Gholam-Mostafaei Fahimeh Sadat, Yadegar Abbas, Asadzadeh Aghdaei Hamid, Shahrokh Shabnam, Ebrahimi Daryani Nasser, Zali Mohammad Reza
1Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Acta Microbiol Immunol Hung. 2021 Aug 6. doi: 10.1556/030.2021.01498.
Treatment of recurrent Clostridioides difficile infection (rCDI) has emerged as an important management dilemma particularly in patients with underlying inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) has been used as a safe and highly effective treatment option for rCDI refractory to standard antibiotic therapies. The aim of this study was to report the efficacy of FMT in Iranian rCDI patients with concurrent IBD. A total of seven consecutive patients with ulcerative colitis (UC) who had experienced 3 episodes of rCDI were enrolled in this study. All patients received at least a single FMT administered during colonoscopy by direct infusion of minimally processed donor stool. Patients were followed for a minimum of 6 months for assessment of treatment efficacy and adverse events (AEs) attributable to FMT. All 7 UC patients (100%) experienced a durable clinical response to a single FMT following 2 months after the procedure. One patient received a second FMT in which a successful resolution of rCDI was ultimately achieved. No serious AEs from FMT were noted. FMT through colonoscopy was a safe, simple and effective alternative treatment approach for rCDI in patients with underlying IBD. However, its use and efficacy should be pursued in long-term prospective controlled trials.
复发性艰难梭菌感染(rCDI)的治疗已成为一个重要的管理难题,尤其是在患有潜在炎症性肠病(IBD)的患者中。粪便微生物群移植(FMT)已被用作对标准抗生素治疗难治的rCDI的一种安全且高效的治疗选择。本研究的目的是报告FMT对并发IBD的伊朗rCDI患者的疗效。共有7例连续的溃疡性结肠炎(UC)患者,他们经历了3次rCDI发作,被纳入本研究。所有患者在结肠镜检查期间通过直接输注最少处理的供体粪便接受了至少一次FMT。对患者进行了至少6个月的随访,以评估治疗效果和归因于FMT的不良事件(AE)。所有7例UC患者(100%)在手术后2个月接受单次FMT后均经历了持久的临床反应。1例患者接受了第二次FMT,最终成功解决了rCDI。未观察到FMT引起的严重AE。通过结肠镜检查进行FMT是一种安全、简单且有效的替代治疗方法,用于患有潜在IBD的rCDI患者。然而,其使用和疗效应在长期前瞻性对照试验中进行研究。