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e118
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
Conclusions:
Continued treatment with OCA for up to 2 years
was safe and generally well tolerated, with trends for improved
tolerability.
OC.12.9
FECAL MICROBIOTA TRANSPLANTATION FOR RECURRENT C.
DIFFICILE INFECTION: A 2-YEAR EXPERIENCE FROM A EUROPEAN
REFERRAL CENTRE
Cammarota G.
1
, Ianiro G.*
1
, Masucci L.
2
, Pecere S.
1
, Bibbò S.
1
,
Dibitetto F.
1
, Monelli E.
1
, Sanguinetti M.
2
, Gasbarrini A.
1
1
Internal Medicine, Gastroenterology and Liver Unit - Catholic
University of Rome, Rome, Italy,
2
Microbiology Unit - Catholic
University of Rome, Rome, Italy
Background and aim:
Fecal microbiota transplantation (FMT) from
healthy donors is considered an effective treatment against recurrent
Clostridium difficile infection (rCDI). To date, however, FMT is
available only in few Centers worldwide. FMT was implemented in
our Centre since June 2013. Our aim is to report outcomes of a large
series of patients treated with FMT for rCDI in a European academic
tertiary care Centre after 2 years of experience.
Material and methods:
All patients treated with FMT for rCDI in
our Centre were prospectively identified. Follow-up data, including
diarrhea, C. difficile toxin status and adverse events were collected
and analyzed.
Results:
45 subjects M/F: 23/22; mean age 70, range 29-91)
received FMT from healthy donors because of rCDI (mean n° of
recurrences: 3, range 2-6). Mean Charlson Comorbidity Index score
was 3. Inpatient/outpatient ratio was 2.5. Twelve patients received
multiple infusions, for a total of 66 procedures. All procedures were
performed by colonoscopy. In 13 patients, endoscopic appearance of
pseudomembranous colitis (PMC) was observed. The mean follow-
up was 12 months (range 1-27 months). Resolution of rCDI occurred
in 43 of the 45 treated patients (96%). No patients experienced
further recurrences after FMT. Fecal material was provided by
unrelated donors in 38 procedures. Both fresh and frozen feces were
used. K. Pneumoniae-related sepsis occurred in one patient (3%) 24
h after the transplant, and resolved after antibiotic treatment. In 2
patients (6%), all suffering from concomitant urinary infections, a
transient, self-limiting bacteriemia was observed 1 to 6 days after
FMT. Two subjects died because of overwhelming CDI from 1 to 10
days after FMT failure. Eight patients died 6 to 12 months after FMT,
because of their own comorbidities (mainly cardiovascular disease)
not relatable to the procedure.
Conclusions:
FMT by colonoscopy achieved a 96% resolution rate
of rCDI in our series. Our results confirm the efficacy of FMT in
the treatment of rCDI in a large series of European patients, with a
mean follow-up of 9 months. Dissemination of FMT is warranted to
provide a better management of patients with rCDI.