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European consensus conference on faecal microbiota transplantation in clinical practice.

Published on Apr 1, 2017in Gut17.94
· DOI :10.1136/gutjnl-2016-313017
G. Cammarota46
Estimated H-index: 46
(UCSC: Catholic University of the Sacred Heart),
Gianluca Ianiro21
Estimated H-index: 21
(UCSC: Catholic University of the Sacred Heart)
+ 25 AuthorsAntonio Gasbarrini70
Estimated H-index: 70
(UCSC: Catholic University of the Sacred Heart)
Cite
Abstract
Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.
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  • References (89)
  • Citations (139)
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References89
Newest
Published on Dec 1, 2017in BMC Infectious Diseases2.56
Edward Broughton1
Estimated H-index: 1
,
Samson Haumba2
Estimated H-index: 2
+ 9 AuthorsPasipamire Munyaradzi1
Estimated H-index: 1
Diagnosis of tuberculosis is difficult among pregnant women because the signs and symptoms of the disease, such as fatigue, shortness of breath, sweating, cough, and mild fever are similar to some manifestations of pregnancy. It is particularly challenging among HIV-infected women as symptoms are often masked or atypical. Currently, WHO recommends a standard four-symptom screening tool for pregnant and lactating women. There is evidence from South Africa that this screening tool (which, despite ...
Published on May 1, 2017in Gut17.94
Tom Holvoet6
Estimated H-index: 6
(Ghent University Hospital),
Marie Joossens23
Estimated H-index: 23
(Vrije Universiteit Brussel)
+ 8 AuthorsDanny De Looze4
Estimated H-index: 4
(Ghent University Hospital)
We read with interest the work by Halmos et al 1 in which they describe the effects of dietary FODMAP (Fermentable Oligo-, Di- and Mono- saccharides And Polyols) restriction in patients with IBS on the intestinal microbiota. They showed that low FODMAP intake was associated with reduced total bacterial and lower relative abundance of butyrate-producing Clostridium cluster XIVa, changes that are generally considered unfavourable.2 Therefore, they discourage long-term dietary FODMAP restriction, a...
Published on Feb 1, 2017in Journal of Clinical Gastroenterology2.72
Luis Furuya-Kanamori12
Estimated H-index: 12
(ANU: Australian National University),
Suhail A. R. Doi29
Estimated H-index: 29
(ANU: Australian National University)
+ 11 AuthorsMatthew P. Kronman13
Estimated H-index: 13
(UW: University of Washington)
Goals: The aim of this study was to compare upper gastrointestinal (UGI) versus lower gastrointestinal (LGI) delivery routes of fecal microbiota transplantation (FMT) for refractory or recurrent/ relapsing Clostridium difficile infection (CDI). Background: FMT has been proven to be a safe and highly effective therapeutic option for CDI. Delivery, however, could be via the UGI or LGI routes, and it is unclear as to which route provides better clinical outcome. Study: A systematic search for studi...
Published on Nov 1, 2016in Annals of Internal Medicine19.32
Colleen R. Kelly16
Estimated H-index: 16
(Miriam Hospital),
Alexander Khoruts43
Estimated H-index: 43
(UMN: University of Minnesota)
+ 10 AuthorsAllison Tisch1
Estimated H-index: 1
Abstract To date, evidence for the efficacy of fecal microbiota transplantation (FMT) in recurrent Clostridium difficile infection (CDI) has been limited to case series and open-label clinical trials. To determine the efficacy and safety of FMT for treatment of recurrent CDI. Randomized, controlled, double-blind clinical trial. (ClinicalTrials.gov: NCT01703494). Two academic medical centers. 46 patients who had 3 or more recurrences of CDI and received a full course of vancomycin for their most ...
Published on Nov 1, 2016in Digestive and Liver Disease3.04
Alexander Link17
Estimated H-index: 17
(Otto-von-Guericke University Magdeburg),
Tim Lachmund1
Estimated H-index: 1
(Otto-von-Guericke University Magdeburg)
+ 2 AuthorsP. J. E. H. M. Kitselaar79
Estimated H-index: 79
(Otto-von-Guericke University Magdeburg)
Abstract Background Fecal microbiota transplantation (FMT) is a valuable treatment modality for recurrent Clostridium difficile ( C. difficile ) colitis. Multiple questions including the best delivery route and volume remain unanswered. Here, we report a case series of high-volume FMT using endoscopic jejunal application route. Methods In prospective observational study, FMT was performed using fresh specimen from healthy unrelated donors to the patients with recurrent or refractory C. difficile...
Published on Oct 20, 2016in Blood16.56
Kazuhiko Kakihana12
Estimated H-index: 12
,
Yuki Fujioka2
Estimated H-index: 2
(Akita University)
+ 16 AuthorsHiroyoshi Nishikawa32
Estimated H-index: 32
Increasing evidence indicates that the gut microbiota is closely associated with acute graft-versus-host disease (aGVHD) in stem cell transplantation (SCT). Fecal microbiota transplantation (FMT) could represent an alternative treatment option for aGVHD. However, FMT for SCT patients carries a potential risk of infection by infused microbiota because of the severely immunosuppressed status. We therefore conducted a pilot study to evaluate the safety of FMT in SCT. A total of 4 patients with ster...
