title: Recurrent Clostridium difficile infections: the importance of the intestinal microbiota.
abstract: Clostridium difficile infections (CDI) are a leading cause of antibiotic-associated and nosocomial diarrhea. Despite effective antibiotic treatments, recurrent infections are common. With the recent emergence of hypervirulent isolates of C. difficile, CDI is a growing epidemic with higher rates of recurrence, increasing severity and mortality. Fecal microbiota transplantation (FMT) is an alternative treatment for recurrent CDI. A better understanding of intestinal microbiota and its role in CDI has opened the door to this promising therapeutic approach. FMT is thought to resolve dysbiosis by restoring gut microbiota diversity thereby breaking the cycle of recurrent CDI. Since the first reported use of FMT for recurrent CDI in 1958, systematic reviews of case series and case report have shown its effectiveness with high resolution rates compared to standard antibiotic treatment. This article focuses on current guidelines for CDI treatment, the role of intestinal microbiota in CDI recurrence and current evidence about FMT efficacy, adverse effects and acceptability.
authors: Marie Céline Zanella Terrier, Martine Louis Simonet, Service of General Internal Medicine, Geneva University Hospital, 1211 Geneva, Switzerland.
authors: Marie Céline
authors: MC
authors: Zanella Terrier
authors: Marie Céline Zanella Terrier, Martine Louis Simonet, Service of General Internal Medicine, Geneva University Hospital, 1211 Geneva, Switzerland.
authors: Martine Louis
authors: ML
authors: Simonet
authors: Marie Céline Zanella Terrier, Martine Louis Simonet, Service of General Internal Medicine, Geneva University Hospital, 1211 Geneva, Switzerland.
authors: Philippe
authors: P
authors: Bichard
authors: Marie Céline Zanella Terrier, Martine Louis Simonet, Service of General Internal Medicine, Geneva University Hospital, 1211 Geneva, Switzerland.
authors: Jean Louis
authors: JL
authors: Frossard
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001691:Biological Therapy / Q000009:adverse effects / Q000379:methods; D016360:Clostridioides difficile / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology* / Q000628:therapy; D005243:Feces / Q000382:microbiology; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000382:microbiology*; D064307:Microbiota / Q000187:drug effects; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome; D014774:Virulence
chemical_list: D000900:Anti-Bacterial Agents
keywords: Clostridium difficile infection; Clostridium difficile recurrence; Fecal microbiota transplantation; Microbiota; Stool transplantation