Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website https://www.gastrores.org

Original Article

Volume 14, Number 4, August 2021, pages 237-243

Fecal Microbiota Transplantation in Patients With Recurrent Clostridium difficile Infection: A Four-Year Single-Center Retrospective Review

**Table 1.** Demographic Variables (N = 64)
	N (%)
PPI: proton pump inhibitors; CDI: Clostridium difficile infection; IBD: inflammatory bowel disease; FMT: fecal microbiota transplant.
Gender
Male	27 (42.2%)
Female	37 (57.8%)
Referral
In-house	55 (85.9%)
Outside	9 (14.1%)
Inpatient	37 (57.8%)
Outpatient	27 (42.2%)
Comorbidities and risk factors
History of PPI use	27 (42.2%)
Antibiotics used before CDI	38 (59.4%)
Use of immunosuppressants	12 (18.8%)
Diabetes	17 (26.6%)
Hypertension	38 (59.4%)
Immunocompromised state including IBD	25 (39.1%)
Antibiotics used for the treatment of CDI before FMT
Vancomycin alone	14 (21.8%)
Fidaxomicin alone	0 (0%)
Metronidazole alone	2 (3.1%)
Vancomycin + metronidazole	16 (25.0%)
Vancomycin + fidaxomicin	10 (15.6%)
Fidaxomicin + metronidazole	0 (0%)
No antibiotic therapies	1 (1.5%)
All three	21(42.1%)
Antibiotics stopped > 48 h before FMT	46 (71.9%)
Adverse events from FMT	12 (18.8%)
Abnormal colonoscopy findings	39 (60.9%)

Table 1. Demographic Variables (N = 64)

N (%)

PPI: proton pump inhibitors; CDI: Clostridium difficile infection; IBD: inflammatory bowel disease; FMT: fecal microbiota transplant.

Gender

Male

27 (42.2%)

Female

37 (57.8%)

Referral

In-house

55 (85.9%)

Outside

9 (14.1%)

Inpatient

37 (57.8%)

Outpatient

27 (42.2%)

Comorbidities and risk factors

History of PPI use

27 (42.2%)

Antibiotics used before CDI

38 (59.4%)

Use of immunosuppressants

12 (18.8%)

Diabetes

17 (26.6%)

Hypertension

38 (59.4%)

Immunocompromised state including IBD

25 (39.1%)

Antibiotics used for the treatment of CDI before FMT

Vancomycin alone

14 (21.8%)

Fidaxomicin alone

0 (0%)

Metronidazole alone

2 (3.1%)

Vancomycin + metronidazole

16 (25.0%)

Vancomycin + fidaxomicin

10 (15.6%)

Fidaxomicin + metronidazole

0 (0%)

No antibiotic therapies

1 (1.5%)

All three

21(42.1%)

Antibiotics stopped > 48 h before FMT

46 (71.9%)

Adverse events from FMT

12 (18.8%)

Abnormal colonoscopy findings

39 (60.9%)

**Table 2.** Primary and Secondary Outcomes (N = 64)
	N (%)
CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.
Improvement in 2 months	48 (75.0%)
FMT failure	10 (15.6%)
Patients lost to follow-up	6 (9.4%)
Recurrence of CDI after 2 months	26 (40.0%)

Table 2. Primary and Secondary Outcomes (N = 64)

N (%)

CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.

Improvement in 2 months

48 (75.0%)

FMT failure

10 (15.6%)

Patients lost to follow-up

6 (9.4%)

Recurrence of CDI after 2 months

26 (40.0%)

