KR Conover et al. JPGN 2023; 76: 440-446. Fecal Microbiota Transplantation for Clostridioides difficile Infection in Immunocompromised Pediatric Patients
In this multicenter retrospective cohort (n=42), the authors examined the efficacy and safety of fecal microbiota transplantation (FMT) in immunocompromised (IC) children with Clostridioides difficile infection (CDI). Etiology of IC included: solid organ transplantation (18, 43%), malignancy (12, 28%), primary immunodeficiency (10, 24%), or other chronic conditions (2, 5%)
- 23 (55%) of FMT was delivered via colonoscopy, 17 (40%) were delivered via enteric tube, and 2 (5%) via capsule
- Success rate was 79% after first FMT and 86% after 1 or more FMT.
- There were serious adverse events (SAEs) in 13 out of 42 (31%) patients; 4 (9.5%) of which were likely treatment-related (all patients recovered). These events included cecal perforation, aspiration pneumonitis, diarrhea and fever. Given retrospective design of study, AEs were likely underreported
My take: Though there are the potential for significant adverse effects, FMT is effective in a high percentage of immunocompromised children with CDI.
Related blog posts:
- Fecal Microbioata Transplantation for Recurrent Clostridium difficile — Position Paper (NASPGHAN-ESPGHAN)
- FDA Approves Pharmaceutical Fecal Transplant Product
- ACG Clostridium Difficile Guidelines Plus One
- Why It Is Still A Bad Idea To Test Asymptomatic Patients For Clostridium Difficile
- Fecal Microbial Transplantation -Evidence for Use Beyond Recurrent Clostridium Difficile
- Two Studies: 1. COVID-19 Transmissibility 2.Fecal Microbiota Transplantation in 372 Children
- Only 3% Make It Through the Donor Screening Process for Fecal Microbiota Transplantation
- FDA News: FDA Warning for FMT, IB-Stim Device Approval, Teduglutide Approval