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rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report

Clostridioides difficile infection (CDI) is the leading cause of nosocomial infectious diarrhea. Fecal microbiota transplantation (FMT) is a successful treatment for recurrent CDI (rCDI), and in some patients FMT has been associated with the resolution of recurrent urinary tract infections (rUTI). R...

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Autores principales: Aira, Andrea, Rubio, Elisa, Vergara Gómez, Andrea, Fehér, Csaba, Casals-Pascual, Climent, González, Begoña, Morata, Laura, Rico, Verónica, Soriano, Alex
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Healthcare 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116417/
https://www.ncbi.nlm.nih.gov/pubmed/33136261
http://dx.doi.org/10.1007/s40121-020-00365-8
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author Aira, Andrea
Rubio, Elisa
Vergara Gómez, Andrea
Fehér, Csaba
Casals-Pascual, Climent
González, Begoña
Morata, Laura
Rico, Verónica
Soriano, Alex
author_facet Aira, Andrea
Rubio, Elisa
Vergara Gómez, Andrea
Fehér, Csaba
Casals-Pascual, Climent
González, Begoña
Morata, Laura
Rico, Verónica
Soriano, Alex
author_sort Aira, Andrea
collection PubMed
description Clostridioides difficile infection (CDI) is the leading cause of nosocomial infectious diarrhea. Fecal microbiota transplantation (FMT) is a successful treatment for recurrent CDI (rCDI), and in some patients FMT has been associated with the resolution of recurrent urinary tract infections (rUTI). Recent evidence suggests that the origin of most bacterial infections in the urinary tract is the gut. Thus, the possibility of using FMT to displace pathogens commonly involved in rUTIs has major therapeutic implications. We report the case of a 93-year-old female patient with a rCDI and rUTI that underwent FMT and reported a complete clinical resolution of CDI; unexpectedly, no new symptomatic UTI episodes were diagnosed post-FMT. We characterized the gut microbiota of the stool donor and of the patient before and after the procedure. Our patient presented a dysbiosis with clear predominance of Enterobacteriaceae (74%) before FMT, which was significantly reduced to 0.07% after FMT. These findings were maintained for almost a year. We also observed an increase in microbial diversity indices compared with the pre-FMT sample reaching diversity values comparable to the donor stool samples. We reasoned that the disappearance of UTIs in our patient resulted from the reduction of Enterobacteriaceae in the gut microbiota. Our findings support previous evidence suggesting the potential of FMT for rUTI, particularly in cases due to multi-drug resistant pathogens where conventional antibiotic treatment is not an option.
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spelling pubmed-81164172021-05-14 rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report Aira, Andrea Rubio, Elisa Vergara Gómez, Andrea Fehér, Csaba Casals-Pascual, Climent González, Begoña Morata, Laura Rico, Verónica Soriano, Alex Infect Dis Ther Case Report Clostridioides difficile infection (CDI) is the leading cause of nosocomial infectious diarrhea. Fecal microbiota transplantation (FMT) is a successful treatment for recurrent CDI (rCDI), and in some patients FMT has been associated with the resolution of recurrent urinary tract infections (rUTI). Recent evidence suggests that the origin of most bacterial infections in the urinary tract is the gut. Thus, the possibility of using FMT to displace pathogens commonly involved in rUTIs has major therapeutic implications. We report the case of a 93-year-old female patient with a rCDI and rUTI that underwent FMT and reported a complete clinical resolution of CDI; unexpectedly, no new symptomatic UTI episodes were diagnosed post-FMT. We characterized the gut microbiota of the stool donor and of the patient before and after the procedure. Our patient presented a dysbiosis with clear predominance of Enterobacteriaceae (74%) before FMT, which was significantly reduced to 0.07% after FMT. These findings were maintained for almost a year. We also observed an increase in microbial diversity indices compared with the pre-FMT sample reaching diversity values comparable to the donor stool samples. We reasoned that the disappearance of UTIs in our patient resulted from the reduction of Enterobacteriaceae in the gut microbiota. Our findings support previous evidence suggesting the potential of FMT for rUTI, particularly in cases due to multi-drug resistant pathogens where conventional antibiotic treatment is not an option. Springer Healthcare 2020-11-02 2021-06 /pmc/articles/PMC8116417/ /pubmed/33136261 http://dx.doi.org/10.1007/s40121-020-00365-8 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/Open Access This article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Case Report
Aira, Andrea
Rubio, Elisa
Vergara Gómez, Andrea
Fehér, Csaba
Casals-Pascual, Climent
González, Begoña
Morata, Laura
Rico, Verónica
Soriano, Alex
rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title_full rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title_fullStr rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title_full_unstemmed rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title_short rUTI Resolution After FMT for Clostridioides difficile Infection: A Case Report
title_sort ruti resolution after fmt for clostridioides difficile infection: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116417/
https://www.ncbi.nlm.nih.gov/pubmed/33136261
http://dx.doi.org/10.1007/s40121-020-00365-8
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