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Safety and Efficacy of Fecal Microbiota Transplant in 9 Critically Ill Patients with Severe and Complicated Clostridium Difficile Infection with Impending Colectomy: A Case Series.

Research paper by Joseph J Alukal, Sudhir K SK Dutta, Balarama Krishna BK Surapaneni, Michelle M Le, Obada O Tabbaa, Laila L Philips, Mark C MC Mattar

Indexed on: 12 Apr '19Published on: 11 Apr '19Published in: Journal of Digestive Diseases



Abstract

There is significant data that support the efficacy and safety of Fecal Microbiota Transplant ( FMT) in Recurrent Clostridium Difficile Infection (RCDI). The objective of our study was to determine the success rate of FMT in patients diagnosed with severe and complicated CDI with impending colectomy in the ICU setting. This was a 2 center study, which consisted of 9 patients who met criteria of severe and complicated CDI and had impending colectomy. All 9 patients failed conventional antibiotic therapy and were deemed too unstable to undergo colectomy. Hence, FMT was considered as the next step in management. Following FMT there was marked improvement in clinical status with resolution of diarrhea, reduced vasopressor requirement, reduction in abdominal distention and pain.The primary cure rate of our study after a single round of FMT was 78% (7/9). 8 out of the 9 patients (88.88%) avoided a colectomy during the same hospital admission. CDI related death was 12.5% (1/9) and non CDI death was 12.5% (1/9). Our success with FMT in fulminant CDI shows that this therapeutic modality is a promising alternative and could be a potential bowel saving intervention. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

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