Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis

Kosaku Nanki; Shinta Mizuno; Katsuyoshi Matsuoka; Keiko Ono; Shinya Sugimoto; Hiroki Kiyohara; Mari Arai; Moeko Nakashima; Kozue Takeshita; Keiichiro Saigusa; Mitsutoshi Senoh; Tadashi Fukuda; Makoto Naganuma; Haru Kato; Wataru Suda; Masahira Hattori; Takanori Kanai

doi:10.5217/ir.2018.16.1.142

Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis

Intest Res. 2018 Jan;16(1):142-146. doi: 10.5217/ir.2018.16.1.142. Epub 2018 Jan 18.

Authors

Kosaku Nanki¹, Shinta Mizuno¹, Katsuyoshi Matsuoka², Keiko Ono¹, Shinya Sugimoto¹, Hiroki Kiyohara¹, Mari Arai¹, Moeko Nakashima¹, Kozue Takeshita¹, Keiichiro Saigusa¹, Mitsutoshi Senoh³, Tadashi Fukuda³, Makoto Naganuma¹, Haru Kato³, Wataru Suda⁴, Masahira Hattori⁵, Takanori Kanai¹

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
² Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.
³ Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, Japan.
⁴ Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan.
⁵ Faculty of Science and Engineering, Waseda University, Tokyo, Japan.

Abstract

Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.

Keywords: Clostridium difficile; Colitis, ulcerative; Fecal microbiota transplantation.