Fecal Microbiota Transplantation for Clostridioides Difficile Infection in Patients with Chronic Liver Disease
Fecal Microbiota Transplantation for Clostridioides Difficile Infection in Patients with Chronic Liver Disease
复制标题
DOI：
10.1155/2020/1874570
复制
发表时间：
2020-01-28
影响因子：
1.8
通讯作者：
Salgia, Reena
中科院分区：
文献类型：
--
作者：
Meighani, Alireza;Alimirah, Maryam;Salgia, Reena
背景粪便微生物群移植（FMT）是抗生素耐药艰难梭菌感染（CDI）患者的一种成熟的治疗选择。然而，FMT在慢性肝病患者中的疗效仍然难以捉摸。目标。我们在我们的三级医疗中心研究了FMT对慢性肝病（CLD）患者CDI的影响。方法.确定了2012年12月至2014年5月接受FMT治疗难治性或复发性CDI的所有患者队列。FMT后对患者进行了一年的监测。进行描述性分析，比较FMT在CLD患者和非CLD患者中的效果。结果共有201例CDI患者接受FMT，其中14例有CLD病史。这些患者中有9例表现为肝硬化，平均Child-Turcotte-Pugh评分为8分。这些患者的CDI发展与近期抗生素暴露相关，观察到两组之间存在显著差异（CLD患者17% vs.一般队列58%，p=0.01）。4例CLD患者接受了>1次FMT，其中2例对治疗无反应。在FMT应答方面，肝病患者与队列其他患者之间无显著差异（12/14（87%）vs. 164/187（88%），p=0.68）。结论FMT是CLD和肝硬化患者抗CDI的安全有效的治疗方法。
Background. Fecal microbiota transplantation (FMT) is a well-established therapeutic option for patients with antibiotic resistant Clostridioides difficile infection (CDI). However, the efficacy of FMT in patients with chronic liver disease remains elusive. Aims. We studied the effect of FMT on chronic liver disease (CLD) patients with CDI at our tertiary medical center. Methods. A cohort of all patients who received FMT from December 2012 to May 2014 for refractory or recurrent CDI was identified. Patients were monitored for a year after FMT. Descriptive analysis was conducted to compare the effect of FMT in patients with and without CLD. Results. A total of 201 patients with CDI received FMT, 14 of which had a history of CLD. Nine of these patients exhibited cirrhosis of the liver with a mean Child-Turcotte-Pugh score of 8. CDI development in these patients was associated with recent exposure to antibiotics and was observed to be significantly different between both groups (17% of CLD patients vs. 58% in the general cohort, p=0.01). Four patients with CLD received >1 FMT, of which 2 did not respond to treatment. There was no significant difference between patients with liver disease and the rest of the cohort with regard to FMT response (12/14 (87%) vs. 164/187 (88%), p=0.68). Conclusion. FMT is a safe and effective therapy against CDI for patients with CLD and cirrhosis.