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Faecal microbiota transplant for recurrent Clostridium difficile infection using long‐term frozen stool is effective: clinical efficacy and bacterial viability data
Author(s) -
Costello S. P.,
Conlon M. A.,
Vuaran M. S.,
RobertsThomson I. C.,
Andrews J. M.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13366
Subject(s) - clostridium difficile , medicine , glycerol , feces , microbiology and biotechnology , diarrhea , bacteria , gastroenterology , surgery , biology , antibiotics , biochemistry , genetics
Summary Background Faecal microbial transplant ( FMT ) for recurrent Clostridium difficile infection ( rCDI ) is greatly facilitated by frozen stool banks. However, the effect of frozen storage of stool for greater than 2 months on the viability of stool bacteria is unknown and the efficacy of FMT is not clear. Aim To evaluate the viability of bacteria in stool frozen for up to 6 months, and the clinical efficacy of FMT with stool frozen for 2–10 months, for the treatment of rCDI . Methods Viability of six representative groups of faecal bacteria after 2 and 6 months of storage at −80 °C, in normal saline ( NS ) or 10% glycerol were assessed by culture on plate media. The clinical outcomes of 16 consecutive patients with rCDI treated with aliquots of stool frozen in 10% glycerol and stored for 2–10 months were also examined. Results Viability at both 2 and 6 months was similar to baseline, in specimens stored in 10% glycerol and at 2 months in stool stored in NS , but was reduced by >1 log at 6 months for Aerobes ( P < 0.01), total Coliforms ( P < 0.01) and Lactobacilli ( P < 0.01) in NS . Using stool frozen for 2–10 months in 10% glycerol, the cure rate for rCDI was 88% with one FMT and 100% after repeat FMT in those who relapsed. Conclusion Stool for faecal microbial transplant to treat rCDI can be safely stored frozen in 10% glycerol for at least 6 months without loss of clinical efficacy or viability in the six bacterial groups tested.