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. 2025 Mar 13;12(4):ofaf149.
doi: 10.1093/ofid/ofaf149. eCollection 2025 Apr.

Outcomes of Fecal Microbiota Transplantation for Clostridioides difficile Infection in South Australia

Emily C Tucker  1   2   3 , Bianca Angelica  2   4 , Ryan M Mathias  2   4 , Louisa Edwards  4 , Robert V Bryant  2   3   4 , Samuel P Costello  2   3   4
Affiliations

Outcomes of Fecal Microbiota Transplantation for Clostridioides difficile Infection in South Australia

Emily C Tucker et al. Open Forum Infect Dis. .

Abstract

Background: Fecal microbiota transplantation (FMT) sourced from a bank of prescreened anaerobically processed frozen donor stool has been available in South Australia since 2013. This study aimed to evaluate the real-world clinical and safety outcomes of FMT for recurrent, refractory, and/or severe or fulminant Clostridioides difficile infection (CDI) facilitated via this centralized facility.

Methods: Donor screening test data were prospectively collected on all donors who passed prescreening evaluations between April 2013 and August 2023. The South Australian FMT for CDI database prospectively recorded outcomes for consecutive patients who underwent FMT for CDI from August 2013 to May 2023 in South Australia.

Results: An overall 98 potential donors passed prescreening assessments and underwent laboratory screening tests: 32 (33%) had tests that failed, 5 (5%) had incomplete screening, and 61 (62%) passed. Detection of an extended-spectrum β-lactamase-producing organism (9/65, 14%) was the common reason for ineligibility following completion of screening tests. In total 220 cases of CDI were recorded, and follow-up data were available in 216. Primary cure occurred in 84% of cases (182/216): 88% (132/150) for recurrent CDI, 76% (50/66) for refractory CDI, 85% (51/60) for severe disease, and 65% (17/26) for fulminant disease. Repeat FMT was delivered in 23 of 34 cases (68%), with secondary cure in 74% (17/23 cases). Serious adverse events were observed in 6 patients overall (3%). No deaths were directly attributable to FMT.

Conclusions: FMT was safe and efficacious for management of recurrent and refractory CDI over a 10-year period in a real-world prospective Australian cohort. Further studies to optimize the use of FMT for severe and fulminant CDI are warranted.

Keywords: Clostridioides difficile; FMT; donor; screening.

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Conflict of interest statement

Potential conflict of interest. R. V. B., S. P. C., and E. C. T. are shareholders in and employees of BiomeBank. All other authors report no potential conflicts.

Figures

Figure 1.
Figure 1.
Overall cure rates following primary treatment with fecal microbiota transplantation. CDI, Clostridioides difficile infection.
See this image and copyright information in PMC

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