A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients

Oluwaseun Shogbesan; Dilli Ram Poudel; Samjeris Victor; Asad Jehangir; Opeyemi O. Fadahunsi; Gbenga Shogbesan; Anthony A Donato

doi:10.1155/2018/1394379

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A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients

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A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients

Oluwaseun Shogbesan, Dilli Ram Poudel, Samjeris Victor, Asad Jehangir, Opeyemi O. Fadahunsi, Gbenga Shogbesan and Anthony A Donato

Canadian journal of gastroenterology & hepatology, v 2018, pp 1-10

01 Jan 2018

DOI: https://doi.org/10.1155/2018/1394379

PMID: 30246002

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Abstract

Background. Fecal microbiota transplantation (FMT) has been shown to be effective in recurrent Clostridium difficile (CD) infection, with resolution in 80% to 90% of patients. However, immunosuppressed patients were often excluded from FMT trials, so safety and efficacy in this population are unknown. Methods. We searched MEDLINE and EMBASE for English language articles published on FMT for treatment of CD infection in immunocompromised patients (including patients on immunosuppressant medications, patients with human immunodeficiency virus (HIV), inherited or primary immunodeficiency syndromes, cancer undergoing chemotherapy, or organ transplant, including-bone marrow transplant) of all ages. We excluded inflammatory bowel disease patients that were not on immunosuppressant medications. Resolution and adverse event rates (including secondary infection, rehospitalization, and death) were calculated. Results. Forty-four studies were included, none of which were randomized designs. A total of 303 immunocompromised patients were studied. Mean patient age was 57.3 years. Immunosuppressant medication use was the reason for the immunocompromised state in the majority (77.2%), and 19.2% had greater than one immunocompromising condition. Seventy-six percent were given FMT via colonoscopy. Of the 234 patients with reported follow-up outcomes, 207/234 (87%) reported resolution after first treatment, with 93% noting success after multiple treatments. There were 2 reported deaths, 2 colectomies, 5 treatment-related infections, and 10 subsequent hospitalizations. Conclusion. We found evidence that supports the use of FMT for treatment of CD infection in immunocompromised patients, with similar rates of serious adverse events to immunocompetent patients.

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Title: A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients
Creators: Oluwaseun Shogbesan (Corresponding Author) - Reading Hospital
Dilli Ram Poudel - Reading Hospital
Samjeris Victor - Pennsylvania State University
Asad Jehangir - Reading Hospital
Opeyemi O. Fadahunsi - Dalhousie University
Gbenga Shogbesan - Piedmont Athens Regional
Anthony A Donato - Reading Hospital
Publication Details: Canadian journal of gastroenterology & hepatology, v 2018, pp 1-10
Publisher: Hindawi
Number of pages: 10
Resource Type: Journal article
Language: English
Academic Unit: Medicine (Graduate); General Internal Medicine
Web of Science ID: WOS:000444973700001
Other Identifier: 991022161339704721

A Systematic Review of the Efficacy and Safety of Fecal Microbiota Transplant for Clostridium difficile Infection in Immunocompromised Patients

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