Fewer Bloodstream Infections With Fecal Transplantation in Recurrent C Diff

By Reuters Staff

November 07, 2019

NEW YORK (Reuters Health) - The incidence of bloodstream infections with recurrent Clostridioides difficile infection (CDI) is lower in patients treated with fecal-microbiota transplantation (FMT) than in those given antibiotics, according to a prospective cohort study.

CDI is associated with an increased risk of bloodstream infection. FMT is more effective than antibiotics in treating recurrent CDI, but whether it also prevents CDI-related bloodstream infections remains unclear.

Dr. Gianluca Ianiro of Universita Cattolica del Sacro Cuore, in Rome, and colleagues assessed the incidence of primary bloodstream infections in 290 patients with recurrent CDI, of whom 109 were treated with FMT and 181 were treated with antibiotics.

Sustained cure rates of CDI were higher after FMT (97%) than after antibiotic treatment (38%), mirroring earlier research.

The overall incidence of bloodstream infection during the 90-day follow-up was 16% (5/290 patients) and was lower in the FMT group (5/109, 5%) than in the antibiotic group (40/181, 22%), the researchers report in Annals of Internal Medicine, online November 5.

The difference with even greater in 57 propensity-score-matched pairs of patients, at 4% (2/57) in the FMT group and 26% (15/57) in the antibiotic group, a significant difference.

The mean length of hospitalization was significantly shorter in patients treated with FMT than in those treated with antibiotics (13.3 days vs. 29.7 days overall and 13.4 days vs. 27.8 days in the propensity-score-matched group).

Overall survival at 90 days was significantly higher in the FMT group than in the antibiotic group (92% vs. 61% overall and 89% vs. 58% in the propensity-score-matched group).

"Should our results be confirmed by larger, randomized studies, FMT could be considered an effective treatment option to both cure recurrent CDI and prevent some of its complications, including bloodstream infections," the authors conclude.

The study had no funding.

Dr. Ianiro did not respond to a request for comments.

SOURCE: https://bit.ly/2PNEwbh

Ann Intern Med 2019.