Open AccessFecal Microbiota Transplantation: Redefining Surgical Management of Refractory Clostridium difficile Infection
Author(s) -
Yao Cheng,
Monika Fischer
Publication year - 2020
Publication title -
clinics in colon and rectal surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.884
H-Index - 38
eISSN - 1521-5741
pISSN - 1530-9681
DOI - 10.1055/s-0040-1701233
Subject(s) - medicine , clostridium difficile , fecal bacteriotherapy , refractory (planetary science) , fulminant , colectomy , antibiotics , clostridioides , mortality rate , surgery , intensive care medicine , gastroenterology , colorectal cancer , microbiology and biotechnology , astrobiology , biology , physics , cancer
Fecal microbiota transplantation (FMT) is the process of transplanting stool from a healthy donor into the gut of a diseased individual for therapeutic purposes. It has a clearly defined role in the treatment of recurrent Clostridium difficile (reclassified as " Clostridioides difficile ") infection (CDI), with cure rates over 90% and decreased rates of subsequent recurrence compared with anti-CDI antibiotics. There is emerging evidence that FMT is also effective in the treatment of severe and fulminant CDI, with associated decreases in mortality and colectomy rates compared with standard antibiotic therapy. FMT shows promise as salvage therapy for critically-ill CDI patients refractory to maximum medical therapy and not deemed to be surgical candidates. FMT should be considered early in the course of severe CDI and should be delivered immediately in patients with signs of refractory CDI. Expansion of FMT's use along the spectrum of CDI severity has potential to decrease associated rates of mortality and colectomy.