Daryl Ramai1, Karl Zakhia2, Paul J Fields3, Andrew Ofosu4, Goonja Patel3, Vahe Shahnazarian4, Jonathan K Lai5, Amaninder Dhaliwal6, Madhavi Reddy4, Shannon Chang7. 1. Department of Medicine, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Ave, Brooklyn, NY, 11201, USA. dramai@tbh.org. 2. Department of Medicine, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Ave, Brooklyn, NY, 11201, USA. 3. School of Medicine, Windward Islands Research and Education Foundation, St. George's University, True Blue, Grenada. 4. Division of Gastroenterology and Hepatology, The Brooklyn Hospital Center, Clinical Affiliate of The Mount Sinai Hospital, 121 DeKalb Ave, Brooklyn, NY, 11201, USA. 5. Department of Pathology, McGill University, 1001 Decarie Boulevard, Montreal, QC, H4A 3J1, Grenada. 6. Division of Gastroenterology, University of Nebraska Medical Center, S 42nd and Emile St, Omaha, NE, 68198, USA. 7. Division of Gastroenterology, NYU Langone Health, 40 East 38th Street, 23rd Floor, New York, NY, 10016, USA.
Abstract
BACKGROUND: Several routes of fecal microbiota transplantation (FMT) administration are available for treating recurrent Clostridioides difficile infections (CDI), the most recent of which are capsules. AIM: To assess the efficacy of colonoscopy, capsule, enema, and nasogastric tube (NGT) FMT for the treatment of recurrent CDI. METHODS: We reported clinical outcomes of colonoscopy, capsule, enema, and NGT FMT for the treatment of recurrent CDI according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. During January 2000 to January 2018, three databases were searched: PubMed, EMBASE, and CINAHL. Primary outcome was overall cure rate which was assessed using a random effects model; secondary outcomes included adverse effects as well as subgroup analyses comparing donor relationship, sample preparation, and study design. RESULTS: Twenty-six studies (1309 patients) were included in the study. FMT was administered using colonoscopy in 16 studies (483 patients), NGT in five studies (149 patients), enema in four studies (360 patients), and capsules in four studies (301 patients). The random effects of pooled FMT cure rates were colonoscopy 94.8% (CI 92.4-96.8%; I2 15.6%), capsule 92.1% (CI 88.6-95.0%; I2 7.1%), enema 87.2% (CI 83.4-90.5%; I2 0%), and NGT/NDT 78.1% (CI 71.6-84.1%; I2 0%). On subgroup analysis of colonoscopy FMT, sample preparation methods had comparable cure rates: fresh 94.9% compared to 94.5%. Similarly, cure rates were unaffected by donor relationship: mixed 94.5% compared to unrelated donor 95.7%. CONCLUSION: CDI cure rates with FMT performed with colonoscopy are superior to enema and NGT FMT, while those with FMT with colonoscopy and capsule are comparable.
BACKGROUND: Several routes of fecal microbiota transplantation (FMT) administration are available for treating recurrent Clostridioides difficile infections (CDI), the most recent of which are capsules. AIM: To assess the efficacy of colonoscopy, capsule, enema, and nasogastric tube (NGT) FMT for the treatment of recurrent CDI. METHODS: We reported clinical outcomes of colonoscopy, capsule, enema, and NGT FMT for the treatment of recurrent CDI according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. During January 2000 to January 2018, three databases were searched: PubMed, EMBASE, and CINAHL. Primary outcome was overall cure rate which was assessed using a random effects model; secondary outcomes included adverse effects as well as subgroup analyses comparing donor relationship, sample preparation, and study design. RESULTS: Twenty-six studies (1309 patients) were included in the study. FMT was administered using colonoscopy in 16 studies (483 patients), NGT in five studies (149 patients), enema in four studies (360 patients), and capsules in four studies (301 patients). The random effects of pooled FMT cure rates were colonoscopy 94.8% (CI 92.4-96.8%; I2 15.6%), capsule 92.1% (CI 88.6-95.0%; I2 7.1%), enema 87.2% (CI 83.4-90.5%; I2 0%), and NGT/NDT 78.1% (CI 71.6-84.1%; I2 0%). On subgroup analysis of colonoscopy FMT, sample preparation methods had comparable cure rates: fresh 94.9% compared to 94.5%. Similarly, cure rates were unaffected by donor relationship: mixed 94.5% compared to unrelated donor 95.7%. CONCLUSION:CDI cure rates with FMT performed with colonoscopy are superior to enema and NGT FMT, while those with FMT with colonoscopy and capsule are comparable.
Authors: Jessica R Allegretti; Monika Fischer; Sashidhar V Sagi; Matthew E Bohm; Hala M Fadda; Sejal R Ranmal; Shrish Budree; Abdul W Basit; Dean L Glettig; Eva L de la Serna; Amanda Gentile; Ylaine Gerardin; Sonia Timberlake; Rotem Sadovsky; Mark Smith; Zain Kassam Journal: Dig Dis Sci Date: 2018-12-05 Impact factor: 3.199
Authors: Jaroslaw Bilinski; Mikolaj Dziurzynski; Pawel Grzesiowski; Edyta Podsiadly; Anna Stelmaszczyk-Emmel; Tomasz Dzieciatkowski; Karol Lis; Martyna Tyszka; Krzysztof Ozieranski; Łukasz Dziewit; Grzegorz W Basak Journal: Front Microbiol Date: 2022-07-01 Impact factor: 6.064
Authors: Simon Mark Dahl Baunwall; Mads Ming Lee; Marcel Kjærsgaard Eriksen; Benjamin H Mullish; Julian R Marchesi; Jens Frederik Dahlerup; Christian Lodberg Hvas Journal: EClinicalMedicine Date: 2020-11-23
Authors: Frederik Cold; Simon Mark Dahl Baunwall; Jens Frederik Dahlerup; Andreas Munk Petersen; Christian Lodberg Hvas; Lars Hestbjerg Hansen Journal: Therap Adv Gastroenterol Date: 2021-08-31 Impact factor: 4.409
Authors: Paul Feuerstadt; Olga C Aroniadis; Felicia L Svedlund; Mariana Garcia; Laura Stong; Mena Boules; Sahil Khanna Journal: Dig Dis Sci Date: 2021-07-18 Impact factor: 3.487