Impact of Clinical and Pharmacological Parameters on Faecal Microbiota Transplantation Outcome in Clostridioides difficile Infections: Results of a 5-Year French National Survey.
Clostridioides difficile infection
faecal microbiota transplantation
frozen preparation
glycerol
Journal
Alimentary pharmacology & therapeutics
ISSN: 1365-2036
Titre abrégé: Aliment Pharmacol Ther
Pays: England
ID NLM: 8707234
Informations de publication
Date de publication:
10 Oct 2024
10 Oct 2024
Historique:
revised:
13
05
2024
received:
24
04
2024
accepted:
25
09
2024
medline:
13
10
2024
pubmed:
13
10
2024
entrez:
10
10
2024
Statut:
aheadofprint
Résumé
Detailed comparative assessment of procedure-related factors associated with faecal microbiota transplantation (FMT) efficacy in Clostridioides difficile infection (CDI) is limited. We took advantage of the differences in procedures at the various French FMT centres to determine clinical and procedure-related factors associated with FMT success in CDI. We performed a nationwide retrospective multicentre cohort study. All FMTs performed within The French Faecal Transplant Group for CDI from 2018 to 2022 were included. Clinical data were collected retrospectively from recipient medical files, characteristics of stool transplant preparations were prospectively collected by each Pharmacy involved. Univariate and multivariate analyses were performed using Fisher's test and multiple logistic regression. Six hundred fifty-eight FMTs were performed for 617 patients in 17 centres. The overall efficacy of FMT was 84.3% (520/617), with 0.5% of severe adverse events possibly related to FMT (3/658). Forty-seven patients were treated at the first recurrence of CDI with a similar success rate (85.1%). Severe chronic kidney disease (CKD; OR: 2.18, 95%CI [1.20-3.88]), non-severe refractory CDI (OR: 15.35, [1.94-318.2]), the use of ≥ 80% glycerol (OR: 2.52, [1.11-5.67]), insufficient bowel cleansing (OR: 5.47, [1.57-20.03]) and partial FMT retention (OR: 9.97, [2.62-48.49]) were associated with CDI recurrence within 8 weeks. Conditions of transplant manufacturing, bowel cleansing, and a route of delivery tailored to the patient's characteristics are key factors in optimising FMT efficacy. FMT at first recurrence showed high success in real-life practice, whereas it had lower efficacy in severe CDI and non-severe refractory CDI.
Sections du résumé
BACKGROUND
BACKGROUND
Detailed comparative assessment of procedure-related factors associated with faecal microbiota transplantation (FMT) efficacy in Clostridioides difficile infection (CDI) is limited.
AIMS
OBJECTIVE
We took advantage of the differences in procedures at the various French FMT centres to determine clinical and procedure-related factors associated with FMT success in CDI.
METHODS
METHODS
We performed a nationwide retrospective multicentre cohort study. All FMTs performed within The French Faecal Transplant Group for CDI from 2018 to 2022 were included. Clinical data were collected retrospectively from recipient medical files, characteristics of stool transplant preparations were prospectively collected by each Pharmacy involved. Univariate and multivariate analyses were performed using Fisher's test and multiple logistic regression.
RESULTS
RESULTS
Six hundred fifty-eight FMTs were performed for 617 patients in 17 centres. The overall efficacy of FMT was 84.3% (520/617), with 0.5% of severe adverse events possibly related to FMT (3/658). Forty-seven patients were treated at the first recurrence of CDI with a similar success rate (85.1%). Severe chronic kidney disease (CKD; OR: 2.18, 95%CI [1.20-3.88]), non-severe refractory CDI (OR: 15.35, [1.94-318.2]), the use of ≥ 80% glycerol (OR: 2.52, [1.11-5.67]), insufficient bowel cleansing (OR: 5.47, [1.57-20.03]) and partial FMT retention (OR: 9.97, [2.62-48.49]) were associated with CDI recurrence within 8 weeks.
CONCLUSIONS
CONCLUSIONS
Conditions of transplant manufacturing, bowel cleansing, and a route of delivery tailored to the patient's characteristics are key factors in optimising FMT efficacy. FMT at first recurrence showed high success in real-life practice, whereas it had lower efficacy in severe CDI and non-severe refractory CDI.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Nicolas Benech
(N)
Nadim Cassir
(N)
Laurent Alric
(L)
Chloé Melchior
(C)
Alexis Mosca
(A)
Anne-Christine Joly
(AC)
Nathalie Kapel
(N)
Frédéric Barbut
(F)
Tatiana Galperine
(T)
Bénédicte Pigneur
(B)
Benjamin Davido
(B)
Stéphane Schneider
(S)
Thomas Briot
(T)
Mathieu Wasiak
(M)
Biba Nebad
(B)
Rui Batista
(R)
Alexis Mosca
(A)
Alexandre Bleibtreu
(A)
Julien Scanzi
(J)
Harry Sokol
(H)
Rachel Sintes
(R)
Alexandrine Corriger
(A)
Laurent Flet
(L)
Rui Batista
(R)
Gabriel Perlemuter
(G)
Mina Ahloulay
(M)
Hassane Sadou Yaye
(H)
Alexis de Rougemont
(A)
Emmanuelle Olivier
(E)
Christophe Burucoa
(C)
Jean Gérard Gobert
(JG)
Cecilia Landman
(C)
Luc Vignal
(L)
Francisca Joly
(F)
Aurelie Ravinet
(A)
Agnès Bellanger
(A)
Jean-Marc Sabate
(JM)
Caroline Humbert
(C)
Judith Aron
(J)
Chloé Charpentier
(C)
Alicia Moreno-Sabater
(A)
Céline Takoudju
(C)
Philippe Poirier
(P)
Florence Tanne
(F)
Victoire Dor
(V)
Camille Stampfli
(C)
Informations de copyright
© 2024 The Author(s). Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd.
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