Decrease in Surgery for <i>Clostridium difficile</i> Infection After Starting a Program to Transplant Fecal Microbiota
Authors: Giovanni Cammarota, Gianluca Ianiro, Sabina Magalini, Antonio Gasbarrini, Daniele Gui
Journal: Annals of Internal Medicine (2015)

Letters15 September 2015Decrease in Surgery for Clostridium difficile Infection After Starting a Program to Transplant Fecal MicrobiotaGiovanni Cammarota, MD, Gianluca Ianiro, MD, Sabina Magalini, MD, Antonio Gasbarrini, MD, and Daniele Gui, MDGiovanni Cammarota, MDFrom A. Gemelli Hospital, Catholic University, Rome, Italy., Gianluca Ianiro, MDFrom A. Gemelli Hospital, Catholic University, Rome, Italy., Sabina Magalini, MDFrom A. Gemelli Hospital, Catholic University, Rome, Italy., Antonio Gasbarrini, MDFrom A. Gemelli Hospital, Catholic University, Rome, Italy., and Daniele Gui, MDFrom A. Gemelli Hospital, Catholic University, Rome, Italy.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L15-5139 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Background: Clostridium difficile infection is increasing in incidence, severity, and mortality (1). Surgery is sometimes used to manage complicated infections because it improves short-term survival (2); however, it is associated with high rates of morbidity and poor long-term survival (3). Surgery is most often used when disease recurs and cannot be controlled with antibiotics, because the risk for severe complications and mortality increases greatly during these recurrences (4). An alternative effective treatment for recurrent disease involves delivery of stool from a healthy donor directly into a patient's colon. This procedure is known as fecal microbiota transplantation (FMT), and it can ...References1. Lessa FC, Mu Y, Bamberg WM, Beldavs ZG, Dumyati GK, Dunn JR, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372:825-34. [PMID: 25714160] doi:10.1056/NEJMoa1408913 CrossrefMedlineGoogle Scholar2. Stewart DB, Hollenbeak CS, Wilson MZ. Is colectomy for fulminant Clostridium difficile colitis life saving? A systematic review. Colorectal Dis. 2013;15:798-804. [PMID: 23350898] doi:10.1111/codi.12134 CrossrefMedlineGoogle Scholar3. Dallas KB, Condren A, Divino CM. Life after colectomy for fulminant Clostridium difficile colitis: a 7-year follow up study. Am J Surg. 2014;207:533-9. [PMID: 24674828] doi:10.1016/j.amjsurg.2013.04.008 CrossrefMedlineGoogle Scholar4. Olsen MA, Yan Y, Reske KA, Zilberberg MD, Dubberke ER. Recurrent Clostridium difficile infection is associated with increased mortality. Clin Microbiol Infect. 2015;21:164-70. [PMID: 25658560] doi:10.1016/j.cmi.2014.08.017 CrossrefMedlineGoogle Scholar5. Drekonja D, Reich J, Gezahegn S, Greer N, Shaukat A, MacDonald R, et al. Fecal microbiota transplantation for Clostridium difficile infection: a systematic review. Ann Intern Med. 2015;162:630-8. [PMID: 25938992] doi:10.7326/M14-2693 LinkGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From A. Gemelli Hospital, Catholic University, Rome, Italy.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=L15-0294. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byCost‐effectiveness analysis of sequential fecal microbiota transplantation for fulminant Clostridioides difficile infectionFecal Microbiota Transplantation for Severe or Fulminant Clostridioides difficile Infection: Systematic Review and Meta-analysisSuccessful use of early, repeat fecal microbiota transplantation for initial treatment of severe, refractory Clostridioides difficile colitisACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile InfectionsMicrobiota-based Therapies Clostridioides difficile infection that is refractory to antibiotic therapySystematic Review with Meta-Analysis: Fecal Microbiota Transplantation for Severe or Fulminant Clostridioides difficileFecal microbiota transplantation: donor selection criteria, storage and preparation of biomaterials (review of current recommendations)Fecal Microbiota Transplantation for Clostridioides difficile in High-Risk Older Adults Is Associated with Early RecurrenceCost-effectiveness analysis of a fecal microbiota transplant center for treating recurrent C.difficile infectionFecal Microbiota Transplant Decreases Mortality in Patients with Refractory Severe or Fulminant Clostridioides difficile InfectionFecal microbiota transplantation in gastrointestinal and extraintestinal disordersFrom Donor to Patient: Collection, Preparation and Cryopreservation of Fecal Samples for Fecal Microbiota TransplantationFecal Microbiota Transplantation: Screening and Selection to Choose the Optimal DonorClinical management of severe, fulminant, and refractory Clostridioides difficile infectionClostridioides difficile (formerly Clostridium difficile) infection in the critically ill: an expert statementExpert opinion on fecal microbiota transplantation for the treatment of Clostridioides difficile infection and beyondTreatment of Severe and Fulminnant Clostridioides difficile InfectionInternational consensus conference on stool banking for faecal microbiota transplantation in clinical practiceIncidence of Bloodstream Infections, Length of Hospital Stay, and Survival in Patients With Recurrent Clostridioides difficile Infection Treated With Fecal Microbiota Transplantation or Antibiotics A Prospective Cohort StudyGianluca Ianiro, MD, Rita Murri, MD, Giusi Desirè Sciumè, MD, Michele Impagnatiello, MD, Luca Masucci, MD, Alexander C. 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Potential role of faecal microbiota transplantationRandomised clinical trial: faecal microbiota transplantation by colonoscopy plus vancomycin for the treatment of severe refractory Clostridium difficile infection-single versus multiple infusionsExploring ways to improve CDI outcomesFaecal Microbiota Transplantation as Emerging Treatment in European CountriesThe Present Status of Fecal Microbiota Transplantation and Its Value in the ElderlyFecal microbiota transplant in severe and severe-complicated Clostridium difficile : A promising treatment approachPredictors of failure after single faecal microbiota transplantation in patients with recurrent Clostridium difficile infection: results from a 3-year, single-centre cohort studyEuropean consensus conference on faecal microbiota transplantation in clinical practiceCurrent challenges in the treatment of severe Clostridium difficile infection: early treatment potential of fecal microbiota transplantationPredictors of fecal transplant failureAltered intestinal microbiota as a major driving force in alcoholic steatohepatitis 15 September 2015Volume 163, Issue 6Page: 487-488KeywordsColonDisclosureObservational studiesResearch laboratoriesSurgeryToxinsTransplantation ePublished: 15 September 2015 Issue Published: 15 September 2015 Copyright & PermissionsCopyright © 2015 by American College of Physicians. 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