Peter Sabaka
University in Bratislava, Slovak Republic
Title: Faecal microbioal transplantation in the treatment of reccurent clostridioides difficile infection in comnorbid patients - high risk of failure
Biography
Biography: Peter Sabaka
Abstract
Clostridioides difficile infection (CDI) the most common casue of nosocomialdiarrhea. Faecal microbial transplantation (FMT) is the most effective treatment of recurrent CDI. However, many patients experience further recurrences after first course of FMT. The raeasons for FMT failure and its risk factors are unclear. Comorbid status is a risk factor for failure of farmacotherapy of the reccurent CDI and it might be associated with the risk of FMT failure as weell.
We carried out a prospective observational cohort study in order assess the association of comorbid status and FMT failure. Patients with recurrent CDI underwent FMT via retention enema and were followed up for 12 weeks for signs and symptoms of CDI recurrence. FMT failure was defined as recurrence of diarrhoea and a positive stool test for the presence of C. difficile antigen or toxin during the follow-up. We assessed the association of single FMT failure with possible manageable and unmanageable risk factors. Charlson Comorbidity Index (CCI) was used to quantify the comorbidity.
A total of 60 patients (34 women, 26 men) were included in the study. Overall, 15 patients (25%) experienced single FMT failure. O patients with CCI ≥ 7, 50% experienced FMT failure compared to 6.67% of those with CCI below 7. Patients who experienced single FMT failure had a significantly higher CCI and significantly lower albumin concentration as compared to patients who experienced single FMT success. There was no difference in age, C-reactive protein concentration, leukocyte count and time from FMT to first defecation. In multivariate analysis, CCI ≥ 7 was positively associated with the FMT failure. In conclusion, cmorobid status is associated with the high risk of FMT failure in the treatment of reccurent CDI.