Outcomes of Fecal Microbiota Transfer in Patients with Recurrent Clostridioides Difficile Infection: Real-World Data from a Single Center in Switzerland.

<p>Introduction: Clostridioides difficile is the most frequently reported healthcare-associated infection with around 125'000 occurrences and 3'700 deaths annually in Europe. Recurrence rates are about 20% and risk factors include age >65 years and inflammatory bowel disease (IBD). Fecal microbiota transfer (FMT) has emerged as a highly effective treatment for recurrent C. difficile infection (rCDI), being successful in more than 90% of patients. This retrospective single-center study aimed to evaluate the effectiveness and safety of FMT in patients with rCDI at the University Hospital Zurich.

methodsBetween 2012 and 2022, 84 patients underwent FMT for rCDI at our center, of which 83 were included in the final analysis. The median patient age was 71 years (22-97 years), and the majority of patients were female (67.5%). All patients had received multiple prior courses of antibiotic treatment for C. difficile infection.

resultsThe success rate following a single FMT was 92.8%, increasing to 97.6% with repeated procedures. Those rates were comparable in the IBD subgroup. FMT was well tolerated. Mild adverse events were reported in 14.5% of patients, most commonly reported adverse event being ongoing IBD activity (33.3%), and diarrhea (33.3%) followed by abdominal pain (25%). Serious adverse events occurred in 3.6% of patients mainly related to underlying conditions.

conclusionOur study confirms that FMT is a highly effective and well-tolerated treatment for rCDI, even in older patients with comorbidities. Importantly, FMT was successfully implemented without the use of a national stool bank, instead relying on locally processed related donor stool, highlighting its feasibility in resource-limited settings. </p>.