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Factors Associated with the Use of Fecal Microbiota Transplant in Patients with Recurrent Clostridium difficile Infections

Published online by Cambridge University Press:  24 January 2018

Sehrish Jamot ,
Vikram Raghunathan ,
Kavin Patel ,
Colleen R. Kelly  and
Seah H. Lim
Sehrish Jamot
Affiliation:
Department of Medicine, Rhode Island Hospital/Brown University Warren Alpert Medical School, Providence, Rhode Island
Vikram Raghunathan
Affiliation:
Department of Medicine, Rhode Island Hospital/Brown University Warren Alpert Medical School, Providence, Rhode Island
Kavin Patel
Affiliation:
Department of Medicine, Rhode Island Hospital/Brown University Warren Alpert Medical School, Providence, Rhode Island
Colleen R. Kelly
Affiliation:
Department of Medicine, Rhode Island Hospital/Brown University Warren Alpert Medical School, Providence, Rhode Island
Seah H. Lim*
Affiliation:
Division of Hematology and Oncology, Department of Medicine, Rhode Island Hospital/Brown University Warren Alpert Medical School, Providence, Rhode Island
*
Address correspondence to Seah H. Lim, MD, PhD, Division of Hematology and Oncology, Room 149, APC Building, Rhode Island Hospital, 593 Eddy Street, Providence, RI 02903 ([email protected]).
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Abstract

OBJECTIVE

To identify the factors associated with first Clostridium difficile infection (CDI) that predict fecal microbiota transplantation (FMT) for recurrent CDI

DESIGN

We carried out a retrospective single-center cohort study to compare the clinical characteristics of 200 patients who underwent FMT for recurrent CDI to 75 patients who did not.

SETTING

A single academic hospital in the United States

PATIENTS

Adult patients

RESULTS

The time from first to second CDI correlated to subsequent FMT use. Concomitant inflammatory bowel disease (IBD; P=.002), use of immunosuppressive therapy (P=.04), and use of metronidazole within 2 months before the first CDI (P=.02) correlated positively to subsequent FMT in univariate analysis. The use of oral vancomycin for first CDI was more common in those who required FMT than those who did not in univariate (P=.02) and multivariate (P=.03) analyses. In contrast, intravenous vancomycin use within 2 months before the first CDI reduced the risk for FMT in univariate P=.000003) and multivariate (P=.0001) analyses. Black patients with recurrent CDI were less likely to receive FMT than white patients (P=.00005). Patients who received FMT were also less likely to have comorbidities.

CONCLUSIONS

This study provides important insights into the factors predictive for FMT in patients with recurrent CDI and highlights the potential racial and medical characteristics that affect the access of the patients to FMT.

Infect Control Hosp Epidemiol 2018;39:302–306

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 39 , Issue 3 , March 2018 , pp. 302 - 306
Copyright
© 2018 by The Society for Healthcare Epidemiology of America. All rights reserved 

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Footnotes

a

Authors of equal contribution

References

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