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. 2022 Jun 24;16(5):768-777.
doi: 10.1093/ecco-jcc/jjab202.

Efficacy and Outcomes of Faecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection in Children with Inflammatory Bowel Disease

Maribeth R Nicholson  1 , Erin Alexander  2 , Sonia Ballal  3 , Zev Davidovics  4 , Michael Docktor  3 , Michael Dole  1 , Jonathan M Gisser  5 , Alka Goyal  6 , Suchitra K Hourigan  7 , M Kyle Jensen  8 , Jess L Kaplan  9 , Richard Kellermayer  10 , Judith R Kelsen  11 , Melissa A Kennedy  11 , Sahil Khanna  2 , Elizabeth D Knackstedt  8 , Jennifer Lentine  12 , Jeffery D Lewis  13 , Sonia Michail  14 , Paul D Mitchell  3 , Maria Oliva-Hemker  15 , Tiffany Patton  16 , Karen Queliza  10 , Sarah Sidhu  15 , Aliza B Solomon  12 , David L Suskind  17 , Madison Weatherly  3 , Steven Werlin  18 , Edwin F de Zoeten  19 , Stacy A Kahn  3 ; North American Society of Pediatric Gastroenterology and Nutrition Faecal Microbiota Transplantation Special Interest Group
Collaborators, Affiliations

Efficacy and Outcomes of Faecal Microbiota Transplantation for Recurrent Clostridioides difficile Infection in Children with Inflammatory Bowel Disease

Maribeth R Nicholson et al. J Crohns Colitis. .

Erratum in

Abstract

Background: Children with inflammatory bowel disease [IBD] are disproportionally affected by recurrent Clostridioides difficile infection [rCDI]. Although faecal microbiota transplantation [FMT] has been used with good efficacy in adults with IBD, little is known about outcomes associated with FMT in paediatric IBD.

Methods: We performed a retrospective review of FMT at 20 paediatric centres in the USA from March 2012 to March 2020. Children with and without IBD were compared with determined differences in the efficacy of FMT for rCDI. In addition, children with IBD with and without a successful outcome were compared with determined predictors of success. Safety data and IBD-specific outcomes were obtained.

Results: A total of 396 paediatric patients, including 148 with IBD, were included. Children with IBD were no less likely to have a successful first FMT then the non-IBD affected cohort [76% vs 81%, p = 0.17]. Among children with IBD, patients were more likely to have a successful FMT if they received FMT with fresh stool [p = 0.03], were without diarrhoea prior to FMT [p = 0.03], or had a shorter time from rCDI diagnosis until FMT [p = 0.04]. Children with a failed FMT were more likely to have clinically active IBD post-FMT [p = 0.002] and 19 [13%] patients had an IBD-related hospitalisation in the 3-month follow-up.

Conclusions: Based on the findings from this large US multicentre cohort, the efficacy of FMT for the treatment of rCDI did not differ in children with IBD. Failed FMT among children with IBD was possibly related to the presence of clinically active IBD.

Keywords: Crohn’s disease; Ulcerative colitis; child; microbiome.

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Figures

Figure 1.
Figure 1.
Schematic of patient selection.
Figure 2.
Figure 2.
Success of faecal wmicrobiota transplantation in children with inflammatory bowel disease did not substantially change over the study period; p-value calculated from logistic regression with year as a continuous variable.
See this image and copyright information in PMC

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