Benech Nicolas, Cassir Nadim, Alric Laurent, Barbut Frédéric, Batista Rui, Bleibtreu Alexandre, Briot Thomas, Davido Benjamin, Galperine Tatiana, Joly Anne-Christine, Kapel Nathalie, Melchior Chloé, Mosca Alexis, Nebbad Biba, Pigneur Bénédicte, Schneider Stéphane M, Wasiak Mathieu, Scanzi Julien, Sokol Harry
French Faecal Transplant Group (GFTF), France.
Hepato-Gastroenterology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France.
Aliment Pharmacol Ther. 2025 Jan;61(1):159-167. doi: 10.1111/apt.18330. Epub 2024 Oct 10.
Detailed comparative assessment of procedure-related factors associated with faecal microbiota transplantation (FMT) efficacy in Clostridioides difficile infection (CDI) is limited.
We took advantage of the differences in procedures at the various French FMT centres to determine clinical and procedure-related factors associated with FMT success in CDI.
We performed a nationwide retrospective multicentre cohort study. All FMTs performed within The French Faecal Transplant Group for CDI from 2018 to 2022 were included. Clinical data were collected retrospectively from recipient medical files, characteristics of stool transplant preparations were prospectively collected by each Pharmacy involved. Univariate and multivariate analyses were performed using Fisher's test and multiple logistic regression.
Six hundred fifty-eight FMTs were performed for 617 patients in 17 centres. The overall efficacy of FMT was 84.3% (520/617), with 0.5% of severe adverse events possibly related to FMT (3/658). Forty-seven patients were treated at the first recurrence of CDI with a similar success rate (85.1%). Severe chronic kidney disease (CKD; OR: 2.18, 95%CI [1.20-3.88]), non-severe refractory CDI (OR: 15.35, [1.94-318.2]), the use of ≥ 80% glycerol (OR: 2.52, [1.11-5.67]), insufficient bowel cleansing (OR: 5.47, [1.57-20.03]) and partial FMT retention (OR: 9.97, [2.62-48.49]) were associated with CDI recurrence within 8 weeks.
Conditions of transplant manufacturing, bowel cleansing, and a route of delivery tailored to the patient's characteristics are key factors in optimising FMT efficacy. FMT at first recurrence showed high success in real-life practice, whereas it had lower efficacy in severe CDI and non-severe refractory CDI.
关于艰难梭菌感染（CDI）中与粪便微生物群移植（FMT）疗效相关的操作因素的详细比较评估有限。
我们利用法国各FMT中心操作的差异，以确定与CDI中FMT成功相关的临床和操作因素。
我们进行了一项全国性回顾性多中心队列研究。纳入了2018年至2022年在法国粪便移植组内进行的所有用于CDI的FMT。临床数据从接受者的医疗档案中回顾性收集，粪便移植制剂的特征由各参与药房前瞻性收集。使用Fisher检验和多重逻辑回归进行单变量和多变量分析。
17个中心为617例患者进行了658次FMT。FMT的总体疗效为84.3%（520/617），0.5%的严重不良事件可能与FMT相关（3/658）。47例患者在CDI首次复发时接受治疗，成功率相似（85.1%）。严重慢性肾病（CKD；比值比：2.18，95%置信区间[1.20 - 3.88]）、非严重难治性CDI（比值比：15.35，[1.94 - 318.2]）、使用≥80%甘油（比值比：2.
