Daneri Lourdes, Urbano Alicia, Escudero-Sánchez Rosa, Halperin Ana Verónica, Moreno-Blanco Ana, Corbacho María Dolores, Suárez-Carantoña Cecilia, Rodríguez-Jiménez Concepción, Serrano-Villar Sergio, Campo Rosa Del, Cobo Javier
Internal Medicine Department, Hospital Principe de Asturias, Alcalá de Henares, Madrid Spain.
Universidad Alcalá de Henares, Madrid Spain.
Int J Antimicrob Agents. 2025 Oct;66(4):107561. doi: 10.1016/j.ijantimicag.2025.107561. Epub 2025 Jul 1.
Recent guidelines recommend fecal microbiota transplantation (FMT) for patients who experience multiple episodes of Clostridioides difficile infection (CDI). The availability of lyophilised and encapsulated FMT in recent years has greatly improved patient comfort and convenience. While the effectiveness of FMT in oral capsules seems comparable to that achieved through other routes, further experience is needed, particularly in Europe, where there is currently limited published experience. The objective of this study was to present our experience with this therapeutic modality.
A retrospective cohort study on patients with recurrent CDI treated by lyophilised, encapsulated FMT. All patients were followed for a minimum of 12 weeks. The primary outcome was recurrence at three months.
A total of 36 patients received 38 FMTs. The median age of the cohort was 78.5 years, with a median of four previous episodes. At the three-month follow-up, 27 of the 36 patients (75.0%) were free of CDI. One patient exhibited recurrence before the six-month mark. Two of the ten patients with FMT failure were successfully rescued with a second FMT. Of the nine patients who underwent rescue attempts, seven did not experience recurrence, resulting in a cure rate of 91.7% for the 36 patients. We did not detect severe adverse effects related to the FMT.
We confirm an acceptable effectiveness of lyophilised capsulated oral FMT. Interestingly, most patients with FMT failure can be cured with a new treatment, which need not necessarily be a new FMT.
近期指南推荐对经历多次艰难梭菌感染（CDI）发作的患者进行粪便微生物群移植（FMT）。近年来冻干封装的FMT的可获得性极大地提高了患者的舒适度和便利性。虽然口服胶囊形式的FMT的有效性似乎与通过其他途径实现的有效性相当，但仍需要更多经验，尤其是在欧洲，目前该地区发表的经验有限。本研究的目的是介绍我们在这种治疗方式上的经验。
一项关于接受冻干封装FMT治疗复发性CDI患者的回顾性队列研究。所有患者至少随访12周。主要结局是三个月时的复发情况。
共有36例患者接受了38次FMT。队列的中位年龄为78.5岁，既往发作次数的中位数为4次。在三个月的随访中，36例患者中有27例（75.0%）未发生CDI。1例患者在六个月前出现复发。10例FMT失败的患者中有2例通过第二次FMT成功挽救。在9例接受挽救尝试的患者中，7例未复发，36例患者的治愈率为91.7%。我们未检测到与FMT相关的严重不良反应。
我们证实了冻干封装口服FMT具有可接受的有效性。有趣的是，大多数FMT失败的患者可以通过新的治疗方法治愈，不一定是新的FMT。
