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1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)

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 hospital’s IRB. Patients 65 years of age a...

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Autores principales: Hassoun, Ali, Edwards, Jonathan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255554/
http://dx.doi.org/10.1093/ofid/ofy210.955
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author Hassoun, Ali
Edwards, Jonathan
author_facet Hassoun, Ali
Edwards, Jonathan
author_sort Hassoun, Ali
collection PubMed
description 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 hospital’s 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: Thirty-five 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. [Image: see text] Older adults are particularly susceptible to this potentially deadly disease DISCLOSURES: All authors: No reported disclosures.
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spelling pubmed-62555542018-11-28 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI) Hassoun, Ali Edwards, Jonathan Open Forum Infect Dis Abstracts 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 hospital’s 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: Thirty-five 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. [Image: see text] Older adults are particularly susceptible to this potentially deadly disease DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6255554/ http://dx.doi.org/10.1093/ofid/ofy210.955 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Abstracts
Hassoun, Ali
Edwards, Jonathan
1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title_full 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title_fullStr 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title_full_unstemmed 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title_short 1122. Evaluation of Fecal Microbiota Transplant (FMT) in Elderly Patients With recurrent Clostridium difficile Infection (CDI)
title_sort 1122. evaluation of fecal microbiota transplant (fmt) in elderly patients with recurrent clostridium difficile infection (cdi)
topic Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6255554/
http://dx.doi.org/10.1093/ofid/ofy210.955
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