University of Mississippi Medical Center, Jackson, MS, USA.
Detroit Medical Center, Detroit, MI, USA.
J Hosp Infect. 2020 Dec;106(4):643-648. doi: 10.1016/j.jhin.2020.09.027. Epub 2020 Sep 28.
Recurrent Clostridioides difficile infection (CDI) is one of the most common and challenging infections to treat in healthcare facilities. Faecal microbiota transplantation (FMT) is recommended as a definitive treatment option.
We performed a retrospective review of 50 patients from January 2015 to December 2019 who underwent FMT for recurrent CDI. Primary outcome was recurrence of CDI within 12-weeks of FMT and secondary outcomes were the need for repeat FMT, serious adverse outcomes related to FMT and all-cause mortality.
Fifty charts were reviewed, of which 47 cases comprising 17 immunocompromised patients treated with FMT via retention enema were included in the study. The majority of the patients had ≥3 recurrent CDIs (62%). Nine (19%) patients failed to respond to the first FMT and five underwent repeat FMT within four to 12 weeks. The cure rate was 81% after the first FMT (38/47) and 91% after the second FMT treatment (43/47). Serious adverse events occurred in 2% and all-cause mortality was 2% at 90-day follow up.
Our study demonstrated the safety and efficacy of FMT administered via retention enema, a simple bedside procedure, for the treatment and prevention of recurrent non-severe and severe CDI with an overall cure rate of 91%.
复发性艰难梭菌感染（CDI）是医疗机构中最常见且最具挑战性的感染之一。粪便微生物群移植（FMT）被推荐为一种明确的治疗选择。
我们对 2015 年 1 月至 2019 年 12 月期间接受 FMT 治疗复发性 CDI 的 50 名患者进行了回顾性研究。主要结局是 FMT 后 12 周内 CDI 的复发，次要结局是需要重复 FMT、与 FMT 相关的严重不良结局以及全因死亡率。
共回顾了 50 份图表，其中包括 47 例病例，这些病例中有 17 例免疫功能低下的患者通过保留灌肠接受了 FMT 治疗。大多数患者有≥3 次复发性 CDI（62%）。9 例（19%）患者对首次 FMT 无反应，5 例患者在 4 至 12 周内进行了重复 FMT。首次 FMT 后的治愈率为 81%（38/47），第二次 FMT 后的治愈率为 91%（43/47）。严重不良事件发生率为 2%，90 天随访时的全因死亡率为 2%。
我们的研究表明，保留灌肠是一种简单的床边操作，通过保留灌肠进行 FMT 治疗和预防非严重和严重复发性 CDI 是安全有效的，总体治愈率为 91%。
