Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease

Masoumeh Azimirad,1 Abbas Yadegar,1 Fatemeh Gholami,1 Shabnam Shahrokh,2 Hamid Asadzadeh Aghdaei,3 Gianluca Ianiro,4 Hidekazu Suzuki,5 Giovanni Cammarota,4 Mohammad Reza Zali2 1Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Behes...

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Autores principales:	Azimirad M, Yadegar A, Gholami F, Shahrokh S, Asadzadeh Aghdaei H, Ianiro G, Suzuki H, Cammarota G, Zali MR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2020
Materias:	fecal microbiota transplantation recurrent clostridium difficile infection inflammatory bowel disease fmt rcdi ibd iran Pathology RB1-214 Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/66b1577637a446929e4c5ac8c928bb4a
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spelling	oai:doaj.org-article:66b1577637a446929e4c5ac8c928bb4a2021-12-02T08:42:40ZTreatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease1178-7031https://doaj.org/article/66b1577637a446929e4c5ac8c928bb4a2020-09-01T00:00:00Zhttps://www.dovepress.com/treatment-of-recurrent-clostridioides-difficile-infection-using-fecal--peer-reviewed-article-JIRhttps://doaj.org/toc/1178-7031Masoumeh Azimirad,1 Abbas Yadegar,1 Fatemeh Gholami,1 Shabnam Shahrokh,2 Hamid Asadzadeh Aghdaei,3 Gianluca Ianiro,4 Hidekazu Suzuki,5 Giovanni Cammarota,4 Mohammad Reza Zali2 1Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy; 5Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, JapanCorrespondence: Abbas YadegarFoodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Shahid Arabi Ave., Yemen St., Velenjak, Tehran, IranEmail a.yadegar@sbmu.ac.irPurpose: Fecal microbiota transplantation (FMT) is an effective treatment option for patients with recurrent Clostridioides difficile infection (rCDI). However, there is a paucity of evidence regarding its efficacy and safety in patients with rCDI and concurrent inflammatory bowel disease (IBD). Here, we present a single-center experience of FMT for treatment of rCDI in Iranian patients with IBD.Patients and Methods: Eight patients with established IBD (7 with ulcerative colitis and 1 with Crohn’s disease) who underwent at least one FMT via colonoscopy for treatment of rCDI were enrolled in this study. Demographics, pre-FMT and post-FMT IBD activity, efficacy for rCDI and adverse events (AEs) were assessed during a 6-month follow-up period. All patients had experienced 3 episodes of rCDI and were refractory to conventional therapies with metronidazole and vancomycin. Primary cure and secondary cure rates were assessed after FMT treatments.Results: A total of 10 FMTs were performed via colonoscopy in 8 patients (6/8; 75% men) with a median age of 35 years (range: 22– 60). Two patients received a second FMT. Overall, the primary and secondary cure rates were 75% and 100%, respectively. Two patients developed CPE-producing C. perfringens diagnoses after second FMTs. There were no other AEs, and no patient experienced IBD flare.Conclusion: We demonstrated that FMT appears to be an effective, safe and rational therapeutic alternative for resolution of rCDI in patients with underlying IBD. Furthermore, we suggest implementing the CPE-producing C. perfringens testing in the screening of FMT donors.Keywords: fecal microbiota transplantation, recurrent Clostridioides difficile infection, inflammatory bowel disease, FMT, rCDI, IBD, IranAzimirad MYadegar AGholami FShahrokh SAsadzadeh Aghdaei HIaniro GSuzuki HCammarota GZali MRDove Medical Pressarticlefecal microbiota transplantationrecurrent clostridium difficile infectioninflammatory bowel diseasefmtrcdiibdiranPathologyRB1-214Therapeutics. PharmacologyRM1-950ENJournal of Inflammation Research, Vol Volume 13, Pp 563-570 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	fecal microbiota transplantation recurrent clostridium difficile infection inflammatory bowel disease fmt rcdi ibd iran Pathology RB1-214 Therapeutics. Pharmacology RM1-950
spellingShingle	fecal microbiota transplantation recurrent clostridium difficile infection inflammatory bowel disease fmt rcdi ibd iran Pathology RB1-214 Therapeutics. Pharmacology RM1-950 Azimirad M Yadegar A Gholami F Shahrokh S Asadzadeh Aghdaei H Ianiro G Suzuki H Cammarota G Zali MR Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
description	Masoumeh Azimirad,1 Abbas Yadegar,1 Fatemeh Gholami,1 Shabnam Shahrokh,2 Hamid Asadzadeh Aghdaei,3 Gianluca Ianiro,4 Hidekazu Suzuki,5 Giovanni Cammarota,4 Mohammad Reza Zali2 1Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 4Digestive Disease Center, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Catholic University of Sacred Heart, Rome, Italy; 5Division of Gastroenterology and Hepatology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, JapanCorrespondence: Abbas YadegarFoodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Shahid Arabi Ave., Yemen St., Velenjak, Tehran, IranEmail a.yadegar@sbmu.ac.irPurpose: Fecal microbiota transplantation (FMT) is an effective treatment option for patients with recurrent Clostridioides difficile infection (rCDI). However, there is a paucity of evidence regarding its efficacy and safety in patients with rCDI and concurrent inflammatory bowel disease (IBD). Here, we present a single-center experience of FMT for treatment of rCDI in Iranian patients with IBD.Patients and Methods: Eight patients with established IBD (7 with ulcerative colitis and 1 with Crohn’s disease) who underwent at least one FMT via colonoscopy for treatment of rCDI were enrolled in this study. Demographics, pre-FMT and post-FMT IBD activity, efficacy for rCDI and adverse events (AEs) were assessed during a 6-month follow-up period. All patients had experienced 3 episodes of rCDI and were refractory to conventional therapies with metronidazole and vancomycin. Primary cure and secondary cure rates were assessed after FMT treatments.Results: A total of 10 FMTs were performed via colonoscopy in 8 patients (6/8; 75% men) with a median age of 35 years (range: 22– 60). Two patients received a second FMT. Overall, the primary and secondary cure rates were 75% and 100%, respectively. Two patients developed CPE-producing C. perfringens diagnoses after second FMTs. There were no other AEs, and no patient experienced IBD flare.Conclusion: We demonstrated that FMT appears to be an effective, safe and rational therapeutic alternative for resolution of rCDI in patients with underlying IBD. Furthermore, we suggest implementing the CPE-producing C. perfringens testing in the screening of FMT donors.Keywords: fecal microbiota transplantation, recurrent Clostridioides difficile infection, inflammatory bowel disease, FMT, rCDI, IBD, Iran
format	article
author	Azimirad M Yadegar A Gholami F Shahrokh S Asadzadeh Aghdaei H Ianiro G Suzuki H Cammarota G Zali MR
author_facet	Azimirad M Yadegar A Gholami F Shahrokh S Asadzadeh Aghdaei H Ianiro G Suzuki H Cammarota G Zali MR
author_sort	Azimirad M
title	Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
title_short	Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
title_full	Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
title_fullStr	Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
title_full_unstemmed	Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease
title_sort	treatment of recurrent clostridioides difficile infection using fecal microbiota transplantation in iranian patients with underlying inflammatory bowel disease
publisher	Dove Medical Press
publishDate	2020
url	https://doaj.org/article/66b1577637a446929e4c5ac8c928bb4a
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Treatment of Recurrent Clostridioides difficile Infection Using Fecal Microbiota Transplantation in Iranian Patients with Underlying Inflammatory Bowel Disease

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