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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Refractory pseudomembranous colitis that was treated successfully with colonoscopic fecal microbial transplantation
Jun Young Shin1, Eun Jung Ko1, Seung Ho Lee1
1Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea.
Abstract:
Pseudomembranous colitis (PMC) is a nosocomial and opportunistic infection caused by Clostridium difficile. PMC is related to the use of antibiotics leading to intestinal dysbiosis and an overgrowth of C. difficile. Metronidazole or vancomycin is considered to be the standard therapy for the management of PMC. However, PMC has a 15%-30% recurrence rate and can be refractory to standard treatments, resulting in morbidity and mortality. Here we describe a patient who experienced refractory PMC who was treated with fecal microbiota transplantation. A 69-year-old woman was admitted to the hospital with consistent abdominal pain and diarrhea, which had been present for 5 months. She was diagnosed with PMC by colonoscopy and tested positive for C. difficile toxin. Even though she took metronidazole for 10 days, followed by vancomycin for 4 weeks, her symptoms did not improve. Because of her recurrent and refractory symptoms, we decided to perform fecal microbiota transplantation. Fifty grams of fresh feces from a donor were obtained on the day of the procedure, mixed with 500 mL of normal saline, and then filtered. The filtered solution was administered to the patient's colon using a colonoscope. After the procedure, her symptoms rapidly improved and a follow-up colonoscopy showed that the PMC had resolved without recurrence.
Insights
Fecal microbiota transplantation effectively treated a patient with recurrent, refractory pseudomembranous colitis (PMC) that did not respond to standard antibiotic therapies. This innovative approach led to rapid symptom improvement and complete resolution of PMC without recurrence.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Microbiology
Background:
- Pseudomembranous colitis (PMC) is a serious intestinal infection often caused by Clostridium difficile.
- Standard treatments like metronidazole and vancomycin have high recurrence rates (15-30%) and can be ineffective for refractory cases.
- Antibiotic use can disrupt gut microbiota, leading to C. difficile overgrowth and PMC.
Purpose of the Study:
- To evaluate the efficacy of fecal microbiota transplantation (FMT) in treating a patient with refractory and recurrent PMC.
- To present a case study of successful FMT for a challenging PMC case.
Main Methods:
- A 69-year-old female patient with a 5-month history of refractory PMC was treated with FMT.
- Fecal matter from a healthy donor was processed and administered via colonoscope.
- Patient symptoms and colonoscopy findings were monitored post-procedure.
Main Results:
- The patient experienced rapid symptom improvement following FMT.
- Follow-up colonoscopy confirmed complete resolution of PMC.
- No recurrence of PMC was observed after the FMT procedure.
Conclusions:
- Fecal microbiota transplantation is a viable and effective treatment option for refractory and recurrent Clostridium difficile-associated pseudomembranous colitis.
- FMT offers a promising alternative when standard therapies fail, potentially reducing morbidity and mortality associated with PMC.
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