Meighani Alireza, Alimirah Maryam, Ramesh Mayur, Salgia Reena
Division of Gastroenterology and Hepatology, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USA.
Department of Internal Medicine, Henry Ford Hospital, 2799 W. Grand Blvd, Detroit, MI 48202, USA.
Int J Hepatol. 2020 Jan 27;2020:1874570. doi: 10.1155/2020/1874570. eCollection 2020.
Fecal microbiota transplantation (FMT) is a well-established therapeutic option for patients with antibiotic resistant infection (CDI). However, the efficacy of FMT in patients with chronic liver disease remains elusive.
We studied the effect of FMT on chronic liver disease (CLD) patients with CDI at our tertiary medical center.
A cohort of all patients who received FMT from December 2012 to May 2014 for refractory or recurrent CDI was identified. Patients were monitored for a year after FMT. Descriptive analysis was conducted to compare the effect of FMT in patients with and without CLD.
A total of 201 patients with CDI received FMT, 14 of which had a history of CLD. Nine of these patients exhibited cirrhosis of the liver with a mean Child-Turcotte-Pugh score of 8. CDI development in these patients was associated with recent exposure to antibiotics and was observed to be significantly different between both groups (17% of CLD patients vs. 58% in the general cohort, = 0.01). Four patients with CLD received >1 FMT, of which 2 did not respond to treatment. There was no significant difference between patients with liver disease and the rest of the cohort with regard to FMT response (12/14 (87%) vs. 164/187 (88%), = 0.01). Four patients with CLD received >1 FMT, of which 2 did not respond to treatment. There was no significant difference between patients with liver disease and the rest of the cohort with regard to FMT response (12/14 (87%) vs. 164/187 (88%).
FMT is a safe and effective therapy against CDI for patients with CLD and cirrhosis.
粪便微生物群移植（FMT）是治疗抗生素耐药性感染（CDI）患者的一种成熟治疗选择。然而，FMT对慢性肝病患者的疗效仍不明确。
我们在我们的三级医疗中心研究了FMT对患有CDI的慢性肝病（CLD）患者的影响。
确定了一组在2012年12月至2014年5月期间因难治性或复发性CDI接受FMT的所有患者。患者在FMT后接受了一年的监测。进行描述性分析以比较FMT对有和没有CLD的患者的影响。
共有201例CDI患者接受了FMT，其中14例有CLD病史。这些患者中有9例表现为肝硬化，平均Child-Turcotte-Pugh评分为8分。这些患者中CDI的发生与近期接触抗生素有关，并且在两组之间观察到显著差异（CLD患者为17%，而一般队列中为58%，P = 0.01）。4例CLD患者接受了>1次FMT，其中2例对治疗无反应。肝病患者与队列中的其他患者在FMT反应方面没有显著差异（12/14（87%）对164/187（88%），P = 0.01）。4例CLD患者接受了>1次FMT，其中2例对治疗无反应。肝病患者与队列中的其他患者在FMT反应方面没有显著差异（12/14（87%）对164/187（88%）。
FMT是治疗CLD和肝硬化患者CDI的一种安全有效的疗法。
