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Faecal microbiota transplantation for Clostridium difficile infection: a multicentre study of non‐responders
Author(s) -
Razik* Roshan,
Osman* Majdi,
Lieberman Alexandra,
Allegretti Jessica R,
Kassam Zain
Publication year - 2017
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/mja16.01452
Subject(s) - clostridium difficile , fecal bacteriotherapy , medicine , clostridium infections , transplantation , c difficile , feces , microbiology and biotechnology , biology , antibiotics
Age at time of FMT (years), mean (SD) 65.9 (17.9) Sex (men) 41 (30%) Ethnic background Caucasian 107 (79%) Black or African American 11 (8%) Hispanic or Latino 6 (4%) Other 3 (2%) Not reported 8 (6%) Long term care resident 19 (14%) History of inflammatory bowel disease 17 (13%) History of irritable bowel syndrome 18 (13%) Medications at time of FMT Proton pump inhibitors 53 (39%) Immunosuppressive agents 33 (24%) Laxatives 3 (2%) Anti-motility agents 26 (19%) Horn index (of disease severity) 1 (mild) 7 (5%) 2 (moderate) 62 (46%) 3 (severe) 45 (33%) 4 (extremely severe) 7 (5%) Not reported 14 (10%) Received antibiotics prior to CDI diagnosis 81 (60%) Health care-associated CDI 34 (25%) Initial CDI diagnosis method* Toxin A or B 42 (31%) Polymerase chain reaction 89 (66%) Anaerobic culture/other 2 (2%) Not reported 12 (9%) CDI treatment prior to FMT* Vancomycin 84 (62%) Metronidazole 59 (44%) Fidaxomicin 2 (2%) CDI type* Refractory CDI 48 (37%) Recurrent CDI 101 (77%) Average number of recurrences, mean (SD) 3.0 (1.9) Inpatient admission to hospital 79 (61%) NAP-1 strain of C. difficile 9 (7%) FMT delivery modality Colonoscopy 81 (60%) Enema 10 (7%) Flexible sigmoidoscopy 2 (2%) Oesophagogastroduodenoscopy 15 (11%) Nasogastric tube 10 (7%) Nasoduodenal tube 2 (2%) Other 11 (8%) Not reported 4 (3%) Colonoscopy preparation 95 (74%) Proton pump inhibitor prior to nasogastric tube 8 (80%) Frozen FMT thaw methods Water bath 73 (56%) Room temperature 40 (30%) Time between FMT and non-response (days), mean (SD) 15.3 (12.8) Patient decontaminated toilets at home Yes 51 (38%) No 26 (19%) Not reported 58 (43%) Assessed for post-infectious irritable bowel syndrome 41 (30%)