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Risk Factors for Antibiotic Exposure Post-Fecal Microbiota Transplantation for Recurrent Infection: A Prospective Multicenter Observational Study.

作者信息

Hirsch William, Fischer Monika, Khoruts Alexander, Allegretti Jessica R, Kelly Colleen R, Vaughn Byron

机构信息

Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.

Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University, Indianapolis, Indiana, USA.

出版信息

Open Forum Infect Dis. 2025 Mar 7;12(3):ofaf130. doi: 10.1093/ofid/ofaf130. eCollection 2025 Mar.


DOI:10.1093/ofid/ofaf130
PMID:40103733
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11913780/
Abstract

BACKGROUND: Recurrent infection (CDI) is primarily driven by antibiotic-induced disruption of the indigenous intestinal microbiota. Restoration of microbiota through fecal microbiota transplantation (FMT) is effective in preventing subsequent CDI, although this effect is attenuated with additional antibiotic exposure. The aim of this study was to identify the risk factors for recurrent antibiotic administration after FMT. METHODS: This is a prospective cohort of patients who were administered FMT for recurrent CDI from 1 July 2019 through 23 November 2023 across 6 institutions in the United States. Providers collected de-identified data at the time of FMT administration and in the months post-FMT administration. RESULTS: The analysis included 448 patients. Risk factors for non-CDI antibiotic administration within 2 months of FMT included immunocompromised status (odds ratio [OR], 2.2 [95% confidence interval {CI}, 1.1-4.4]; = .02), >3 non-CDI antibiotic courses pre-FMT (OR, 3.1 [95% CI, 1.4-6.8]; = .006), and prior hospitalization for CDI (OR, 2.0 [95% CI, 1.1-3.8]; = .02). The most common indications for non-CDI antibiotic administration post-FMT were urinary tract infections, respiratory infections, and procedure prophylaxis. CONCLUSIONS: Non-CDI antibiotic exposure significantly increases the risk of CDI recurrence post-FMT. Risk factors for non-CDI antibiotic administration within 2 months of FMT include immunocompromised status, multiple prior non-CDI antibiotics, and prior hospitalization for CDI. These individuals may benefit from additional or modified recurrent CDI prevention strategies.

摘要

相似文献

[1]
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[6]
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本文引用的文献

[1]
infection: history, epidemiology, risk factors, prevention, clinical manifestations, treatment, and future options.

Clin Microbiol Rev. 2024-6-13

[2]
A Systematic Literature Review on Risk Factors for and Timing of Clostridioides difficile Infection in the United States.

Infect Dis Ther. 2024-2

[3]
Antimicrobial Stewardship in Immunocompromised Patients: Current State and Future Opportunities.

Infect Dis Clin North Am. 2023-12

[4]
Fecal microbiota transplantation for the treatment of recurrent Clostridioides difficile (Clostridium difficile).

Cochrane Database Syst Rev. 2023-4-25

[5]
Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent infection.

Gut Microbes. 2022

[6]
Effectiveness and Safety of Colonic and Capsule Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection.

Clin Gastroenterol Hepatol. 2023-5

[7]
Variability of strain engraftment and predictability of microbiome composition after fecal microbiota transplantation across different diseases.

Nat Med. 2022-9

[8]
Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults.

Clin Infect Dis. 2021-9-7

[9]
ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections.

Am J Gastroenterol. 2021-6-1

[10]
Oral Fecal Microbiota Transplant Capsules Are Safe and Effective for Recurrent Clostridioides difficile Infection: A Systematic Review and Meta-Analysis.

J Clin Gastroenterol. 2021-4-1

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