Fecal Flora Reconstitution for Recurrent Clostridium difficile Infection: Results and Methodology

被引:118
作者
Rohlke, Faith [1 ]
Surawicz, Christina M. [2 ]
Stollman, Neil [1 ]
机构
[1] NCGC, Oakland, CA 94609 USA
[2] Univ Washington, Sch Med, Dept Med, Div Gastroenterol, Seattle, WA 98195 USA
关键词
Clostridium difficile; fecal bacteriotherapy; Fecal Flora Reconstitution; stool transplantation; ANTIBIOTIC-ASSOCIATED DIARRHEA; IRRITABLE-BOWEL-SYNDROME; CHAIN FATTY-ACIDS; CHRONIC CONSTIPATION; ULCERATIVE-COLITIS; PUTTING BACK; RISK-FACTORS; DISEASE; BACTERIOTHERAPY; ENTEROCOLITIS;
D O I
10.1097/MCG.0b013e3181dadb10
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Goals: Recurrent Clostridium difficile infection (RCDI) is an increasingly common clinical problem without ideal treatment options. Our aim was to evaluate our results using Fecal Flora Reconstitution (FFR), and promulgate our methodology to the GI community to foster its more widespread use in appropriate candidates. Background: FFR, sometimes termed "fecal transplantion'' has been shown in numerous reports to be an effective treatment of RCDI, however, most of these studies have small sample sizes and few focus specifically on the methodology used in colonoscopic preparation and delivery of donated stool. Study: Nineteen patients with confirmed multiply recurrent CDI were treated by infusing donor stool through a colonoscope. Results: Out of 19 patients, 18 initially responded to treatment with a single FFR treatment, 1 patient responded after a second FFR infusion. All 19 patients maintained prolonged cured status followed until submission, ranging from 6 months to 5 years. Three patients were presumed reinfected after remaining symptom free for a period spanning from 6 months to 4 years. These patients tested positive for C. difficile after prescription of additional antibiotics for unrelated infections. Conclusions: Fecal Flora Reconstitution is an effective, viable, and simple method of treatment for the difficult to treat patients with RCDI who fail standard therapy.
引用
收藏
页码:567 / 570
页数:4
相关论文
共 40 条
[11]  
Borody TJ, 2000, AM J GASTROENTEROL, V95, P3028
[12]   Bacteriotherapy using fecal flora - Toying with human motions [J].
Borody, TJ ;
Warren, EF ;
Leis, SM ;
Surace, R ;
Ashman, O ;
Siarakas, S .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2004, 38 (06) :475-483
[13]   Treatment of ulcerative colitis using fecal bacteriotherapy [J].
Borody, TJ ;
Warren, EF ;
Leis, S ;
Surace, R ;
Ashman, O .
JOURNAL OF CLINICAL GASTROENTEROLOGY, 2003, 37 (01) :42-47
[14]  
BORODY TJ, 2006, UPTODATE AUG
[15]  
BOWDEN TA, 1981, AM SURGEON, V47, P178
[16]  
EISEMAN B, 1958, SURGERY, V44, P854
[17]  
Fekety R, 1997, AM J GASTROENTEROL, V92, P739
[18]   Recurrent Clostridium difficile diarrhea: Characteristics of and risk factors for patients enrolled in a prospective, randomized, double-blinded trial [J].
Fekety, R ;
McFarland, LV ;
Surawicz, CM ;
Greenberg, RN ;
Elmer, GW ;
Mulligan, ME .
CLINICAL INFECTIOUS DISEASES, 1997, 24 (03) :324-333
[19]   The effect of faecal enema on five microflora-associated characteristics in patients with antibiotic-associated diarrhoea [J].
Gustafsson, A ;
Berstad, A ;
Lund-Tonnesen, S ;
Midtvedt, T ;
Norin, E .
SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY, 1999, 34 (06) :580-586
[20]  
Gustafsson A, 1998, SCAND J GASTROENTERO, V33, P721