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粪便微生物群移植治疗多重合并症患者的复发性感染:来自三级医疗社区医院的长期安全性和有效性结果

Fecal Microbiota Transplantation for Recurrent Infection in Patients With Multiple Comorbidities: Long-Term Safety and Efficacy Results From a Tertiary Care Community Hospital.

作者信息

Raghu Subramanian Charumathi, Talluri Swapna, Khan Safi Ullah, Katz Jeffry A, Georgetson Michael, Sinh Preetika

机构信息

Department of Medicine, Guthrie Clinic/Robert Packer Hospital, Sayre, PA, USA.

Washington Hospital Healthcare System, Fremont, CA, USA.

出版信息

Gastroenterology Res. 2020 Aug;13(4):138-145. doi: 10.14740/gr1275. Epub 2020 Aug 14.

DOI:10.14740/gr1275
PMID:32864024
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7433372/
Abstract

BACKGROUND

Cure rates of infection (CDI) with fecal microbiota transplant (FMT) have been promising. However, there is debate regarding success of FMT in patients with comorbidities.

METHODS

Electronic chart review was done to collect data on patients who underwent FMT from January 2015 to August 2017. Charts were analyzed in November 2018 with a median follow-up of 25.4 months (interquartile range 20 - 31 months).

RESULTS

Twenty patients underwent FMT. The primary success rate at our institution was 90% and overall success rate was 100%. Six patients (43%) had FMT failure (two early and four late).

CONCLUSIONS

This case series is a description of our center's initial experience with FMT for treatment of recurrent CDI. Our high success rate reiterates the efficacy and safety of FMT in this population including patients with comorbidities.

摘要

背景

粪便微生物群移植(FMT)治疗艰难梭菌感染(CDI)的治愈率很可观。然而,对于合并症患者FMT的成功率存在争议。

方法

进行电子病历回顾,以收集2015年1月至2017年8月接受FMT患者的数据。2018年11月分析病历,中位随访时间为25.4个月(四分位间距20 - 31个月)。

结果

20例患者接受了FMT。我们机构的主要成功率为90%,总体成功率为100%。6例患者(43%)FMT失败(2例早期失败和4例晚期失败)。

结论

本病例系列描述了我们中心用FMT治疗复发性CDI的初步经验。我们的高成功率重申了FMT在包括合并症患者在内的这一人群中的有效性和安全性。

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本文引用的文献

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The Super-Donor Phenomenon in Fecal Microbiota Transplantation.粪便微生物移植中的超级供体现象。
Front Cell Infect Microbiol. 2019 Jan 21;9:2. doi: 10.3389/fcimb.2019.00002. eCollection 2019.
2
Long-Term Safety and Efficacy of Fecal Microbiota Transplantation in the Treatment of Infection in Patients With and Without Inflammatory Bowel Disease: A Tertiary Care Center's Experience.粪便微生物群移植治疗炎症性肠病患者和非炎症性肠病患者感染的长期安全性和有效性:一家三级护理中心的经验
Gastroenterology Res. 2018 Dec;11(6):397-403. doi: 10.14740/gr1091. Epub 2018 Dec 17.
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A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Infection in Immunocompromised Patients.
免疫功能低下患者感染粪菌移植的疗效和安全性的系统评价。
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Fecal microbiota transplantation for recurrent Clostridium difficile infection: Experience, protocol, and results.粪便微生物群移植治疗复发性艰难梭菌感染:经验、方案及结果
Rev Esp Quimioter. 2018 Oct;31(5):411-418. Epub 2018 Sep 14.
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Fecal microbiota transplantation: Review and update.粪便微生物群移植:综述与更新。
J Formos Med Assoc. 2019 Mar;118 Suppl 1:S23-S31. doi: 10.1016/j.jfma.2018.08.011. Epub 2018 Sep 1.
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Comparing fecal microbiota transplantation to standard-of-care treatment for recurrent Clostridium difficile infection: a systematic review and meta-analysis.比较粪便微生物群移植与复发性艰难梭菌感染的标准治疗:一项系统评价和荟萃分析。
Eur J Gastroenterol Hepatol. 2018 Nov;30(11):1309-1317. doi: 10.1097/MEG.0000000000001243.
7
Early Results of Fecal Microbial Transplantation Protocol Implementation at a Community-based University Hospital.在一家社区大学医院实施粪便微生物移植方案的早期结果。
J Glob Infect Dis. 2018 Apr-Jun;10(2):47-57. doi: 10.4103/jgid.jgid_145_17.
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Results From a Randomized, Placebo-Controlled Clinical Trial of a RBX2660-A Microbiota-Based Drug for the Prevention of Recurrent Clostridium difficile Infection.RBX2660-A 基于微生物组的药物预防复发性艰难梭菌感染的随机、安慰剂对照临床试验结果。
Clin Infect Dis. 2018 Sep 28;67(8):1198-1204. doi: 10.1093/cid/ciy259.
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Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).临床实践指南:成人和儿童艰难梭菌感染:美国传染病学会(IDSA)和美国医疗保健流行病学学会(SHEA) 2017 年更新。
Clin Infect Dis. 2018 Mar 19;66(7):e1-e48. doi: 10.1093/cid/cix1085.
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