Methods: A retrospective study was performed in two urban medical centers in Detroit, Michigan from May 2010 to April 2015. Nine SCT recipients with recurrent CDI of moderate to severe intensity, not responding to conventional antibiotic therapy were evaluated by Infectious Diseases and referred for FMT. Data abstracted include demographics, co-morbidities, anti-microbial use, immune suppression, severity and number of CDI episodes. Neutropenic subjects were excluded. Healthy donors were screened for communicable diseases. Using fresh stools from the day of procedure, FMT was performed using a nasogastric (NG) or enema route in the outpatient setting. All patients were followed for at least 100 days post-FMT.
Results: Nine SCT recipients (allogeneic 6; autologous 3) received FMT for recurrent CDI during the study period. Median age of the subjects was 56 years (range 43-70). NG route was used to perform FMT in 3 out of 9 patients and enema in the reminder. Resolution of CDI was seen in all patients within 7 days of FMT. By day 100 post-FMT, none of the subjects had any recurrence of CDI. The 30-day all-cause mortality was 0%. No major adverse effect was attributable to FMT. Three of six allogeneic SCT recipients had gastrointestinal graft-versus-host disease (GVHD) at the time of FMT. After FMT, there was no worsening of GVHD and immune suppression was tapered gradually.
Conclusion: In SCT, FMT is effective in treating recurrent CDI. FMT can be safely performed in the outpatient setting.
R. Jayaprakash, None
O. Abreu-Lanfranco, None
G. Alangaden, None
J. Uberti, None
S. Revankar, Astellas: Investigator , Research grant
Merck: Investigator , Research grant
Gilead: Investigator , Research grant
P. Chandrasekar, Astellas: Speaker's Bureau , Speaker honorarium
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