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Updated: Apr 21, 2026
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
[Fecal microbiota transplantation: first case report in Chile and review]
Abstract:
Clostridium difficile (CD) infection is increasing in frequency and severity in in-hospital and outpatient clinical settings, with a recurrence that can reach 30% after first episode. The recurrences are usually treated with longer courses of metronidazole or vancomycin. Other treatments have been used, such as probiotics, fidaxomicin, rifaximin, immunoglobulins and monoclonal antibodies against toxins A and B. Fecal microbiota transplantation (FMT) has emerged as a promising strategy in this group of patients, with effectiveness greater than 90%. We present the first case reported in Chile of this therapeutic strategy in a patient with Crohn's disease and recurrent CD infection who presented after the fecal transplantation an Escherichia coli bacteremia, suggesting the need for caution in the use of this strategy. 10 months after the FMT the patient presented a new episode of E. coli bacteremia and two episodes of diarrhea due to CD infection, treated both of them with vancomycin with good clinical response.
Insights
Fecal microbiota transplantation (FMT) offers high effectiveness for recurrent Clostridium difficile (CD) infections. However, this case highlights potential risks like Escherichia coli bacteremia, necessitating careful patient selection and monitoring.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiome Therapeutics
Background:
- Clostridium difficile (CD) infection presents significant challenges due to increasing frequency, severity, and high recurrence rates (up to 30%).
- Standard treatments for recurrent CD include prolonged antibiotic courses, with emerging options like probiotics, novel antibiotics, and immunotherapy.
- Fecal microbiota transplantation (FMT) has demonstrated over 90% effectiveness for recurrent CD, positioning it as a promising therapeutic strategy.
Observation:
- This report details the first case in Chile of FMT for recurrent CD infection in a patient with Crohn's disease.
- Following FMT, the patient developed Escherichia coli bacteremia, indicating a potential complication of the procedure.
- The patient experienced a subsequent episode of E. coli bacteremia and two CD infections 10 months post-FMT, both successfully treated with vancomycin.
Findings:
- Fecal microbiota transplantation (FMT) was utilized for a patient with Crohn's disease and recurrent Clostridium difficile (CD) infection.
- The patient experienced post-FMT Escherichia coli bacteremia, a rare but serious adverse event.
- Despite the bacteremia, the patient later responded well to vancomycin for subsequent CD infections.
Implications:
- This case underscores the need for caution and careful monitoring when employing FMT, particularly in immunocompromised or complex patients.
- The occurrence of Escherichia coli bacteremia suggests potential risks associated with donor-derived bacteria or altered gut dynamics post-FMT.
- Further research is warranted to optimize FMT protocols and mitigate risks, especially in patients with underlying inflammatory bowel disease.
