Fecal microbiota transplantation for management of Clostridium difficile infection
- 444 Downloads
The widespread use of antibiotics has led Clostridium difficile infection (CDI) to become a common problem with pronounced medical and economic effects. The recurrence of CDI after treatment with standard antibiotics is becoming more common with the emergence of more resistant strains of C. difficile. As CDI is an antibiotic-associated disease, further treatment with antibiotic is best avoided. As the gut flora is severely disturbed in CDI, approaches that restore the gut microbiota may become good alternative modes of CDI therapies. Fecal microbiota transplantation (FMT) is the procedure of transplantation of fecal bacteria from a healthy donor individual into a patient for restoration of the normal colonic flora. Thus, FMT helps in the eradication of C. difficile and resolution of clinical symptoms such as diarrhea, cramping, and urgency. Though this approach to treatment is not new, presently, it has become an alternative and promising way of combating infections. The procedure is not in regular use because of the time required to identify a suitable donor, the risk of introducing opportunistic pathogens, and a general patient aversion to the transplant. However, FMT is gaining popularity because of its success rate as a panacea for recurrent attacks of CDI and is being increasingly used in clinical practice. This review describes the rationale, the indications, the results, the techniques, the potential donors, the benefits as well as the complications of fecal microbiota instillation to CDI patients in order to restore the normal gut flora.
KeywordsDonors Dysbiosis Methods Rationale
Conflict of interest
CV does not have any conflict of interest to declare.
- 1.Bakken JS. Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe. 2009;15:285–9.Google Scholar
- 2.van Nood E, Speelman P, Kuijper EJ, Keller JJ. Struggling with recurrent Clostridium difficile infections: is donor faeces the solution? Euro Surveill. 2009;14. pii:19316.Google Scholar
- 4.Sanders WE, Sanders C. Modification of normal flora by antibiotics: Effects on individuals and the environment. In: Root RK, Sande MA, (eds). New Dimensions in Antimicrobial Therapy: Contemporary Issues in Infectious Diseases. New York: Churchill Livingstone; 1984. pp. 217–41.Google Scholar
- 17.Ananthaswamy A. Faecal transplant eases symptoms of Parkinson’s. New Sci. 2011;209:8–9.Google Scholar
- 33.Borody T, Wettstein A, Leis S, Hills L, Campbell J, Torres M. Clostridium difficile complicating inflammatory bowel diseases: pre- and post-treatment findings. Gastroenterology. 2008;134 4 Suppl 1:A–361.Google Scholar
- 36.Russell G, Kaplan J, Ferraro M, Michelow I. Fecal bacteriotherapy for relapsing Clostridium difficile infection in a child: a proposed treatment protocol. Pediatrics. 2010;126:e239–42.Google Scholar
- 40.Wettstein A, Borody T, Leis S, Chongan J, Torres M, Hills L. Faecal bacteriotherapy—an effective treatment for relapsing symptomatic Clostridium difficile infection. Abstract WED-G-67. In: 15th Gut. United European Gastroenterology Week. United European Gastroenterology Federation, France, 2007:39 Suppl 1.Google Scholar
- 44.Louie T. Home-based fecal flora infusion to arrest multiply-recurrent Clostridium difficile infection (CDI). In: Abstracts of the Interscience Conference on Antimicrobial Agents and Chemotherapy (Washington DC) Arlington, VA: Infectious Disease Society of America, 2008.Google Scholar