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Updated: Nov 1, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Current Challenges in Fecal Microbiota Transplantation for Clostridioides difficile Infection in Children
Maribeth R Nicholson1, Suchitra K Hourigan2, Maire Conrad3
1Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Insights
Pediatric fecal microbiota transplantation (FMT) practices were significantly impacted by a 2019 FDA safety alert and the COVID-19 pandemic, leading many programs to alter or halt treatments for children.
Area of Science:
- Pediatric Gastroenterology
- Microbiome Therapeutics
- Infectious Disease Control
Background:
- The 2019 US Food and Drug Administration (FDA) safety alert highlighted risks associated with fecal microbiota transplantation (FMT), specifically the transmission of multidrug-resistant organisms.
- The COVID-19 pandemic introduced unprecedented challenges to healthcare delivery and patient management globally.
- The combined impact of these events on the utilization of FMT in pediatric populations remained unclear.
Purpose of the Study:
- To assess the influence of the 2019 FDA safety alert and the COVID-19 pandemic on pediatric fecal microbiota transplantation (FMT) practices.
- To quantify changes in FMT protocols and program operations among pediatric gastroenterologists.
Main Methods:
- A survey was distributed to pediatric gastroenterologists who perform FMT for Clostridioides difficile infection.
- The survey collected data on practice modifications in response to the FDA alert and the pandemic.
Main Results:
- Out of 36 surveyed pediatric gastroenterologists, a significant majority reported changes in their FMT practices.
- 17 respondents (47%) modified practices due to the FDA safety alert.
- 30 respondents (83%) altered practices because of the COVID-19 pandemic, with 22 programs (61%) being halted.
Conclusions:
- Both the FDA safety alert and the COVID-19 pandemic have substantially affected the availability and accessibility of FMT for pediatric patients.
- These external factors necessitated significant adjustments in clinical practice and program continuity for pediatric FMT.
Introduction:
The impact of the 2019 US Food and Drug Administration safety alert involving transmission of multidrug resistant organisms through fecal microbiota transplantation (FMT), and the COVID-19 pandemic on the use of FMT in children, is unknown.
Methods:
A survey of pediatric gastroenterologists performing FMT for Clostridioides difficile infection was conducted.
Results:
Of 36 respondents, 17 (47%) and 30 (83%) changed their FMT practices related to the US Food and Drug Administration safety alert and COVID-19 pandemic, respectively, with 22 (61%) of programs halted.
Discussion:
The US Food and Drug Administration safety alert and COVID-19 pandemic have substantially influenced the availability and access of FMT for children.
