Applying fecal microbiota transplantation (FMT) to treat recurrent Clostridium difficile infections (rCDI) in children

Content Provider	Semantic Scholar
Author	Fareed, Shaaz Sarode, Neha Stewart, Frank J. Malik, Aneeq Laghaie, Elham Khizer, Saadia Yan, Fengxia Pratte, Zoe A. Lewis, Jeffery L. Immergluck, Lilly Cheng
Copyright Year	2018
Abstract	Background Fecal Microbiota Transplantation (FMT) is an innovative means of treating recurrent Clostridium difficile infection (rCDI), through restoration of gut floral balance. However, there is a lack of data concerning the efficacy of FMT and its impact on the gut microbiome among pediatric patients. This study analyzes clinical outcomes and microbial community composition among 15 pediatric patients treated for rCDI via FMT. Methods This is a prospective, observational, pilot study of 15 children ≤18 years, who presented for rCDI and who met inclusion criteria for FMT at a pediatric hospital and pediatric gastroenterology clinic. Past medical history and demographics were recorded at enrollment and subsequent follow-up. Specimens of the donors' and the patients' pre-FMT and post-FMT fecal specimen were collected and used to assess microbiome composition via 16S rRNA gene sequencing. Results FMT successfully prevented rCDI episodes for minimum of 3 months post-FMT in all patients, with no major adverse effects. Three patients reported continued GI bleeding; however, all three also had underlying Inflammatory Bowel Disease (IBD). Our analyses confirm a significant difference between pre-and post-FMT gut microbiome profiles (Shannon diversity index), whereas no significant difference was observed between post-FMT and donor microbiome profiles. At the phyla level, post-FMT profiles showed significantly increased levels of Bacteroidetes and significantly decreased levels of Proteobacteria. Subjects with underlying IBD showed no difference in their pre-and post-FMT profiles. Conclusion The low rate of recurrence or re-infection by C. difficile, coupled with minimal adverse effects post-FMT, suggests that FMT is a viable therapeutic means to treat pediatric rCDI. Post-FMT microbiomes are different from pre-FMT microbiomes, and similar to those of healthy donors, suggesting successful establishment of a healthier microbiome.
Starting Page	549
Ending Page	557
Page Count	9
File Format	PDF HTM / HTML
Alternate Webpage(s)	https://dash.harvard.edu/bitstream/handle/1/37298568/5984579.pdf?sequence=1
Alternate Webpage(s)	https://peerj.com/articles/4663.pdf
PubMed reference number	5984579
Alternate Webpage(s)	https://doi.org/10.7717/peerj.4663
DOI	10.7717/peerj.4663
Journal	PeerJ
Volume Number	6
Language	English
Access Restriction	Open
Subject Keyword	Bacteroidetes CDISC SEND Biospecimens Terminology Clostridium difficile infection Demography Fecal Microbiota Transplantation Gastrointestinal Hemorrhage Gastrointestinal Microbiome Hospitals, Pediatric Inflammatory Bowel Diseases Intestinal Diseases Irritable Bowel Syndrome Microbiota (plant) Patients Specimen negative regulation of gut granule assembly recurrent childhood brain stem glioma recurrent childhood supratentorial primitive neuroectodermal tumors
Content Type	Text
Resource Type	Article