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Cited by 140Clostridium difficile and Clostridium perfringens researchGut microbiota and healthGastrointestinal motility and disorders

The DOI matches its Crossref record; 60 of the 60 references it cites were found in a registry or an index.

Fecal microbiota transplantation for treatment of recurrent C. difficile infection: An updated randomized controlled trial meta-analysis

Open access
Hui, Wenjia, Li, Ting, Liu, Weidong, Zhou, Chunyan, Gao, Feng·2019·PLoS ONE
DOI 10.1371/journal.pone.0210016PMC PMC6343888
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Abstract

OBJECTIVES: Although systematic evaluation has confirmed the efficacy of fresh fecal microbiota transplantation (FMT) for treatment of recurrent and/or refractory and/or relapse C. difficile infection (RCDI), it lacks the support of well-designed randomized controlled trials (RCTs), and the latest guidelines do not optimize the management of FMT. In this paper, we focus on an in-depth study of fresh FMT and fecal infusion times to guide clinical practice. METHODS: We reviewed studies in PubMed, Medline, Embase, the Cochrane library and Cochrane Central written in English. The retrieval period was from the establishment of the databases to September 20th, 2018. The retrieval objects were published RCTs of RCDI treated by fresh FMT. The intervention group was fresh FMT group, while the control group included antibiotic therapy or placebo or frozen FMT or capsule. The primary and secondary outcomes were the clinical remission of diarrhea without relapse after 8-17 weeks and the occurrence of severe adverse events, respectively. Subgroup analysis analyzed the effect of single and multiple fecal infusions. Two authors independently completed the information extraction and assessed risk of bias and overall quality of the evidence. RESULTS: 8 randomized controlled trials met the inclusion criteria, involving 537 patients (273 in the fresh FMT group and 264 in the control group). The recurrence rate of clinical diarrhea in the fresh FMT group was 11.0% (30/273), which was significantly lower than the control group (24.6%, 65/264; P < 0.05); the pooled relative risk (RR) was 0.38 (95%CI:0.16-0.87; I2 = 67%; P = 0.02) in the fresh FMT group, and the clinical heterogeneity was significant and random effects model was used; However, there was no significant difference neither for the effect of antibiotic treatment/frozen feces transplanted by enema (RR = 1.07; 95%CI: 0.64-1.80; I2 = 0%; P = 0.79) or capsule/frozen feces transplanted by colonoscopy (RR = 0.42; 95%CI: 0.05-3.94; I2 = 43%; P = 0.45) compared with fresh FMT. The subgroup analysis showed that FMT by multiple infusions could effectively and significantly (RR = 0.24; 95%CI:0.10-0.58; I2 = 0%; P = 0.001) improve the clinical diarrhea remission rate. Most mild to moderate adverse events caused by FMT were self-limited and could be quickly alleviated; no severe adverse events happened because of FMT. CONCLUSIONS: Overall, the use of fresh feces for bacterial transplantation was the best efficiency for RCDI compared to antibiotic therapy or placebo. The fecal transmission method by enema was not ideal, but capsules or frozen feces transported by colonoscopy could be an alternative treatment compared to fresh FMT. For patients with severe RCDI, multiple fecal transplants can effectively improve their diarrhea remission rate. The focus of future research should be on how to standardize the production of capsules or frozen feces to better guide the clinical management of RCDI patients by FMT.

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Research works printed but not linked: 4

  1. F Barbut, 2015, [Fecal microbiota transplantation: review], Ann Pharm Fr, 73
  2. T Seufferlein, 2014, [Recurrent Clostridium difficile infection. Treatment with duodenal infusion of donor feces], Internist (Berl), 55
  3. D Kao, 2017, Effect of Oral Capsule–vs Colonoscopy-Delivered Fecal Microbiota Transplantation on Recurrent Clostridium difficile Infection, Jama, 318
  4. A Camacho-Ortiz, 2017, Randomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiome, PLoS ONE, 12, e0189768, 10.1371/journal.pone.0189768 · DOI

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Metadata

Authors
Hui, W., Li, T., Liu, W., Zhou, C., & Gao, F.
Affiliations
  • People's Hospital of Xinjiang Uygur Autonomous Region (CN)
  • Nanchang University (CN)
Corresponding author
Gao, Feng
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2019-01-23
Volume
14
Issue
1
Pages
e0210016
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0210016
PMC
PMC6343888
OpenAlex
W2912755977
Cited by
140
References
60
Citations by year
2026: 3 · 2025: 12 · 2024: 26 · 2023: 18 · 2022: 23 · 2021: 24 · 2020: 20 · 2019: 14
FWCI
15.53
Type
journal article
Language
en
Status
Retracted
Update notices
retraction (2024-12-13)
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
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, recurrent Clostridium difficile infection, antibiotic therapy, adverse events, clinical remission, treatment efficacy comparison, risk of bias assessment, subgroup analysis, meta-analysis of RCTs, evidence quality grading
MeSH terms
Fecal Microbiota Transplantation, Anti-Bacterial Agents, Clostridium Infections, Diarrhea, Feces, Humans, Recurrence, Randomized Controlled Trials as Topic, Clostridioides difficile, Treatment Outcome

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