BACKGROUND:Faecal microbiota transplantation (FMT) has become routine in managing recurrent C. difficile infection (CDI) refractory to antibiotics. AIM: To compare clinical response and improvements in colonic microbiota diversity in subjects with recurrent CDI using different donor product. METHODS:Seventy-two subjects with ≥3 bouts of CDI were randomised in a double-blind study to receive fresh, frozen or lyophilised FMT product via colonoscopy from 50 g of stool per treatment from eight healthy donors. Recipients provided stools pre- and 7, 14 and 30 days post-FMT for C. difficile toxin and, in a subset, microbiome composition by 16S rRNA gene profiling. RESULTS:Overall resolution of CDI was 87% during 2 months of follow-up after FMT. Stool samples before FMT had significantly decreased bacterial diversity with a high proportion of Proteobacteria compared to donors. Cure rates were highest for the group receiving fresh product seen in 25/25 (100%), lowest for the lyophilised product 16/23 (78%; P = 0.022 vs. fresh and 0.255 vs. frozen) and intermediate for frozen product 20/24 (P = 0.233 vs. fresh). Microbial diversity was reconstituted by day 7 in the subjects receiving fresh or frozen product. Improvement in diversity was seen by day 7 in those randomised to lyophilised material with reconstitution by 30 days. CONCLUSIONS: Comparative efficacy in faecal microbiota transplantation was observed in subjects receiving fresh or frozen faecal product from the same donors. The lyophilised product had a slightly lowered efficacy compared with fresh product, but it resembled other treatments in microbial restoration 1 month after faecal microbiota transplantation.
RCT Entities:
BACKGROUND: Faecal microbiota transplantation (FMT) has become routine in managing recurrent C. difficileinfection (CDI) refractory to antibiotics. AIM: To compare clinical response and improvements in colonic microbiota diversity in subjects with recurrent CDI using different donor product. METHODS: Seventy-two subjects with ≥3 bouts of CDI were randomised in a double-blind study to receive fresh, frozen or lyophilised FMT product via colonoscopy from 50 g of stool per treatment from eight healthy donors. Recipients provided stools pre- and 7, 14 and 30 days post-FMT for C. difficile toxin and, in a subset, microbiome composition by 16S rRNA gene profiling. RESULTS: Overall resolution of CDI was 87% during 2 months of follow-up after FMT. Stool samples before FMT had significantly decreased bacterial diversity with a high proportion of Proteobacteria compared to donors. Cure rates were highest for the group receiving fresh product seen in 25/25 (100%), lowest for the lyophilised product 16/23 (78%; P = 0.022 vs. fresh and 0.255 vs. frozen) and intermediate for frozen product 20/24 (P = 0.233 vs. fresh). Microbial diversity was reconstituted by day 7 in the subjects receiving fresh or frozen product. Improvement in diversity was seen by day 7 in those randomised to lyophilised material with reconstitution by 30 days. CONCLUSIONS: Comparative efficacy in faecal microbiota transplantation was observed in subjects receiving fresh or frozen faecal product from the same donors. The lyophilised product had a slightly lowered efficacy compared with fresh product, but it resembled other treatments in microbial restoration 1 month after faecal microbiota transplantation.
Authors: Andreas Stallmach; Arndt Steube; Philip Grunert; Michael Hartmann; Lena M Biehl; Maria J G T Vehreschild Journal: Dtsch Arztebl Int Date: 2020-01-17 Impact factor: 5.594
Authors: Maribeth R Nicholson; Paul D Mitchell; Erin Alexander; Sonia Ballal; Mark Bartlett; Penny Becker; Zev Davidovics; Michael Docktor; Michael Dole; Grace Felix; Jonathan Gisser; Suchitra K Hourigan; M Kyle Jensen; Jess L Kaplan; Judith Kelsen; Melissa Kennedy; Sahil Khanna; Elizabeth Knackstedt; McKenzie Leier; Jeffery Lewis; Ashley Lodarek; Sonia Michail; Maria Oliva-Hemker; Tiffany Patton; Karen Queliza; George H Russell; Namita Singh; Aliza Solomon; David L Suskind; Steven Werlin; Richard Kellermayer; Stacy A Kahn Journal: Clin Gastroenterol Hepatol Date: 2019-04-19 Impact factor: 11.382
Authors: Theodore Rokkas; Javier P Gisbert; Antonio Gasbarrini; Georgina L Hold; Herbert Tilg; Peter Malfertheiner; Francis Megraud; Colm O'Morain Journal: United European Gastroenterol J Date: 2019-05-27 Impact factor: 4.623