Department of Medical Microbiology and Immunology, University of Pécs Clinical Centre, Pécs, Hungary.
1stDepartment of Internal Medicine - Department of Infectology, University of Pécs Clinical Centre, Pécs, Hungary.
Front Cell Infect Microbiol. 2021 Jun 4;11:657320. doi: 10.3389/fcimb.2021.657320. eCollection 2021.
Metronidazol and vancomycin were long the two best options against (formerly ) infections (CDI). Now, the cost of new drugs such as fidaxomicin directs us towards alternative treatment options, such as faecal microbiota transplant (FMT). Its effectiveness is similar to fidaxomicin. There are questions regarding its safety, but the biggest challenges are prejudice and inconvenience. Most protocols refer to FMT applied in the form of a solution. We investigated different modalities of FMT.
Instead of using nasoenteric tubes or colonoscopy, we place frozen or lyophilised stool in non-coated, size "00", hard gelatine capsules or enterosolvent, size "0" capsules.
We found that non-coated, size "00", hard gelatine capsules are appropriate for conducting FMT. Capsules containing lyophilised supernatant with a low number of bacteria have been proven to be non-inferior to other FMT modalities. The primary cure rate in the supernatant group was 93.75%, and 66.67% in the sediment group. The overall cure rate was 82.14%. Depending on the protocol, 4-7 capsules are sufficient per patient. Capsules can be stored for up to one year at -20°C.
FMT is a feasible alternative to antibiotic treatments in CDI. Our method makes the process flexible and less inconvenient to patients. Long storage time allows a consistent supply of capsules, while small volume and formulation make the procedure tolerable.
甲硝唑和万古霉素长期以来一直是治疗 （前） 感染（CDI）的两种最佳选择。现在，像非达霉素这样的新药的成本促使我们转向替代治疗方案，如粪便微生物群移植（FMT）。它的有效性与非达霉素相似。关于其安全性存在一些问题，但最大的挑战是偏见和不便。大多数方案都提到了以溶液形式应用的 FMT。我们调查了 FMT 的不同方式。
我们没有使用鼻肠管或结肠镜检查，而是将冷冻或冻干的粪便放入无涂层、大小为“00”的硬明胶胶囊或肠溶、大小为“0”的胶囊中。
我们发现无涂层、大小为“00”的硬明胶胶囊适合进行 FMT。含有细菌数量低的冻干上清液的胶囊已被证明与其他 FMT 方式一样有效。上清液组的主要治愈率为 93.75%，沉淀物组为 66.67%。总体治愈率为 82.14%。根据方案，每个患者需要 4-7 个胶囊。胶囊可在-20°C 下储存长达一年。
FMT 是 CDI 抗生素治疗的可行替代方案。我们的方法使该过程对患者更灵活且不便。较长的储存时间允许持续供应胶囊，而较小的体积和配方使该过程更耐受。