Published on Oct 1, 2016in Journal of Clinical Gastroenterology2.72
Arianna Waye1
Estimated H-index: 1
,
Kerry Atkins1
Estimated H-index: 1
,
Dina Kao2
Estimated H-index: 2
Fecal microbiota transplantation (FMT) is highly effective in treating recurrent Clostridium difficile infection (RCDI). However, the ideal timing for offering FMT remains to be determined. Furthermore, the direct medical costs averted with timely FMT have not been examined.A retrospective review of the Edmonton FMT program database included patients who received FMT for RCDI (October 2012 to September 2014). They were divided into 2 groups: those who received FMT after 2 recurrences (the timely...
Published on Oct 1, 2016in Clinical Gastroenterology and Hepatology7.96
Alexander Khoruts43
Estimated H-index: 43
(UMN: University of Minnesota),
Kevin M. Rank4
Estimated H-index: 4
(UMN: University of Minnesota)
+ 4 AuthorsMichael J. Sadowsky66
Estimated H-index: 66
(UMN: University of Minnesota)
Background & Aims A significant fraction of patients with recurrent Clostridium difficile infections (CDI) have inflammatory bowel disease (IBD). Fecal microbiota transplantation (FMT) can break the cycle of CDI recurrence and can be performed without evaluation of the colon. We evaluated the efficacy of colonoscopic FMT in patients with and without IBD, and whether we could identify IBD in patients during this procedure. Methods We collected clinical meta-data and colonoscopy results from 272 c...
Published on Sep 1, 2016in Alimentary Pharmacology & Therapeutics7.73
Akhilesh Wadhwa4
Estimated H-index: 4
(Mayo Clinic),
M. F. Al Nahhas1
Estimated H-index: 1
(Mayo Clinic)
+ 5 AuthorsMadhusudan Grover22
Estimated H-index: 22
(Mayo Clinic)
SummaryBackground Infectious enteritis is a commonly identified risk factor for irritable bowel syndrome (IBS). The incidence of Clostridium difficile infection (CDI) is on the rise. However, there is limited information on post-infectious IBS (PI-IBS) development following CDI and the host- and infection-related risk factors are not known. Aim To determine the incidence and risk factors for PI-IBS following CDI. Methods A total of 684 cases of CDI identified from September 2012 to November 2013...
Published on Jul 15, 2016in The Journal of Infectious Diseases5.04
Sahil Khanna26
Estimated H-index: 26
(Mayo Clinic),
Darrell S. Pardi45
Estimated H-index: 45
(Mayo Clinic)
+ 13 AuthorsJonathan Winkler1
Estimated H-index: 1
Patients with recurrent Clostridium difficile infection (CDI) have a ≥60% risk of relapse, as conventional therapies do not address the underlying gastrointestinal dysbiosis. This exploratory study evaluated the safety and efficacy of bacterial spores for preventing recurrent CDI.Stool specimens from healthy donors were treated with ethanol to eliminate pathogens. The resulting spores were fractionated and encapsulated for oral delivery as SER-109. Following their response to standard-of-care an...
Cited By139
Newest
Published on Dec 1, 2019in Scientific Reports4.01
Sebastian Burz (Université Paris-Saclay), Anne-Laure Abraham1
Estimated H-index: 1
(Université Paris-Saclay)
+ 13 AuthorsFlorence Levenez30
Estimated H-index: 30
(Université Paris-Saclay)
Owing to the growing recognition of the gut microbiota as a main partner of human health, we are expecting that the number of indications for fecal microbiota transplantation (FMT) will increase. Thus, there is an urgent need for standardization of the entire process of fecal transplant production. This study provides a complete standardized procedure to prepare and store live and ready-to-use transplants that meet the standard requirements of good practices to applied use in pharmaceutical indu...
Published on Dec 1, 2019in Current Opinion in Pharmacology5.20
Francis Dailey3
Estimated H-index: 3
(MU: University of Missouri),
Erica P. Turse1
Estimated H-index: 1
(St. Joseph's Hospital and Medical Center)
+ 1 AuthorsVeysel Tahan25
Estimated H-index: 25
(MU: University of Missouri)
Fecal microbiota transplantation is becoming a growing therapy for a variety of indications, including recurrent or refractory Clostridium difficile infection (CDI), as well as many other gastrointestinal and extra-intestinal diseases. In fact, fecal microbiota transplantation is now strongly recommended as the treatment of choice for multiple recurrences of CDI, given its strong efficacy and a favorable short-term side effect profile. As the application of this therapy expands, awareness of its...
