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2017 ; 23
(39
): 7174-7184
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gab.com Text
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Faecal microbiota transplantation in patients with Clostridium difficile and
significant comorbidities as well as in patients with new indications: A case
series
#MMPMID29093626
Lahtinen P
; Mattila E
; Anttila VJ
; Tillonen J
; Teittinen M
; Nevalainen P
; Salminen S
; Satokari R
; Arkkila P
World J Gastroenterol
2017[Oct]; 23
(39
): 7174-7184
PMID29093626
show ga
Fecal microbiota transplantation (FMT) is effective in recurrent Clostridium
difficile infection (rCDI). Knowledge of the safety and efficacy of FMT treatment
in immune deficient patients is scarce. FMT has been suggested as a potential
method for an increasing number of new indications besides rCDI. Among our
FMT-treated rCDI patients, we reviewed those with major comorbidities: two human
immunodeficiency virus patients, six haemodialysis patients, two kidney
transplant patients, two liver transplant patients and a patient with chronic
lymphatic leukaemia. We also reviewed those treated with FMT for indications
other than rCDI: Salmonella carriage (two patients), trimethylaminuria (two
patients), small intestinal bacterial overgrowth (SIBO; one patient), and
lymphocytic colitis (one patient), as well as a common variable immunodeficiency
patient with chronic norovirus infection and ESBL-producing Escherichia coli (E.
coli) carriage. Of the thirteen rCDI patients treated with FMT, eleven cleared
the CDI. The observed adverse events were not directly attributable to FMT.
Concerning the special indications, both Salmonellas and ESBL-producing E. coli
were eradicated. One trimethylaminuria patient and one SIBO-patient reported a
reduction of symptoms. Three patients did not experience a benefit from FMT:
chronic norovirus, lymphocytic colitis and the other fish malodour syndrome.
There were no reported side effects in this group. FMT appeared to be safe and
effective for immunocompromised patients with rCDI. FMT showed promise for the
eradication of antibiotic-resistant bacteria, but further research is warranted.