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Experiences with fecal microbiota transplantation in Clostridium difficile infections via upper gastrointestinal tract

Vigvári, Szabolcs and Vincze, Áron and Solt, Jenő and Sipos, Dávid and Feiszt, Zsófia and Kovács, Beáta and Kappéter, Ágnes and Péterfi, Zoltán (2019) Experiences with fecal microbiota transplantation in Clostridium difficile infections via upper gastrointestinal tract. Acta Microbiologica et Immunologica Hungarica, 66 (2). pp. 179-188. ISSN 1217-8950

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Abstract

Dramatic changes in the epidemiology of Clostridium difficile infections have been reported from the western world in the past decade. The proportion of severe cases is significantly elevating and clinicians now have to contend with the problem of additional and more frequent episodes of recurrences including an upward trend in the mortality rate. This situation led us to investigate the possibility of the fecal microbiota transplantation (FMT). An amount of 100 ml of fecal microbiota solution was instilled into a nasojejunal (NJ) tube in 16 cases and into a nasogastric (NG) tube in 44 cases. In all of the cases, where the solution was instilled via nasojejunal tubes, the symptoms resolved within 24 h. We did not note any recurrences in this group. When the material was flushed in through nasogastric tubes, the symptoms resolved in 39 (88.64%) cases within 24 h. In this group, we have experienced a recurrent episode of C. difficile infection in five (11.36%) cases. Three of them were cured with a second transplantation. We have found that in our practice the upper gastrointestinal tract methods had the primary cure rate of 91.67%, whereas the secondary cure rate is 96.67%. When we compared the NJ and NG methods, we have found that the differences in the outcomes are not significant statistically (p = 0.3113 using Fisher’s exact probability test). In conclusion, FMT proved to be very effective, particularly in recurrent infections and in cases where conventional treatment had failed.

Item Type: Article
Subjects: Q Science / természettudomány > QR Microbiology / mikrobiológia
Depositing User: Ágnes Sallai
Date Deposited: 02 Aug 2019 08:17
Last Modified: 17 Jun 2020 13:46
URI: http://real.mtak.hu/id/eprint/94867

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