ABSTRACT
Background: Faecal microbiota transplantation (FMT) has high efficacy against recurrent Clostridioides difficile infection (CDI). Despite the increasing use of this therapy, the delay between diagnosis and treatment is excessive. Furthermore, donor selection is an important and time-consuming process. Methods: We reviewed patients who underwent FMT for recurrent CDI at the CHU Charleroi Hospital between 2015 and 2022. The general context, type of administration, adverse events, and donor selection were reported. FMT was conducted using gastroduodenoscopy, colonoscopy, and enema with either fresh or frozen material. Results: Ten patients with multiple comorbidities were treated by FMT. Seven patients were cured after one procedure. One patient was successfully cured after a change to an unrelated donor, and preliminary efficacy was established. Conclusions: FMT is an effective treatment that should be considered during the earlier phases of treatment. Stool donors should be thoroughly screened for infectious diseases and other criteria related to microbiota composition.
Subject(s)
Clostridioides difficile , Clostridium Infections , Humans , Clostridium Infections/therapy , Fecal Microbiota Transplantation/methods , Feces , Recurrence , Treatment OutcomeABSTRACT
Clostridium difficile infection is a major cause of nosocomial diarrhea. Its incidence has increased in the past 20 years and is associated with a significant morbidity and mortality. Relapsing is frequent after treatment and the management of these recurrent Clostridium difficile infections is challenging. Several studies over the years have shown that fecal microbiota transplantion is associated with a high degree of success. Fecal microbiota transplantion is now part of the European recommendations in the treatment of recurrent Clostridium difficile infections. However, standard procedures are needed to define indications, donor's selection criteria, preparation of the stool sample and its administration as well as the patients follow up. Illustration by a case report.
Les infections à Clostridium difficile sont une cause majeure de diarrhées nosocomiales. Elles sont grevées d'une morbi-mortalité non négligeable et leur incidence a fortement augmenté ces 20 dernières années. Les récidives après traitement sont fréquentes et ces infections à Clostridium difficile récurrentes représentent un vrai défi thérapeutique. Depuis plusieurs années déjà, diverses études ont montré l'efficacité de la greffe de microbiote fécale dans le traitement des infections à Clostridium difficile récurrentes et son utilisation fait maintenant partie des dernières recommandations européennes. Une procédure standardisée définissant les indications, les critères de sélection du donneur, la préparation de la solution et son administration ainsi que le suivi du patient postgreffe est nécessaire. Illustration par un cas clinique.
