Universität zu Köln

Peri, Rosemarie, Aguilar, Rebeca Cruz, Tueffers, Kester, Erhardt, Andreas, Link, Alexander ORCID: 0000-0002-9514-4562, Ehlermann, Philipp, Angeli, Wolfgang, Frank, Thorsten, Storr, Martin, Gluck, Thomas, Sturm, Andreas, Rosien, Ulrich, Tacke, Frank, Bachmann, Oliver ORCID: 0000-0002-6830-2975, Solbach, Philipp, Stallmach, Andreas, Goeser, Felix and Vehreschild, Maria J. G. T. (2019). The impact of technical and clinical factors on fecal microbiota transfer outcomes for the treatment of recurrent Clostridioides difficile infections in Germany. United European Gastroenterol. J., 7 (5). S. 716 - 723. THOUSAND OAKS: SAGE PUBLICATIONS INC. ISSN 2050-6414

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Abstract

Introduction Fecal microbiota transfer (FMT) is highly effective in the treatment and prevention of recurrent Clostridioides difficile infection (rCDI) with cure rates of about 80% after a single treatment. Nevertheless, the reasons for failure in the remaining 20% remain largely elusive. The aim of the present study was to investigate different potential clinical predictors of response to FMT in Germany. Methods Information was extracted from the MicroTrans Registry (NCT02681068), a retrospective observational multicenter study, collecting data from patients undergoing FMT for recurrent or refractory CDI in Germany. We performed binary logistic regression with the following covariates: age, gender, ribotype 027, Eastern Co-operative Oncology Group score, immunosuppression, preparation for FMT by use of proton pump inhibitor, antimotility agents and bowel lavage, previous recurrences, severity of CDI, antibiotic induction treatment, fresh or frozen FMT preparation, and route of application. Results Treatment response was achieved in 191/240 evaluable cases (79.6%) at day 30 (D30) post FMT and 78.1% at day 90 (D90) post FMT. Assessment of clinical predictors for FMT failure by forward and confirmatory backward-stepwise regression analysis yielded higher age as an independent predictor of FMT failure (p = 0.001; OR 1.060; 95%CI 1.025-1.097). Conclusion FMT in Germany is associated with high cure rates at D30 and D90. No specific pre-treatment, preparation or application strategy had an impact on FMT success. Only higher age was identified as an independent risk factor for treatment failure. Based on these and external findings, future studies should focus on the assessment of microbiota and microbiota-associated metabolites as factors determining FMT success.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Peri, Rosemarie UNSPECIFIED UNSPECIFIED UNSPECIFIED Aguilar, Rebeca Cruz UNSPECIFIED UNSPECIFIED UNSPECIFIED Tueffers, Kester UNSPECIFIED UNSPECIFIED UNSPECIFIED Erhardt, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Link, Alexander UNSPECIFIED orcid.org/0000-0002-9514-4562 UNSPECIFIED Ehlermann, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Angeli, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Frank, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Storr, Martin UNSPECIFIED UNSPECIFIED UNSPECIFIED Gluck, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Sturm, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Rosien, Ulrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Tacke, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Bachmann, Oliver UNSPECIFIED orcid.org/0000-0002-6830-2975 UNSPECIFIED Solbach, Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Stallmach, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Goeser, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Vehreschild, Maria J. G. T. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-146572
DOI:	10.1177/2050640619839918
Journal or Publication Title:	United European Gastroenterol. J.
Volume:	7
Number:	5
Page Range:	S. 716 - 723
Date:	2019
Publisher:	SAGE PUBLICATIONS INC
Place of Publication:	THOUSAND OAKS
ISSN:	2050-6414
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANSPLANTATION; PREDICTORS; EFFICACY; FAILURE; SOCIETY Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/14657