Comparing the efficacy of different methods of faecal microbiota transplantation via oral capsule, oesophagogastroduodenoscopy, colonoscopy, or gastric tube. (January 2023)

• Record Type: Journal Article
• Authors: Lee, E.H.; Lee, S.K.; Cheon, J.H.; Koh, H.; Lee, J.A.; Kim, C.H.; Kim, J.N.; Lee, K.H.; Lee, S.J.; Kim, J.H.; Ahn, J.Y.; Jeong, S.J.; Ku, N.S.; Yong, D.E.; Yoon, S.S.; Yeom, J.S.; Choi, J.Y.
• Is Part Of: Journal of hospital infection. Volume 131(2023)
• Page Start: 234
• Page End: 243
• Publication Date: 2023-01
• Subjects: Faecal microbiota transplantation -- Multidrug-resistant organism -- Decolonization; Cross infection -- Periodicals; Cross infection -- Prevention -- Periodicals; Nosocomial infections -- Periodicals; Nosocomial infections -- Prevention -- Periodicals; Cross Infection -- Periodicals; Cross Infection -- prevention & control -- Periodicals; Infection Control -- Periodicals; Electronic journals; 614.44
• DOI: 10.1016/j.jhin.2022.11.007
• Languages: English
• ISSNs: 0195-6701

Abstract

Summary: Background: The increasing prevalence of multidrug-resistant organism (MDRO) carriage poses major challenges to medicine as healthcare costs increase. Recently, faecal microbiota transplantation (FMT) has been discussed as a novel and effective method for decolonizing MDRO. Aim: To compare the efficacy of different FMT methods to optimize the success rate of decolonization in patients with MDRO carriage. Methods: This prospective cohort study enrolled patients with MDRO carriages from 2018 to 2021. Patients underwent FMT via one of the following methods: oral capsule, oesophagogastroduodenoscopy (EGD), colonoscopy, or gastric tube. Findings: A total of 57 patients underwent FMT for MDRO decolonization. The colonoscopy group required the shortest time for decolonization, whereas the EGD group required the longest (24.9 vs 190.4 days, P = 0.022). The decolonization rate in the oral capsule group was comparable to that in the EGD group (84.6% vs 85.7%, P = 0.730). An important clinical factor associated with decolonization failure was antibiotic use after FMT (odds ratio = 6.810, P = 0.008). All four groups showed reduced proportions of MDRO species in microbiome analysis after FMT. Conclusion: Compared to other conventional methods, the oral capsule is an effective FMT method for patients who can tolerate an oral diet. The discontinuation of antibiotics after FMT is a key factor in the success of decolonization.