Pediatric Study – Treating Recurrent Clostridium difficile Infection with Fecal Microbiota Transplant:
A small pilot study featuring 15 pediatric patients found that 14 out of 15 with recurring
C. difficile infections reported no additional episodes more than 3 months following the procedure, reported Aneeq Malik, BS, of Morehouse School of Medicine in Atlanta, and colleagues. They presented their results at the Pediatric Academic Societies (PAS) annual meeting.
Overall, 15 children underwent the procedure — seven male and eight female, with a mean age of 7.9 years, with at least three episodes of C. difficile within a 3-month period. The patients ranged from 21 months to 18 years, and had an average of 5.7 diarrheal stools per day, as well as an average of 3.3 courses of antibiotics within a 12-month period. Seven also had ulcerative colitis, while two apiece had Crohn’s disease and GERD.
Following a stool transplant from a pre-screened stool bank, patients were followed up via phone at 24 hours and 1 week after the procedure and were instructed to see their GI doctor at 1 and 3 months afterwards. Three patients were hospitalized a month following the procedure for diarrhea, dehydration and rCDI. However, only one patient was actually found to have clinical symptoms of C. difficile plus a positive stool test.
Limitations to the study included the size of the sample, as well as the fact that clinical symptoms were based on self-report and that several of their patients had underlying GI conditions. Co-author Lilly Immergluck, MD, also of Morehouse School of Medicine, said at the presentation that she considered that a strength of the study — that the success rate of the procedure was high, despite the patients’ other conditions.
Brandt said that despite limitations, he still characterized the procedure as exciting and said the evaluation of the microbiome will be very important for the future of this research.
“I think in the future we probably will not be using stool – we’ll be using some product derived from stool – because we don’t really know what the protecting organism is,” he said.
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