Korean J Gastroenterol.  2017 Apr;69(4):226-231. 10.4166/kjg.2017.69.4.226.

Fecal Microbiota Transplantation for Refractory and Recurrent Clostridium difficile Infection: A Case Series of Nine Patients

• Bang BW
• Park JS
• Kim HK
• Shin YW
• Kwon KS
• Kwon HY
• Baek JH
• Lee JS

• KMID: 2383400
• DOI: http://doi.org/10.4166/kjg.2017.69.4.226

Abstract

BACKGROUND/AIMS
Fecal microbiota transplantation (FMT) is a highly effective therapy for refractory and recurrent Clostridium difficile infection (CDI). Despite its excellent efficacy and recent widespread use, FMT has not been widely used in South Korea thus far. We describe our experience with FMT to treat refractory/recurrent CDI.
METHODS
We conducted a chart review of patients who underwent FMT for refractory/recurrent CDI at Inha University Hospital, between March 2014 and June 2016. The demographic information, treatment data, and adverse events were reviewed. FMT was administered via colonoscopy and/or duodenoscopy. All stool donors were rigorously screened to prevent infectious disease transmission.
RESULTS
FMT was performed in nine patients with refractory/recurrent CDI. All patients were dramatically cured. Bowel movement was normalized within one week after FMT. There were no procedure-related adverse events, except aspiration pneumonia in one patient. During the follow-up period (mean 11.4 months), recurrence of CDI was observed in one patient at one month after FMT due to antibiotics.
CONCLUSIONS
FMT is a safe, well-tolerated and highly effective treatment for refractory/recurrent CDI. Although there are many barriers to using FMT, we expect that FMT will be widely used to treat refractory/recurrent CDI in South Korea.

Keyword

Fecal microbiota transplantation; Clostridium difficile; Colonoscopy; Gastrointestinal microbiome

MeSH Terms

Anti-Bacterial Agents
Clostridium difficile*
Clostridium*
Colonoscopy
Disease Transmission, Infectious
Duodenoscopy
Fecal Microbiota Transplantation*
Follow-Up Studies
Gastrointestinal Microbiome
Humans
Korea
Pneumonia, Aspiration
Recurrence
Tissue Donors
Anti-Bacterial Agents

Figure

• 

  Fig. 1. Bowel movement change of before and after fecal microbiota transplantation (FMT). The mean bowel movement was 5.5±3.1 stools per day, one day prior to FMT. The mean bowel movements decreased 1.4±1.1 stools per day, at four days after FMT, and normalized within one week.

• 

  Fig. 2. Colonoscopic findings of pseudomembranous colitis. Colonoscopic finding at the time of diagnosis of pseudomembranous colitis (A), after metronidazole for 14 days (B), after vancomycin for 10 days (C), during fecal microbiota transplantation (FMT) (D) and one month after FMT (E).

Reference

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