JOURNAL ARTICLE

Efficacy of combined jejunal and colonic fecal microbiota transplantation for recurrent Clostridium difficile Infection

Sudhir K Dutta, Mohit Girotra, Shashank Garg, Anand Dutta, Erik C von Rosenvinge, Cynthia Maddox, Yang Song, John G Bartlett, Rakesh Vinayek, W Florian Fricke
Clinical Gastroenterology and Hepatology 2014, 12 (9): 1572-6
24440222
The prevalence of recurrent Clostridium difficile infection (RCDI) is increasing; fecal microbiota transplantation (FMT) is an effective therapy. However, there have been no studies of the efficacy of a single session of combined enteral and colonic FMT or characterizations of changes in the microbiota between donors and recipients. We performed a study of 27 patients with RCDI who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. Patients were closely monitored, and fecal samples were collected from 2 patient-donor pairs for 16S rRNA analysis. All patients had reduced stool frequency, abdominal pain, white blood cell counts, and elimination of fecal C difficile toxin (P < .05). FMT increased microbial diversity, increasing proportions of Lachnospiraceae (phylum Firmicutes) and reducing proportions of Enterobacteriaceae. FMT was associated with marked changes in the composition of fecal microbiota in 2 patients with RCDI.

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