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. 2019 Jul 16;8(7):1036.
doi: 10.3390/jcm8071036.

Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis

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Free PMC article

Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis

Jae Hyun Shin et al. J Clin Med. .
Free PMC article

Abstract

Fecal microbiota transplantation (FMT) has been shown to be an effective treatment for recurrent Clostridioides difficile infections (rCDIs). We assessed the benefits of a multidisciplinary C. difficile clinic for screening FMT eligibility in patients with rCDI. Patients seen at the University of Virginia Complicated C. difficile Clinic (CCDC) underwent comprehensive evaluation for possible FMT. Patients were eligible for FMT if there was history of greater than two episodes of rCDI. Patients were evaluated for the outcome after evaluation in the clinic. A total of 113 patients were evaluated: 77 were eligible for FMT, of which 25 patients did not undergo FMT. The rate of recurrence at three months and all-cause mortality were 4.5% and 7% for patients who received FMT and 16.7% and 12.5% for eligible patients who did not receive FMT. There were 36 patients who were not eligible for FMT, with two or fewer recurrences and a recurrence rate of 8.8% and all-cause mortality of 6%. One in three patients screened for FMT had a nutritional deficiency diagnosed, with zinc deficiency being most common (20%). Additional diagnoses, including inflammatory bowel disease, were made during the evaluation. FMT is a highly effective treatment for rCDI, most notably in patients with multiple recurrences. A systematic approach for evaluating patients with rCDI helps identify patients who benefit most from FMT and those who have other conditions.

Keywords: Clostridioides difficile infection; Clostridium difficile infection; fecal microbiota transplant; recurrent C. difficile.

Conflict of interest statement

Guerrant is a member of the Danone Yakult US probiotics scientific board. All other authors (Shin, Chaplin, Archbald-Pannone, Hays, Kolling, Vance, Warren) have no conflict of interest.

Figures

Figure 1
Figure 1
Recurrence-free survival in FMT and non-FMT groups. Recurrence-free survival analysis was performed using the Mantel–Cox log-rank test. The following three groups were compared: patients with three or more recurrent CDIs (rCDIs) who underwent FMT, patients with less than three rCDIs and therefore ineligible for FMTs, and patients with three or more rCDIs who deferred FMT due to other reasons.
Figure 2
Figure 2
Secondary outcomes in follow-up for FMT and non-FMT groups.

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