Background: CDI is a bacterial infection that typically occurs after the use of broad-spectrum antibiotics. Older adults are particularly susceptible to this potentially deadly disease and at higher risk of recurrence.
Methods: The study was approved by the hospitals IRB. Patients 65 years of age and older with refractory or recurrent CDI who received FMT administered via colonoscopy or oral capsules were included. Patients with severe-complicated infection were excluded and ineligible to receive FMT. Each patient was evaluated 8 weeks post-transplant to assess for sustained clinical response and adverse events. Data collection included patient demographics, number of recurrent CDI episodes, CDI severity, previous antibiotic treatment regimens, clinical cure, adverse events, and donor information.
Results: 35 patients were enrolled (23 colonoscopy FMT vs 13 oral capsule FMT). One patient received FMT via colonoscopy twice. Mean age was 77 years [65-93], female 60%, median recurrent episode was 3, and median CDI severity score was 2. Total success rate was 69.4% (25/36), 60.9% (14/23) via colonoscopy vs. 84.6% (11/13) via capsule. Total success rate for female 67% vs 73% male and age group of 65-75 was 60% vs 76% in age group 75+. For capsules only, cure rate was 80% in female vs 100% in male and 75% in 65-75 age group vs 89% in patients older than 75 while in colonoscopy only group, success rate was 55% in female vs 67% in males and 46% in 65-75 age group vs 67% in age group 75+. There did not seem to be a correlation between FMT donor and success rate. No serious adverse events were reported in the study population.
Conclusion: FMT may be considered a potentially useful therapy for the treatment of refractory or recurrent CDI cases in patients 65 years of age and older. Further studies are needed to confirm the above findings.
Older adults are particularly susceptible to this potentially deadly disease