Urbonas Tadas, Petrauskas Dalius, Kiudelis Vytautas, Jonaitis Laimas, Skieceviciene Jurgita, Gedgaudas Rolandas, Kiudeliene Edita, Valantiene Irena, Zykus Romanas, Varkalaite Greta, Inciuraite Ruta, Trapenske Elzbieta, Kulokiene Ugne, Jonaitis Paulius, Ramonaite Rima, Velickiene Justina, Zvirbliene Aida, Morkunas Egidijus, Kuliaviene Irma, Sumskiene Jolanta, Adamonis Kestutis, Macas Andrius, Kupcinskiene Kristina, Lukosiene Laura, Janciauskas Dainius, Poskiene Lina, Vitkauskiene Astra, Ianiro Gianluca, Gasbarrini Antonio, Kiudelis Gediminas, Kupcinskas Juozas
Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas; Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
J Gastrointestin Liver Dis. 2025 Jun 28;34(2):199-204. doi: 10.15403/jgld-5990.
Fecal microbiota transplantation is an effective treatment method for recurrent Clostridioides difficile infection. Widely used enteric tube and colonoscopy methods demonstrate excellent efficacy and safety results. Recent data suggest that new fecal microbiota transplantation methods using oral capsules may provide a less invasive approach. In this study, we aimed to compare primary fecal microbiota transplantation efficacy as well as short- and long-term safety of two different administration routes: oral capsules and enteric tube.
This retrospective study included 60 consecutive patients who underwent fecal microbiota transplantation for recurrent Clostridioides difficile infection. Thirty participants received 50 oral capsules containing frozen material for a single day and 30 patients received fecal microbiota transplantation via nasoenteric tube. All patients received standard treatment with oral vancomycin 500 mg q.i.d. for at least five days before the procedure. After intervention, patients were followed up for at least six months. Data on Clostridioides difficile infection recurrences and health status were collected and analyzed.
The oral capsules group consisted of 30 patients. Among them, 22 (73.3%) participants experienced resolution of symptoms after a single fecal microbiota transplantation, while eight (26.7%) patients developed recurrent diarrhea within eight weeks. The other 30 patients received treatment via nasoenteric tube. Among them, 24 (80%) patients were cured after a single fecal microbiota transplantation, while six (20%) experienced recurrent disease within eight weeks. The primary efficacy did not show significant differences between the two groups (p=0.85). Throughout the follow-up period, no serious adverse events or fecal microbiota transplantation related deaths were reported in both groups.
Fecal microbiota transplantation with frozen oral capsules is a safe, less invasive method with comparable efficacy to nasoenteric administration route.
粪便微生物群移植是复发性艰难梭菌感染的一种有效治疗方法。广泛使用的肠内导管和结肠镜检查方法显示出优异的疗效和安全性结果。近期数据表明，使用口服胶囊的新型粪便微生物群移植方法可能提供一种侵入性较小的途径。在本研究中，我们旨在比较两种不同给药途径（口服胶囊和肠内导管）的初次粪便微生物群移植疗效以及短期和长期安全性。
这项回顾性研究纳入了60例因复发性艰难梭菌感染接受粪便微生物群移植的连续患者。30名参与者一天内接受50粒含有冷冻材料的口服胶囊，30名患者通过鼻肠管接受粪便微生物群移植。所有患者在手术前至少五天接受口服万古霉素500毫克每日四次的标准治疗。干预后，对患者进行至少六个月的随访。收集并分析艰难梭菌感染复发和健康状况的数据。
口服胶囊组有30名患者。其中，22名（73.3%）参与者在单次粪便微生物群移植后症状得到缓解，而8名（26.7%）患者在八周内出现复发性腹泻。另外30名患者通过鼻肠管接受治疗。其中，24名（80%）患者在单次粪便微生物群移植后治愈，而6名（20%）患者在八周内出现疾病复发。两组之间的主要疗效没有显著差异（p=0.85）。在整个随访期间，两组均未报告严重不良事件或与粪便微生物群移植相关的死亡。
冷冻口服胶囊粪便微生物群移植是一种安全、侵入性较小的方法，其疗效与鼻肠给药途径相当。
