Sahil Khanna1, Aaron Tande2, David T Rubin3, Alexander Khoruts4, Stacy A Kahn5, Darrell S Pardi6. 1. Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN. Electronic address: khanna.sahil@mayo.edu. 2. Infectious Diseases, Mayo Clinic, Rochester, MN. 3. Section of Gastroenterology, Hepatology and Nutrition, University of Chicago Medicine, Chicago, IL. 4. Gastroenterology, Hepatology and Nutrition, University of Minnesota, Minneapolis, MN. 5. Division of Gastroenterology, Hepatology and Nutrition, Boston Children's Hospital, Boston, MA. 6. Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN.
Abstract
OBJECTIVE: To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. METHODS: A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. RESULTS: Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. CONCLUSIONS: With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.
OBJECTIVE: To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficileinfection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. METHODS: A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. RESULTS: Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. CONCLUSIONS: With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.
Authors: Bas Groenewegen; Emilie van Lingen; Rogier E Ooijevaar; Els Wessels; Mariet C W Feltkamp; Eline Boeije-Koppenol; Hein W Verspaget; Ed J Kuijper; Joffrey van Prehn; Josbert J Keller; Elisabeth M Terveer Journal: PLoS One Date: 2022-03-17 Impact factor: 3.240