Mark J Koenigsknecht1, Vincent B Young. 1. aDepartment of Internal Medicine, Division of Infectious Diseases bDepartment of Microbiology & Immunology, The University of Michigan, Ann Arbor, Michigan, USA.
Abstract
PURPOSE OF REVIEW: The use of faecal microbiota transplantation (FMT) as treatment for recurrent Clostridium difficile infection (CDI) has increased rapidly over the past few years. In this review, we highlight clinical studies of FMT for treatment of recurrent CDI and discuss the safety, standardization and future of this treatment option. The major risk factor for CDI is prior antibiotic use, which results in an altered state of the gut microbiota characterized by decreased microbial diversity. This altered gut microbiota increases the patient's susceptibility to CDI. In patients with recurrent CDI, the microbiota remains in a state with decreased diversity, and FMT from a healthy individual restores the gut microbiota and subsequently colonization resistance against the pathogen. RECENT FINDINGS: Recent studies have shown the success rate for FMT as treatment for recurrent CDI being greater than 90%. Standardized, frozen preparations of faeces can be used, which increases the availability of faeces for FMT and decreases the cost of screening individual donors. In addition, there have been recent advances in identifying a defined microbial community isolated from faeces that can restore colonization resistance against C. difficile. SUMMARY: The use of FMT is a successful treatment for recurrent CDI when primary treatment options have failed. However, more work needs to define potential long-term consequences of this treatment and understand how specific members of the gut microbiota can restore colonization resistance against C. difficile.
PURPOSE OF REVIEW: The use of faecal microbiota transplantation (FMT) as treatment for recurrent Clostridium difficileinfection (CDI) has increased rapidly over the past few years. In this review, we highlight clinical studies of FMT for treatment of recurrent CDI and discuss the safety, standardization and future of this treatment option. The major risk factor for CDI is prior antibiotic use, which results in an altered state of the gut microbiota characterized by decreased microbial diversity. This altered gut microbiota increases the patient's susceptibility to CDI. In patients with recurrent CDI, the microbiota remains in a state with decreased diversity, and FMT from a healthy individual restores the gut microbiota and subsequently colonization resistance against the pathogen. RECENT FINDINGS: Recent studies have shown the success rate for FMT as treatment for recurrent CDI being greater than 90%. Standardized, frozen preparations of faeces can be used, which increases the availability of faeces for FMT and decreases the cost of screening individual donors. In addition, there have been recent advances in identifying a defined microbial community isolated from faeces that can restore colonization resistance against C. difficile. SUMMARY: The use of FMT is a successful treatment for recurrent CDI when primary treatment options have failed. However, more work needs to define potential long-term consequences of this treatment and understand how specific members of the gut microbiota can restore colonization resistance against C. difficile.
Authors: Matthew J Hamilton; Alexa R Weingarden; Michael J Sadowsky; Alexander Khoruts Journal: Am J Gastroenterol Date: 2012-01-31 Impact factor: 10.864
Authors: Stacy A Kahn; Ashley Vachon; Dylan Rodriquez; Sarah R Goeppinger; Bonnie Surma; Julia Marks; David T Rubin Journal: Inflamm Bowel Dis Date: 2013-06 Impact factor: 5.325
Authors: Lawrence J Brandt; Olga C Aroniadis; Mark Mellow; Amy Kanatzar; Colleen Kelly; Tina Park; Neil Stollman; Faith Rohlke; Christina Surawicz Journal: Am J Gastroenterol Date: 2012-03-27 Impact factor: 10.864
Authors: Els van Nood; Anne Vrieze; Max Nieuwdorp; Susana Fuentes; Erwin G Zoetendal; Willem M de Vos; Caroline E Visser; Ed J Kuijper; Joep F W M Bartelsman; Jan G P Tijssen; Peter Speelman; Marcel G W Dijkgraaf; Josbert J Keller Journal: N Engl J Med Date: 2013-01-16 Impact factor: 91.245
Authors: L V McFarland; C M Surawicz; R N Greenberg; R Fekety; G W Elmer; K A Moyer; S A Melcher; K E Bowen; J L Cox; Z Noorani Journal: JAMA Date: 1994 Jun 22-29 Impact factor: 56.272
Authors: Elaine O Petrof; Gregory B Gloor; Stephen J Vanner; Scott J Weese; David Carter; Michelle C Daigneault; Eric M Brown; Kathleen Schroeter; Emma Allen-Vercoe Journal: Microbiome Date: 2013-01-09 Impact factor: 14.650