Fecal Microbiota Transplantation

Breaking the Chain of Recurrent C. difficile Infection

Amy Marinski, MSN, RN, CCRN, CNL

Disclosures

Am Nurs Today. 2013;8(6) 

In This Article

Postprocedure Care

For at least 2 hours after the procedure, keep the head of the bed elevated at least 30 degrees to reduce reflux and aspiration. Patients may experience belching, abdominal cramping, and nausea, but these symptoms should last only a few hours. They may resume their normal diet or tube feedings 2 hours after the procedure.

Many patients report feeling better within 24 hours of FMT. Be sure to document continued diarrhea, as FMT may need to be repeated after 5 days if the diarrhea continues. FMT is deemed successful if symptoms resolve and don't recur for 8 weeks; at that point, the patient is considered clinically cured. Patients don't need to be retested for C. difficile, as they're likely to remain colonized with the bacteria but not infected. Patients are tested only if they're symptomatic.

In patients who've undergone FMT, the cure rate for MR-CDI is nearly 90%. Yet barriers to this procedure persist; for instance, most insurance companies don't cover donor screening costs. Also, few hospitals have FMT protocols, making preparation and administration difficult.

As a nurse, you may come in contact with patients who have MR-CDI. You can play a crucial role in reducing MR-CDI by disseminating information about FMT. The next time you encounter a patient with MR-CDI, consider recommending FMT to the healthcare team.

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