**Table 3.** Success and Recurrence Rates in Different Demographic Variables and Risk Factors
Demographic variables	N	Success^a	P value	Recurrence	P value
^aSuccess was defined as more than 50% improvement of symptoms in 2 months. Values were shown as n (%). CDI: Clostridium difficile infection; FMT: fecal microbiota transplant; PPI: proton pump inhibitor.
Gender
Male	27	23 (85.3%)		10 (37.0%)
Female	37	25 (67.6%)	0.24	16 (43.2%)	0.61
Referral
In-house	55	43 (78.2%)		21 (38.2%)
Outside	9	5 (55.6%)	0.002	5 (55.6%)	0.32
Inpatient	37	30 (81.1%)		17 (45.9%)
Outpatient	27	18 (66.7%)	0.09	9 (33.3%)	0.31
Comorbidities and risk factors
History of PPI use	27	21 (77.8%)	0.66	14 (51.9%)	0.11
Antibiotics used before CDI	38	27 (71.1%)	0.05	14 (36.8%)	0.45
Use of immunosuppressants	12	10 (83.3%)	0.72	8 (66.7%)	0.04
Diabetes	17	12 (70.6%)	0.87	6 (35.3%)	0.62
Hypertension	38	30 (78.9%)	0.68	18 (47.4%)	0.18
Immunocompromised state	25	19 (76%)	0.72	11 (44.0%)	0.66
Antibiotics stopped > 48 h before FMT	46	34 (73.9%)	0.90	17 (37.0%)	0.19
Adverse events from FMT	12	7 (58.3%)	0.17	3 (25.0%)	0.22
Abnormal colonoscopy findings	37	26 (70.3%)	0.53	15 (40.5%)	0.62

Table 3. Success and Recurrence Rates in Different Demographic Variables and Risk Factors

Demographic variables

Success^a

P value

Recurrence

P value

^aSuccess was defined as more than 50% improvement of symptoms in 2 months. Values were shown as n (%). CDI: Clostridium difficile infection; FMT: fecal microbiota transplant; PPI: proton pump inhibitor.

Gender

Male

23 (85.3%)

10 (37.0%)

Female

25 (67.6%)

0.24

16 (43.2%)

0.61

Referral

In-house

43 (78.2%)

21 (38.2%)

Outside

5 (55.6%)

0.002

5 (55.6%)

0.32

Inpatient

30 (81.1%)

17 (45.9%)

Outpatient

18 (66.7%)

0.09

9 (33.3%)

0.31

Comorbidities and risk factors

History of PPI use

21 (77.8%)

0.66

14 (51.9%)

0.11

Antibiotics used before CDI

27 (71.1%)

0.05

14 (36.8%)

0.45

Use of immunosuppressants

10 (83.3%)

0.72

8 (66.7%)

0.04

Diabetes

12 (70.6%)

0.87

6 (35.3%)

0.62

Hypertension

30 (78.9%)

0.68

18 (47.4%)

0.18

Immunocompromised state

19 (76%)

0.72

11 (44.0%)

0.66

Antibiotics stopped > 48 h before FMT

34 (73.9%)

0.90

17 (37.0%)

0.19

Adverse events from FMT

7 (58.3%)

0.17

3 (25.0%)

0.22

Abnormal colonoscopy findings

26 (70.3%)

0.53

15 (40.5%)

0.62

**Table 4.** Characteristics of Patients With CDI Recurrence (N = 26)
	N (%)
CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.
Antibiotic use before CDI recurrence	9 (34.6%)
Immunosuppressant use before recurrence	8 (30.7%)
Crohn’s disease	3 (11.5%)
Ulcerative colitis	3 (11.5%)
Organ transplant recipients	1 (3%)
Treatment with repeat FMT	18 (69.2%)
Treatment with antibiotics	7 (26.9%)

Table 4. Characteristics of Patients With CDI Recurrence (N = 26)

N (%)

CDI: Clostridium difficile infection; FMT: fecal microbiota transplant.

Antibiotic use before CDI recurrence

9 (34.6%)

Immunosuppressant use before recurrence

8 (30.7%)

Crohn’s disease

3 (11.5%)

Ulcerative colitis

3 (11.5%)

Organ transplant recipients

1 (3%)

Treatment with repeat FMT

18 (69.2%)

Treatment with antibiotics

7 (26.9%)