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Faecal microbiota transplantation in patients with Clostridium difficile and significant comorbidities as well as in patients with new indications:A case series

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World Journal of Gastroenterology 2017年第39期23卷 7174-7184页

作者： Perttu Lahtinen Eero Mattila veli-jukka anttila Jyrki Tillonen Matti Teittinen Pasi Nevalainen Seppo Salminen Reetta Satokari Perttu Arkkila Department of Gastroenterology Paijat-Hame Central HospitalLahti 15850Finland Department of Infectious Diseases Helsinki University Hospital Department of Medicine Hyvinkaa Hospital Department of Medicine Tampere University Hospital Functional Foods Forum University of Turku Immunobiology Research Program Faculty of MedicineUniversity of Helsinki Department of Gastroenterology Helsinki University Hospital

Fecal microbiota transplantation(FMT) is effective in recurrent Clostridium difficile infection(r CDI). Knowledge of the safety and efficacy of FMT treatment in immune deficient patients is scarce. FMT has been suggested as a potential method for an increasing number of new indications besides r CDI. Among our FMT-treated r CDI patients, we reviewed those with major comorbidities: two human immunodeficiency virus patients, six haemodialysis patients, two kidney transplant patients, two liver transplant patients and a patient with chronic lymphatic leukaemia. We also reviewed those treated with FMT for indications other than r CDI: Salmonella carriage(two patients), trimethylaminuria(two patients), small intestinal bacterial overgrowth(SIBO;one patient), and lymphocytic colitis(one patient), as well as a common variable immunodeficiency patient with chronic norovirus infection and ESBL-producing Escherichia coli(E. coli) carriage. Of the thirteen r CDI patients treated with FMT, eleven cleared the CDI. The observed adverse events were not directly attributable to FMT. Concerning the special indications, both Salmonellas and ESBL-producing E. coli were eradicated. One trimethylaminuria patient and one SIBO-patient reported a reduction of symptoms. Three patients did not experience a benefit from FMT: chronic norovirus, lymphocytic colitis and the other fish malodour syndrome. There were no reported side effects in this group. FMT appeared to be safe and effective for immunocompromised patients with r CDI. FMT showed promise for the eradication of antibiotic-resistant bacteria, but further research is warranted.

关键词： Faecal microbiota transplantation Antibiotic resistance Clostridium difficile infection Microbiota Immunodeficiency Salmonella infection

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