title: Long-term Follow-up Study of Fecal Microbiota Transplantation for Severe and/or Complicated Clostridium difficile Infection: A Multicenter Experience.
abstract: OBJECTIVE
  Our aim was to investigate fecal microbiota transplantation (FMT) efficacy in patients with severe and/or complicated Clostridium difficile infection (CDI).
  
  
  BACKGROUND
  FMT is successful for recurrent CDI, although its benefit in severe or complicated CDI has not specifically been evaluated.
  
  
  METHODS
  A multicenter long-term follow-up study was performed in patients who received FMT for severe and/or complicated CDI (diagnosed using standard criteria). Pre-FMT and post-FMT questionnaires were completed. Study outcomes included cure rates and time to resolution of symptoms.
  
  
  RESULTS
  A total of 17 patients (82% inpatients, 18% outpatients) were included (76.4% women; mean age, 66.4 y; mean follow-up, 11.4 mo). Patients had severe and complicated (76.4%) or either severe or complicated (23.6%) CDI. Sixteen patients (94.1%) had diarrhea, which resolved in 12 (75%; mean time to resolution, 5.7 d) and improved in 4 (25%) after FMT. Eleven patients (64.7%) had abdominal pain, which resolved in 8 (72.7%; mean time to resolution, 9.6 d) and improved in 3 (27.3%) after FMT. Two of 17 patients experienced early CDI recurrence (≤90 d) after FMT (primary cure rate, 88.2%); and in 1 patient, a second FMT resulted in cure (secondary cure rate, 94.1%). Late CDI recurrence (≥90 d) was seen in 1 of 17 patients (5.9%) in association with antibiotics and was successfully treated with a repeat FMT. No adverse effects directly related to FMT occurred.
  
  
  CONCLUSIONS
  FMT was successful and safe in this cohort of patients with severe or complicated CDI. Primary and secondary cure rates were 88.2% and 94.1%, respectively.
authors.affiliation: *Montefiore Medical Center, Bronx, NY †Centre for Digestive Diseases, Five Dock, NSW, Australia ‡Brown Alpert Medical School, Providence, RI §Integris Baptist Medical Center, Oklahoma City, OK ∥Division of Gastroenterology, University of Washington, Seattle ¶Peace Health Southwest Hospital, Vancouver, WA #Mayo Clinic, Rochester, MN **East Bay Center for Digestive Health, Oakland, CA ††Ochsner Medical Center, New Orleans, LA.
authors.forename: Olga C
authors.initials: OC
authors.lastname: Aroniadis
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Brandt
authors.forename: Adam
authors.initials: A
authors.lastname: Greenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Borody
authors.forename: Colleen R
authors.initials: CR
authors.lastname: Kelly
authors.forename: Mark
authors.initials: M
authors.lastname: Mellow
authors.forename: Christina
authors.initials: C
authors.lastname: Surawicz
authors.forename: Leslie
authors.initials: L
authors.lastname: Cagle
authors.forename: Leila
authors.initials: L
authors.lastname: Neshatian
authors.forename: Neil
authors.initials: N
authors.lastname: Stollman
authors.forename: Andrea
authors.initials: A
authors.lastname: Giovanelli
authors.forename: Arnab
authors.initials: A
authors.lastname: Ray
authors.forename: Robert
authors.initials: R
authors.lastname: Smith
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000382:microbiology / Q000628:therapy*; D003967:Diarrhea / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents