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Updated: Dec 11, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Factors Related to Outcomes of Fecal Microbiota Transplantation in Patients with Clostridioides difficile Infection
Hyuk Yoon1, Hyun Ik Shim1, Mijin Seol2
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Background/Aims:
The aim of this study was to evaluate factors related to outcomes of fecal microbiota transplantation (FMT) in patients with Clostridioides difficile infection (CDI) and viability of frozen stock for FMT.
Methods:
Clinical data of patients who had received FMT for CDI were prospectively collected. Next-generation 16S rRNA gene sequencing of bacteria was performed from donors' and recipients' stool. Colony-forming units (CFUs) of cultures from frozen stock solutions for FMT were measured at 0, 4, 8, 12, 24, 48 weeks after preparation of the solutions.
Results:
In total, 25 FMT procedures were performed in 20 cases (14 fresh and 11 frozen FMT). Forty-five percent of cases involved fulminant CDI. The overall success rate was 55% after the 1st FMT and 75% after the 2nd FMT. The success rate was significantly higher in partially treated CDI than in refractory CDI (100% vs 71.4%; p=0.001). In successful cases only, the decrease in alpha-diversity in the recipient stool microbiomes was recovered after FMT to a level similar to that in donor stools. There was a significant difference in the microbiome composition in pre-FMT recipients' stool between successful and failed cases (p=0.001). The CFUs of frozen solution for FMT did not decrease for 48 weeks in both aerobic and anaerobic cultures.
Conclusions:
FMT is highly effective in partially treated CDI but not in refractory CDI. The microbiome differs between failed and successful cases. Frozen stock for FMT is viable up to 48 weeks.
Insights
Fecal microbiota transplantation (FMT) shows high success in partially treated Clostridioides difficile infection (CDI) but not refractory CDI. Frozen FMT preparations remain viable for 48 weeks, supporting their clinical utility.
Area of Science:
- Microbiology
- Gastroenterology
- Immunology
Background:
- Clostridioides difficile infection (CDI) poses a significant clinical challenge.
- Fecal microbiota transplantation (FMT) is an emerging therapeutic option for recurrent and refractory CDI.
- Understanding factors influencing FMT success and the stability of FMT preparations is crucial.
Purpose of the Study:
- To evaluate factors influencing the outcomes of fecal microbiota transplantation (FMT) in patients with Clostridioides difficile infection (CDI).
- To assess the viability of frozen fecal microbiota stock for FMT procedures.
- To analyze the impact of FMT on recipient microbiome diversity and composition.
Main Methods:
- Prospective collection of clinical data from patients undergoing FMT for CDI.
- 16S rRNA gene sequencing to analyze bacterial communities in donor and recipient stool samples.
- Measurement of colony-forming units (CFUs) in frozen FMT stock solutions over 48 weeks.
Main Results:
- Overall success rates were 55% after the first FMT and 75% after the second FMT.
- FMT demonstrated significantly higher success rates in partially treated CDI (100%) compared to refractory CDI (71.4%).
- Successful FMT restored alpha-diversity in recipient microbiomes to donor levels, with distinct pre-FMT microbiome compositions in successful versus failed cases. Frozen stock maintained CFU counts for 48 weeks.
Conclusions:
- FMT is highly effective for partially treated CDI but less so for refractory CDI.
- Microbiome composition differences are significant between successful and failed FMT cases.
- Frozen FMT stock is stable and viable for at least 48 weeks, supporting its use in clinical practice.
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