Published on Dec 1, 2019in Current Opinion in Pharmacology5.20
Erica P. Turse1
Estimated H-index: 1
(St. Joseph's Hospital and Medical Center),
Francis Dailey3
Estimated H-index: 3
(MU: University of Missouri)
+ 1 AuthorsVeysel Tahan25
Estimated H-index: 25
(MU: University of Missouri)
Fecal microbiota transplantation (FMT) is being studied and utilized for various medical conditions including Clostridium difficile colitis, inflammatory bowel diseases (IBD), obesity, myasthenia gravis, and so on. Yet, FMT donation, whether from an individual or a stool bank, can be challenging given the numerous requirements and donor costs. Furthermore, data outcomes on recipients of FMT regarding donor’s health co-morbidities, age, and weight are limited but emerging. The purpose of this rev...
Published on May 6, 2019in Scientific Reports4.01
Sergio García-Fernández4
Estimated H-index: 4
,
Martinique Frentrup2
Estimated H-index: 2
(Leibniz Association)
+ 8 AuthorsRafael Cantón46
Estimated H-index: 46
To trace the routes and frequencies of transmission of Clostridioides difficile in a tertiary-care hospital in Madrid (Spain), we sequenced the genomes from all C. difficile isolates collected over 36 months (2014–2016) that were indistinguishable from any other isolate by PCR ribotyping. From a total of 589 C. difficile infection cases, we cultivated and PCR-ribotyped 367 C. difficile isolates (62%), of which 265 were genome-sequenced. Based on close relatedness of successively collected isolat...
Published on Jan 29, 2019in Scientific Reports4.01
Christian Carlucci3
Estimated H-index: 3
(U of G: University of Guelph),
Carys S. Jones1
Estimated H-index: 1
(U of G: University of Guelph)
+ 7 AuthorsEmma Allen-Vercoe24
Estimated H-index: 24
(U of G: University of Guelph)
Many cases of Clostridioides difficile infection (CDI) are poorly responsive to standard antibiotic treatment strategies, and often patients suffer from recurrent infections characterized by severe diarrhea. Our group previously reported the successful cure of two patients with recurrent CDI using a standardized stool-derived microbial ecosystem therapeutic (MET-1). Using an in vitro model of the distal gut to support bacterial communities, we characterized the metabolite profiles of two defined...
Published on Dec 1, 2019in Journal of animal science and biotechnology3.44
Nuria Canibe19
Estimated H-index: 19
(AU: Aarhus University),
Mark O’Dea5
Estimated H-index: 5
(UWA: University of Western Australia),
Sam Abraham12
Estimated H-index: 12
(UWA: University of Western Australia)
It is becoming increasingly evident that the gastrointestinal microbiota has a significant impact on the overall health and production of the pig. This has led to intensified research on the composition of the gastrointestinal microbiota, factors affecting it, and the impact of the microbiota on health, growth performance, and more recently, behavior of the host. Swine production research has been heavily focused on assessing the effects of feed additives and dietary modifications to alter or ta...
Published on Dec 1, 2019in Current Opinion in Pharmacology5.20
Faming Zhang (Nanjing Medical University), Ting Zhang (Nanjing Medical University)+ 1 AuthorsThomas J. Borody44
Estimated H-index: 44
Fecal microbiota transplantation (FMT), the core therapy for remodeling the gut microbiota with a long medical history, has gained great attention worldwide in recent years. Increasing studies have explored its indications, methodology, efficacy, safety, and ethics. Purified forms of FMT, using an automated method for the purification of fecal microbiota from stool, has become a reality. Colonic transendoscopic enteral tubing makes frequent FMT delivery into the whole colon feasible. This review...
Published on Dec 30, 2018in International Journal of Cancer4.98
Danfeng Chen1
Estimated H-index: 1
(Tianjin Medical University),
Jingyi Wu1
Estimated H-index: 1
(Tianjin Medical University)
+ 2 AuthorsHailong Cao1
Estimated H-index: 1
(Tianjin Medical University)
Resume Objectif Decrire les pratiques pharmaceutiques en vigueur associees a la transplantation de microbiote fecal dans les hopitaux francais en prenant en compte les aspects relatifs a la prescription, a la preparation pharmaceutique et a la reglementation. Materiel et methode Une enquete nationale a ete realisee aupres de 28 centres hospitaliers universitaires suivie de l’envoi d’un questionnaire GoogleForm ® de juin a aout 2018 dans les 16 centres repondeurs ayant une activite de transplanta...
Published in BMJ27.60
B. Guery33
Estimated H-index: 33
,
Tatiana Galperine1
Estimated H-index: 1
(UNIL: University of Lausanne),
Frédéric Barbut32
Estimated H-index: 32
(Paris V: Paris Descartes University)
Abstract Clostridioides difficile (formerly Clostridium) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, C difficile infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of C difficile infection and the use of new therapeutic molecules. The evolution of diagnosis showed there was an important under- and ...