Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile Infection.
The prevalence of recurrent Clostridium difficile infection (RCDI) is increasing; fecal microbiota transplantation (FMT) is an effective therapy. However, there have been no studies of the efficacy of a single session of combined enteral and colonic FMT or characterizations of changes in the microbiota between donors and recipients. We performed a study of 27 patients with RCDI who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. Patients were closely monitored, and fecal samples were collected from 2 patient-donor pairs for 16S rRNA analysis. All patients had reduced stool frequency, abdominal pain, white blood cell counts, and elimination of fecal C difficile toxin (P < .05). FMT increased microbial diversity, increasing proportions of Lachnospiraceae (phylum Firmicutes) and reducing proportions of Enterobacteriaceae. FMT was associated with marked changes in the composition of fecal microbiota in 2 patients with RCDI.
University of Maryland School of Medicine and Department of Gastroenterology, Sinai Hospital of Baltimore, Baltimore, Maryland. Electronic address: sdutta@gmail.com.
Sudhir K
SK
Dutta
Division of Gastroenterology, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland. Electronic address: girotra.mohit@gmail.com.
Mohit
M
Girotra
Department of Medicine, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland.
Shashank
S
Garg
Division of Gastroenterology, Johns Hopkins University/Sinai Hospital Program in Internal Medicine, Baltimore, Maryland.
Anand
A
Dutta
University of Maryland School of Medicine and Department of Gastroenterology, VA Maryland Health Care System, Baltimore, Maryland.
Erik C
EC
von Rosenvinge
Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
Cynthia
C
Maddox
Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, Maryland.
Yang
Y
Song
Johns Hopkins University School of Medicine and Division of Infectious Diseases, Johns Hopkins Hospital, Baltimore, Maryland.
John G
JG
Bartlett
Department of Hepatology, Sinai Hospital of Baltimore, Baltimore, Maryland.
Rakesh
R
Vinayek
Department of Microbiology and Immunology, University of Maryland School of Medicine, Baltimore, Maryland.
W Florian
WF
Fricke
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044822:Biodiversity; D001691:Biological Therapy / Q000379:methods*; D058448:Biota; D003015:Clostridium Infections / Q000628:therapy*; D003967:Diarrhea / Q000628:therapy*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D012008:Recurrence; D017422:Sequence Analysis, DNA; D016896:Treatment Outcome; D055815:Young Adult
16s rRNA Analysis; Clostridium difficile; Colonic; FMT; Fecal Microbiota Transplantation; Jejunal; Lachnospiraceae; Microbiota; RCDI; Recurrent