Fecal Bacteriotherapy for Recurrent Clostridium difficile Infection: A Systematic Literature Review

Kang, Jahyun

Abstract

BACKGROUND
Over the past several years, Clostridium difficile has become a major healthcare-associated pathogen. Fecal bacteriotherapy has been reported as an effective intervention for treating recurrent C. difficile infection by restoring the normal intestinal microbiota.
METHODS
Articles on fecal bacteriotherapy were collected through PubMed, CINAHL, Cochrane Library, and Web of Science databases using the keywords "Clostridium difficile," "feces," "fecal transplantation," "fecal microbiota transplantation," and "fecal bacteriotherapy." Using a systematic literature review, variables of interest from articles that met the inclusion criteria were extracted and summarized.
RESULTS
Among 141 articles that were published in English from January 1, 2000 to August 31, 2012, 8 studies were selected for analysis after assessing the titles, abstracts, and full contents. Fecal bacteriotherapy procedures varied with respect to donor selection, screening, infusion route, and preparation of the suspension. Donors were mostly family members or relatives, and donor screening included tests for blood borne and stool pathogens. Selected infusion routes were colonoscopy (62.5%), nasogastric tube (25%), and enema (12.5%). The success rate was reported to be 73-100%. There was a lack of a standard procedure for fecal bacteriotherapy in all of the selected studies.
CONCLUSION
Fecal bacteriotherapy is an effective intervention for combating C. difficile infection that has a high success rate and no adverse effects. This therapy would be helpful for infection control in hospital settings by facilitating early eradication of C. difficile infection.