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Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis

Fecal microbiota transplantation (FMT) has been shown to be an effective treatment for recurrent Clostridioides difficile infections (rCDIs). We assessed the benefits of a multidisciplinary C. difficile clinic for screening FMT eligibility in patients with rCDI. Patients seen at the University of Vi...

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Autores principales: Shin, Jae Hyun, Chaplin, Ashley S., Hays, R. Ann, Kolling, Glynis L., Vance, Sheila, Guerrant, Richard L., Archbald-Pannone, Laurie, Warren, Cirle A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678700/
https://www.ncbi.nlm.nih.gov/pubmed/31315214
http://dx.doi.org/10.3390/jcm8071036
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author Shin, Jae Hyun
Chaplin, Ashley S.
Hays, R. Ann
Kolling, Glynis L.
Vance, Sheila
Guerrant, Richard L.
Archbald-Pannone, Laurie
Warren, Cirle A.
author_facet Shin, Jae Hyun
Chaplin, Ashley S.
Hays, R. Ann
Kolling, Glynis L.
Vance, Sheila
Guerrant, Richard L.
Archbald-Pannone, Laurie
Warren, Cirle A.
author_sort Shin, Jae Hyun
collection PubMed
description Fecal microbiota transplantation (FMT) has been shown to be an effective treatment for recurrent Clostridioides difficile infections (rCDIs). We assessed the benefits of a multidisciplinary C. difficile clinic for screening FMT eligibility in patients with rCDI. Patients seen at the University of Virginia Complicated C. difficile Clinic (CCDC) underwent comprehensive evaluation for possible FMT. Patients were eligible for FMT if there was history of greater than two episodes of rCDI. Patients were evaluated for the outcome after evaluation in the clinic. A total of 113 patients were evaluated: 77 were eligible for FMT, of which 25 patients did not undergo FMT. The rate of recurrence at three months and all-cause mortality were 4.5% and 7% for patients who received FMT and 16.7% and 12.5% for eligible patients who did not receive FMT. There were 36 patients who were not eligible for FMT, with two or fewer recurrences and a recurrence rate of 8.8% and all-cause mortality of 6%. One in three patients screened for FMT had a nutritional deficiency diagnosed, with zinc deficiency being most common (20%). Additional diagnoses, including inflammatory bowel disease, were made during the evaluation. FMT is a highly effective treatment for rCDI, most notably in patients with multiple recurrences. A systematic approach for evaluating patients with rCDI helps identify patients who benefit most from FMT and those who have other conditions.
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spelling pubmed-66787002019-08-19 Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis Shin, Jae Hyun Chaplin, Ashley S. Hays, R. Ann Kolling, Glynis L. Vance, Sheila Guerrant, Richard L. Archbald-Pannone, Laurie Warren, Cirle A. J Clin Med Article Fecal microbiota transplantation (FMT) has been shown to be an effective treatment for recurrent Clostridioides difficile infections (rCDIs). We assessed the benefits of a multidisciplinary C. difficile clinic for screening FMT eligibility in patients with rCDI. Patients seen at the University of Virginia Complicated C. difficile Clinic (CCDC) underwent comprehensive evaluation for possible FMT. Patients were eligible for FMT if there was history of greater than two episodes of rCDI. Patients were evaluated for the outcome after evaluation in the clinic. A total of 113 patients were evaluated: 77 were eligible for FMT, of which 25 patients did not undergo FMT. The rate of recurrence at three months and all-cause mortality were 4.5% and 7% for patients who received FMT and 16.7% and 12.5% for eligible patients who did not receive FMT. There were 36 patients who were not eligible for FMT, with two or fewer recurrences and a recurrence rate of 8.8% and all-cause mortality of 6%. One in three patients screened for FMT had a nutritional deficiency diagnosed, with zinc deficiency being most common (20%). Additional diagnoses, including inflammatory bowel disease, were made during the evaluation. FMT is a highly effective treatment for rCDI, most notably in patients with multiple recurrences. A systematic approach for evaluating patients with rCDI helps identify patients who benefit most from FMT and those who have other conditions. MDPI 2019-07-16 /pmc/articles/PMC6678700/ /pubmed/31315214 http://dx.doi.org/10.3390/jcm8071036 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Shin, Jae Hyun
Chaplin, Ashley S.
Hays, R. Ann
Kolling, Glynis L.
Vance, Sheila
Guerrant, Richard L.
Archbald-Pannone, Laurie
Warren, Cirle A.
Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title_full Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title_fullStr Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title_full_unstemmed Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title_short Outcomes of a Multidisciplinary Clinic in Evaluating Recurrent Clostridioides difficile Infection Patients for Fecal Microbiota Transplant: A Retrospective Cohort Analysis
title_sort outcomes of a multidisciplinary clinic in evaluating recurrent clostridioides difficile infection patients for fecal microbiota transplant: a retrospective cohort analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678700/
https://www.ncbi.nlm.nih.gov/pubmed/31315214
http://dx.doi.org/10.3390/jcm8071036
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