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Cited by 186Clostridium difficile and Clostridium perfringens researchGut microbiota and healthGastrointestinal motility and disorders

The Long-term Efficacy and Safety of Fecal Microbiota Transplant for Recurrent, Severe, and Complicated Clostridium difficile Infection in 146 Elderly Individuals

Agrawal, Manasi, Aroniadis, Olga C., Brandt, Lawrence J., Kelly, Colleen, Freeman, Sarah, Surawicz, Christina, Broussard, Elizabeth, Stollman, Neil +10 more·2016·Journal of Clinical Gastroenterology
DOI 10.1097/mcg.0000000000000410
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Abstract

OBJECTIVES: Clostridium difficile infection (CDI) in the elderly has a higher prevalence, greater morbidity and mortality, and lower response to conventional treatment than the general population. Fecal microbiota transplant (FMT) is highly effective therapy for CDI but has not been studied specifically in the elderly. This study aims to determine the long-term efficacy and safety of FMT for recurrent (RCDI), severe (SCDI), and complicated (CCDI) CDI in elderly patients. METHODS: A multicenter, long-term follow-up study was performed with demographic, pre-FMT, and post-FMT data collected from elderly patients with RCDI, SCDI, and CCDI, through a 47-item questionnaire. Outcome measures included primary and secondary cure rates, early (<12 wk) and late (≥12 wk) recurrence rates, and adverse events (AEs), including post-FMT diagnoses. RESULTS: Of 168 eligible patients, 146 patients met the inclusion criteria. Of these, 68.5% were women. The mean (range) age was 78.6 (65 to 97) years and the follow-up period was 12.3 (1 to 48) months. FMT was performed for RCDI in 89 (61%), SCDI in 45 (30.8%), and CCDI in 12 (8.2%) patients. The primary and secondary cure rates were 82.9% and 95.9%, respectively. Early and late recurrences occurred in 25 and 6 patients, respectively. AEs included CDI-negative diarrhea in 7 (4.8%) and constipation in 4 (2.7%) patients. Serious AEs, recorded in 6 patients, were hospital admissions for CDI-related diarrhea, one of which culminated in death. New diagnoses post-FMT included microscopic colitis (2), Sjogren syndrome (1), follicular lymphoma (1), contact dermatitis and idiopathic Bence-Jones proteinuria (1), and laryngeal carcinoma (1)-all, however, were associated with predisposing factors. CONCLUSIONS: FMT is a safe and effective treatment option for RCDI, SCDI, and CCDI in elderly patients.

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  • Fecal microbiota transplantation is the best methodology to reduce C. difficile-associated diarrhea and eradicate the pathogen, with up to 95.9% success including recalcitrant and severe cases.

    “Regarding C. difficile infection, the best methodology to reduce the associated diarrhea and to eradicate this pathogen is the fecal microbiota transplantation, which has shown up to 95.9% success, including recalcitrant and severe cases (114).”

    From Bifidobacteria and Their Health-Promoting Effects (2017) · cites this paper as [114]

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Authors
Agrawal, M., Aroniadis, O. C., Brandt, L. J., Kelly, C., Freeman, S., Surawicz, C., Broussard, E., Stollman, N., Giovanelli, A., Smith, B., Yen, E., Trivedi, A., Hubble, L., Kao, D., Borody, T., Finlayson, S., Ray, A., & Smith, R.
Affiliations
Montefiore Medical Center (US)
ORCID
Venue
Journal of Clinical Gastroenterology
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2016-05
Volume
50
Issue
5
Pages
403-407
ISSN
0192-0790 (ISSN-L)
DOI
10.1097/mcg.0000000000000410
OpenAlex
W2176600848
Cited by
186
References
30
Citations by year
2026: 5 · 2025: 4 · 2024: 11 · 2023: 14 · 2022: 15 · 2021: 24 · 2020: 25 · 2019: 18 · 2018: 25 · 2017: 24 · 2016: 17 · 2015: 3
FWCI
17.93
Type
journal article
Language
en
Open access
closed
Locations
  • Journal of Clinical Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • OPUS - Open Publications of UTS Scholars (University of Technology Sydney) (submittedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Clostridium difficile and Clostridium perfringens research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Gastroenterology › Gastrointestinal motility and disorders
Keywords
fecal microbiota transplantation, Clostridium difficile infection, recurrent Clostridium difficile infection, severe CDI, elderly patients, long-term efficacy, safety, recurrence, adverse events, microscopic colitis, Sjögren's syndrome, follicular lymphoma, constipation
MeSH terms
Fecal Microbiota Transplantation, Age Factors, Aged, Aged, 80 and over, Clostridium Infections, Female, Humans, Male, Surveys and Questionnaires, Recurrence, Retrospective Studies, Severity of Illness Index, Time Factors, Clostridioides difficile, Treatment Outcome

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