Keywords
Clostridioides Difficile
Clostridium Infections
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Abstract
Objective: To evaluate the efficacy of fecal microbiota transplantation (FMT) in the treatment of primary and recurrent Clostridioides difficile infections in adult patients. Methods: This integrative review included a search of the PubMed Central (PMC) database, resulting in 584 articles identified using MeSH terms and Boolean operators. After applying the inclusion and exclusion criteria, 23 articles were selected. Results: The studies indicate that fecal microbiota transplantation (FMT) is promising in the treatment of Clostridioides difficile (CD) infections, reducing pathogens and engaging the immune response. In addition, different forms of TMF, such as capsule and frozen, have demonstrated efficacy, although formulation standardization is still a challenge. Other aspects addressed include the possible consequences of fecal transplantation, such as changes in the microbiota and cardiometabolic implications. Final considerations: The research points to fecal microbiota transplantation (FMT) as an effective and safe treatment for Clostridioides difficile infection (CDI), surpassing conventional methods. However, there are gaps in the understanding of the mechanisms of FMT and concerns about possible associations with acute myocardial infarction (AMI). Continued research is crucial, as TMF promises to solve recurrent DCI, benefiting patients' quality of life and reducing costs.
References
BRUNO G, et al. Fecal Microbial Transplantation impact on gut microbiota composition and metabolome, microbial translocation and T-lymphocyte immune activation in recurrent Clostridium difficile infection patients. New Microbiologica, 2019; 42(4): 221-224.
DAWWAS GK, et al. Long-term Outcomes Following Multiply Recurrent Clostridioides difficile Infection and Fecal Microbiota Transplantation. Clinical Gastroenterology and Hepatology, 2022; 20(4): 806-816.e6.
FRISBEE AL e PETRI WA. Considerando o sistema imunológico durante o transplante de microbiota fecal para infecção por Clostridioides difficile. Tendências em medicina molecular, 2020; 26(5): 496-507.
HALAWEISH HF, et al. Encapsulated Fecal Microbiota Transplantation: Development, Efficacy, and Clinical Application. Frontier Cellular Infection Microbiology, 2022;12:826114.
HOCKING L, et al. Transplante de microbiota fecal para infecções recorrentes por C. difficile: desafios e oportunidades de melhoria para a prática clínica e sistemas de saúde. Alimentary Pharmacology & Therapeutics, 2023; 57 (5): 549-564.
HOCQUART M. Early Fecal Microbiota Transplantation Improves Survival in Severe Clostridium difficile Infections. Clinical Infectious Diseases, 2018; 66(5):645-50
HUI W, et al. Fecal microbiota transplantation for treatment of recurrent C. difficile infection: An updated randomized controlled trial meta-analysis. PLoS One, 2019; 14(1):e0210016.
HVAS CL, et al. Fecal microbiota transplantation is superior to fidaxomicin for treatment of recurrent Clostridium difficile infection. Gastroenterology, 2019; 156(5): 1324-1332
JARMO O, et al. Treatment of Clostridioides (Clostridium) difficile infection. Ann Med, 2020; 52 (1-2):12-20.
KHAN MY, et al. Comparing fecal microbiota transplantation to standard-of-care treatment for recurrent Clostridium difficile infection: a systematic review and meta-analysis.European Journal of Gastroenterology & Hepatology, 2018; 30(11):1309-1317.
KHANNA S. Microbiota restoration for recurrent Clostridioides difficile: Getting one step closer every day! Journal of Internal Medicine, 2021; 290(2): 294-309.
KHORUTS A. Is fecal microbiota transplantation a temporary patch for treatment of Clostridium difficile infection or a new frontier of therapeutics? Expert Review of Gastroenterology & Hepatology 2018, 12(5), 435-438
MARTINEZ-GILI L, et al. Understanding the mechanisms of efficacy of fecal microbiota transplant in treating recurrent Clostridioides difficile infection and beyond: the contribution of gut microbial-derived metabolites. Gut Microbes, 2020; 12(1): 1810531.
MONAGHAN TM, et al. A multi-factorial observational study on sequential fecal microbiota transplant in patients with medically refractory Clostridioides difficile infection. Cells, 2021;10(11), 3234.
MONAGHAN TM, et al. Fecal microbiota transplantation for recurrent Clostridioides difficile infection associates with functional alterations in circulating microRNAs. Gastroenterology, 2021a; 161(1): 255-270
OSMAN M, et al. Effectiveness and Safety of Fecal Microbiota Transplantation for Clostridioides Difficile Infection: Results From a 5344-Patient Cohort Study. Gastroenterology, 2022; 163(1): 319-322.
PAKNIKAR R e PEKOW J. Transplante de microbiota fecal para o manejo da infecção por Clostridium difficile. Infecções cirúrgicas, 2018; 19 (8): 785-791.
PARK H, et al. The success of fecal microbial transplantation in Clostridium difficile infection correlates with bacteriophage relative abundance in the donor: a retrospective cohort study. Gut Microbes, 2019; 10(6): 676-687.
PERLER BK, et al. Long-Term Efficacy and Safety of Fecal Microbiota Transplantation for Treatment of Recurrent Clostridioides difficile Infection. Journal of Clinical Gastroenterology, 2020; 54(8): 701-706.
PONTE A, et al. Fecal microbiota transplantation in refractory or recurrent Clostridium difficile infection: a real-life experience in a non-academic center. Rev Esp Enferm Dig, 2018; 110(5), 311-315.
ROKKAS T, et al. A network meta-analysis of randomized controlled trials exploring the role of fecal microbiota transplantation in recurrent Clostridium difficile infection. United European Gastroenterology Journal 2019, 7(8), 1051-1063.
SAHA S, et al. Long-term Safety of Fecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection. Gastroenterology. 2021; 160(6), 1961-1969.
SHIN JH, et al. Prevention and treatment of recurrent Clostridioides difficile infection. Current Opinion in Infectious Diseases, 2019;32(5), 482-489.
SOVERAL LF, et al. Immunological mechanisms of fecal microbiota transplantation in recurrent Clostridioides difficile infection. World Journal of Gastroenterology, 2022; 28(33): 4762-4772.
URBONAS T. Fecal Microbiome Transplantation for Recurrent Clostridioides difficile Infection: Treatment Efficacy, Short and Long-term Follow-up Results from Consecutive Case Series. J Gastrointestin Liver Dis, 2021; 30(4):470-476
WANG JW, et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc, 2019; 118 (1): 23-31.
WEI S, et al. Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection. Gut Microbes, 2022; 14(1): 2084306
YADEGAR A, et al. Efeitos benéficos do transplante de microbiota fecal na infecção recorrente por Clostridioides difficile. Cell Host & Microbe, 2023; 31(5): 695-711.
ZUO T, et al. Bacteriophage transfer during faecal microbiota transplantation in Clostridium difficile infection is associated with treatment outcome. Gut, 2018; 67(4): 634-643.