title: Efficacy and safety of, and patient satisfaction with, colonoscopic-administered fecal microbiota transplantation in relapsing and refractory community- and hospital-acquired Clostridium difficile infection.
abstract: OBJECTIVE
  To report the efficacy and safety of, and patient satisfaction with, colonoscopic fecal microbiota transplantation (FMT) for community- and hospital-acquired Clostridium difficile infection (CDI).
  
  
  METHODS
  A retrospective medical records review of patients who underwent FMT between July 1, 2012 and August 31, 2013 was conducted. A total of 22 FMTs were performed on 20 patients via colonoscopy. The patients were divided into 'community-acquired' and 'hospital-acquired' CDI. Telephone surveys were conducted to determine procedure outcome and patient satisfaction. Primary cure rate was defined as resolution of diarrhea without recurrence within three months of FMT, whereas secondary cure rate described patients who experienced resolution of diarrhea and return of normal bowel function after a second course of FMT.
  
  
  RESULTS
  Nine patients met the criteria for community-acquired CDI whereas 11 were categorized as hospital-acquired CDI. A female predominance in the community-acquired group (88.89% [eight of nine]) was found (P=0.048). The primary cure rate was 100% (nine of nine) and 81.8% (nine of 11 patients) in community- and hospital-acquired CDI groups, respectively (P=0.189). Two patients in the hospital-acquired group had to undergo a repeat FMT for persistent symptomatic infection; the secondary cure rate was 100%. During the six-month follow-up, all patients were extremely satisfied with the procedure and no complications or adverse events were reported.
  
  
  CONCLUSIONS
  FMT was a highly successful and very acceptable treatment modality for treating both community- and hospital-acquired CDI.
authors.forename: Muhammad Ali
authors.initials: MA
authors.lastname: Khan
authors.forename: Aijaz Ahmed
authors.initials: AA
authors.lastname: Sofi
authors.forename: Usman
authors.initials: U
authors.lastname: Ahmad
authors.forename: Osama
authors.initials: O
authors.lastname: Alaradi
authors.forename: Abdur Rahman
authors.initials: AR
authors.lastname: Khan
authors.forename: Tariq
authors.initials: T
authors.lastname: Hammad
authors.forename: Jennifer
authors.initials: J
authors.lastname: Pratt
authors.forename: Thomas
authors.initials: T
authors.lastname: Sodeman
authors.forename: William
authors.initials: W
authors.lastname: Sodeman
authors.forename: Sehrish
authors.initials: S
authors.lastname: Kamal
authors.forename: Ali
authors.initials: A
authors.lastname: Nawras
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification; D003015:Clostridium Infections / Q000628:therapy*; D003113:Colonoscopy / Q000379:methods*; D003428:Cross Infection / Q000382:microbiology / Q000628:therapy; D003967:Diarrhea / Q000382:microbiology / Q000628:therapy*; D005243:Feces / Q000382:microbiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D064307:Microbiota; D008875:Middle Aged; D017060:Patient Satisfaction; D012008:Recurrence; D019233:Retreatment; D012189:Retrospective Studies; D016896:Treatment Outcome