated infection globally, causing significant morbidity and mortality. Faecal microbiota transplantation (FMT) has emerged as a promising option for recurrent and refractory CDI. This study aimed to assess the safety, efficacy, and feasibility of FMT for CDI in Hong Kong.
We conducted a single-centre, retrospective study for all consecutive cases of recurrent or refractory CDI who underwent FMT from 2013 to 2018. Clinical demographics, outcome, and safety parameters were collected.
A total of 24 patients with recurrent or refractory CDI (median age 70 years, interquartile range=45.0-78.3 years; 67% male) were included. Over 80% had been recently hospitalised or were long-term care facility residents. Faecal microbiota transplantation was delivered by feeding tube in 11 (45.8%), oesophagogastroduodenoscopy in eight (33.3%), and colonoscopy in six (25%) of the patients. Resolution of diarrhoea without relapse within 8 weeks was achieved in 21 out of 24 patients (87.5%) after FMT. No deaths occurred within 30 days. The FMT was well tolerated and no serious adverse events attributable to FMT were reported.
Our results confirm that FMT is a safe, efficacious, and feasible intervention for patients with refractory or recurrent CDI in Hong Kong. Given the increasing disease burden and the lack of effective alternatives in Hong Kong for difficult-to-treat cases of CDI, we recommend that a territory-wide FMT service be established to address increasing demand for this treatment.
感染（CDI）是全球医疗相关感染的主要原因，导致了大量的发病率和死亡率。粪便微生物群移植（FMT）已成为复发性和难治性 CDI 的一种有前途的选择。本研究旨在评估 FMT 在香港治疗 CDI 的安全性、疗效和可行性。
我们对 2013 年至 2018 年期间接受 FMT 的所有复发性或难治性 CDI 连续病例进行了一项单中心回顾性研究。收集了临床人口统计学、结局和安全性参数。
共纳入 24 例复发性或难治性 CDI 患者（中位年龄 70 岁，四分位距=45.0-78.3 岁；67%为男性）。超过 80%的患者最近住院或长期护理机构居住。11 例（45.8%）通过喂养管、8 例（33.3%）通过上消化道内镜、6 例（25%）通过结肠镜进行粪便微生物群移植。24 例患者中有 21 例（87.5%）在 FMT 后 8 周内腹泻缓解且无复发。30 天内无死亡病例。FMT 耐受良好，未报告与 FMT 相关的严重不良事件。
我们的结果证实，FMT 是治疗香港难治性或复发性 CDI 患者的一种安全、有效且可行的干预措施。鉴于该病在香港的疾病负担不断增加，且对 CDI 治疗困难的病例缺乏有效替代方法，我们建议建立全港性的 FMT 服务，以满足对这种治疗方法日益增长的需求。
