rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report

Area of Science:

• Microbiology
• Gastroenterology
• Urology

Background:

• Clostridioides difficile infection (CDI) is a major cause of hospital-acquired diarrhea.
• Recurrent urinary tract infections (rUTI) can be linked to gut microbiota dysbiosis.
• Fecal microbiota transplantation (FMT) is effective for recurrent CDI (rCDI) and may impact rUTI.

Purpose of the Study:

• To investigate the potential of FMT in treating co-existing rCDI and rUTI.
• To analyze the impact of FMT on gut microbiota composition in a patient with rCDI and rUTI.
• To explore the link between gut dysbiosis and recurrent infections.

Main Methods:

• Case report of a 93-year-old female patient with rCDI and rUTI.
• Fecal microbiota transplantation (FMT) procedure.
• 16S rRNA gene sequencing to characterize gut microbiota before and after FMT.
• Clinical follow-up for CDI and UTI symptoms.

Main Results:

• Successful clinical resolution of CDI post-FMT.
• Unexpected resolution of rUTI symptoms post-FMT, with no new episodes diagnosed.
• Significant reduction in gut Enterobacteriaceae from 74% to 0.07% post-FMT.
• Increased gut microbial diversity post-FMT, comparable to donor levels.

Conclusions:

• FMT may be a viable therapeutic option for recurrent urinary tract infections (rUTI), especially those caused by multi-drug resistant pathogens.
• Restoration of gut microbiota balance through FMT can lead to the resolution of both CDI and rUTI.
• Gut dysbiosis, particularly Enterobacteriaceae overgrowth, may contribute to recurrent infections in both the gut and urinary tract.