Faecal microbiota transplantation for Clostridium difficile infection

Area of Science:

• Microbiology
• Gastroenterology
• Infectious Diseases

Background:

• Clostridium difficile infection (CDI) is a significant healthcare-associated pathogen causing severe diarrhea.
• CDI incidence, severity, and recurrence rates are increasing, with high relapse rates despite standard treatments.
• Emerging evidence indicates CDI is expanding beyond traditional hospital settings.

Purpose of the Study:

• To review the clinical literature on fecal microbiota transplantation (FMT) for severe and recurrent Clostridium difficile disease (CDAD).
• To assess the efficacy and current evidence supporting FMT in managing challenging CDI cases.

Main Methods:

• A systematic literature search was conducted using PubMed.
• Keywords included 'Clostridium difficile infection,' 'fecal transplantation,' and 'recurrent C. difficile infection.'
• The search was limited to human studies published in English between 2011 and June 2013.

Main Results:

• 104 publications were identified; 20 were clinical reviews, 6 case reports, 3 clinical trials, and 1 meta-analysis focused on FMT for CDI.
• Since 1958, 36 reports documented FMT for 583 patients with CDI.
• Overall FMT success rates ranged from 80% to 98%, with higher efficacy observed when administered via colonoscopy.

Conclusions:

• Fecal microbiota transplantation effectively restores the colonic microbiome, achieving cure rates exceeding 90% for CDI.
• Strong evidence supports FMT's utility in severe and recurrent CDI cases.
• Future efforts should address patient acceptance, standardize protocols, and conduct further clinical trials.