Fecal Microbiota Transplantation Using Upper Gastrointestinal Tract for the Treatment of Refractory or Severe Complicated Clostridium difficile Infection in Elderly Patients in Poor Medical Condition: The First Study in an Asian Country.

Tae-Geun Gweon,Jae Myung Park,Myung-Gyu Choi,Sang Woo Kim,Jinsu Kim,Dong-Gun Lee,Young-Seok Cho,Chul-Hyun Lim,In Seok Lee

doi:10.1155/2016/2687605

Abstract

Background and Aims. Fecal microbiota transplantation (FMT) is a highly effective treatment option for refractory Clostridium difficile infection (CDI). FMT may be challenging in patients with a low performance status, because of their poor medical condition. The aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated CDI using FMT via the upper GI tract route. Methods. This study was a retrospective review of seven elderly patients with refractory or severe complicated CDI and a poor medical condition who were treated with FMT through the upper GI tract route from May 2012 through August 2013. The outcomes studied included the cure rate of CDI and adverse events. Results. Of these seven patients who received FMT via the upper GI tract route, all patients were cured. During the 11-month follow-up period, CDI recurrence was observed in two patients; rescue FMT was performed in these patients, which led to a full cure. Vomiting was observed in two patients. Conclusions. FMT via the upper gastrointestinal tract route may be effective for the treatment of refractory or severe complicated CDI in patients with a low performance status. Physicians should be aware of adverse events, especially vomiting.

Highlights

The incidence and severity of Clostridium difficile infection (CDI) have been increasing [1, 2]
This study was a retrospective review of seven elderly patients with refractory or severe complicated CDI and a poor medical condition who were treated with Fecal microbiota transplantation (FMT) through the upper GI tract route at Seoul St
We treated refractory or severe complicated CDI in patients with a poor medical condition via FMT using the upper GI tract route; all patients were cured after FMT

Summary

Introduction

The incidence and severity of Clostridium difficile infection (CDI) have been increasing [1, 2]. When FMT is performed using the upper GI tract route, the foul odor of the fecal suspension may cause discomfort, nausea, and vomiting in patients This might contribute to the choice of the lower GI tract by physicians as an infusion route. The aims of this study were to describe our experience treating patients in poor medical condition with refractory or severe complicated CDI using FMT via the upper GI tract route. This study was a retrospective review of seven elderly patients with refractory or severe complicated CDI and a poor medical condition who were treated with FMT through the upper GI tract route from May 2012 through August 2013. FMT via the upper gastrointestinal tract route may be effective for the treatment of refractory or severe complicated CDI in patients with a low performance status.

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Methods

Results

Conclusion