Browsing by Subject "Faecal microbiota transplantation"

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  • Lahtinen, Perttu; Mattila, Eero; Anttila, Veli-Jukka; Tillonen, Jyrki; Teittinen, Matti; Nevalainen, Pasi; Salminen, Seppo; Satokari, Reetta; Arkkila, Perttu (2017)
    Fecal microbiota transplantation (FMT) is effective in recurrent Clostridium difficile infection (rCDI). Knowledge of the safety and efficacy of FMT treatment in immune deficient patients is scarce. FMT has been suggested as a potential method for an increasing number of new indications besides rCDI. Among our FMT-treated rCDI patients, we reviewed those with major comorbidities: two human immunodeficiency virus patients, six haemodialysis patients, two kidney transplant patients, two liver transplant patients and a patient with chronic lymphatic leukaemia. We also reviewed those treated with FMT for indications other than rCDI: Salmonella carriage (two patients), trimethylaminuria (two patients), small intestinal bacterial overgrowth (SIBO; one patient), and lymphocytic colitis (one patient), as well as a common variable immunodeficiency patient with chronic norovirus infection and ESBL-producing Escherichia coli (E. coli) carriage. Of the thirteen rCDI patients treated with FMT, eleven cleared the CDI. The observed adverse events were not directly attributable to FMT. Concerning the special indications, both Salmonellas and ESBL-producing E. coli were eradicated. One trimethylaminuria patient and one SIBO-patient reported a reduction of symptoms. Three patients did not experience a benefit from FMT: chronic norovirus, lymphocytic colitis and the other fish malodour syndrome. There were no reported side effects in this group. FMT appeared to be safe and effective for immunocompromised patients with rCDI. FMT showed promise for the eradication of antibiotic-resistant bacteria, but further research is warranted.
  • Draper, L. A.; Ryan, F. J.; Smith, M. K.; Jalanka, J.; Mattila, E.; Arkkila, P.; Ross, R. P.; Satokari, R.; Hill, C. (2018)
    BackgroundFaecal microbiota transplantation (FMT) is used in the treatment of recurrent Clostridium difficile infection. Its success is typically attributed to the restoration of a diverse microbiota. Viruses (including bacteriophages) are the most numerically dominant and potentially the most diverse members of the microbiota, but their fate following FMT has not been well studied.ResultsWe studied viral transfer following FMT from 3 donors to 14 patients. Recipient viromes resembled those of their donors for up to 12months. Tracking individual bacteriophage colonisation revealed that engraftment of individual bacteriophages was dependent on specific donor-recipient pairings. Specifically, multiple recipients from a single donor displayed highly individualised virus colonisation patterns.ConclusionsThe impact of viruses on long-term microbial dynamics is a factor that should be reviewed when considering FMT as a therapeutic option.
  • Draper, L. A; Ryan, F. J; Smith, M. K; Jalanka, J.; Mattila, E.; Arkkila, P. A; Ross, R. P; Satokari, R.; Hill, C. (BioMed Central, 2018)
    Abstract Background Faecal microbiota transplantation (FMT) is used in the treatment of recurrent Clostridium difficile infection. Its success is typically attributed to the restoration of a diverse microbiota. Viruses (including bacteriophages) are the most numerically dominant and potentially the most diverse members of the microbiota, but their fate following FMT has not been well studied. Results We studied viral transfer following FMT from 3 donors to 14 patients. Recipient viromes resembled those of their donors for up to 12 months. Tracking individual bacteriophage colonisation revealed that engraftment of individual bacteriophages was dependent on specific donor-recipient pairings. Specifically, multiple recipients from a single donor displayed highly individualised virus colonisation patterns. Conclusions The impact of viruses on long-term microbial dynamics is a factor that should be reviewed when considering FMT as a therapeutic option.
  • Baunwall, Simon Mark Dahl; Terveer, Elisabeth M.; Dahlerup, Jens Frederik; Erikstrup, Christian; Arkkila, Perttu; Vehreschild, Maria JGT; Ianiro, Gianluca; Gasbarrini, Antonio; Sokol, Harry; Kump, Patrizia K.; Satokari, Reetta; De Looze, Danny; Vermeire, Séverine; Nakov, Radislav; Brezina, Jan; Helms, Morten; Kjeldsen, Jens; Rode, Anne A.; Kousgaard, Sabrina Just; Alric, Laurent; Trang-Poisson, Caroline; Scanzi, Julien; Link, Alexander; Stallmach, Andreas; Kupcinskas, Juozas; Johnsen, Peter Holger; Garborg, Kjetil; Rodríguez, Eugenia Sánchez; Serrander, Lena; Brummer, Robert J.; Galpérine, Katerina Tatiana; Goldenberg, Simon D.; Mullish, Benjamin H.; Williams, Horace RT; Iqbal, Tariq H.; Ponsioen, Cyriel; Kuijper, Ed J.; Cammarota, Giovanni; Keller, Josbert J.; Hvas, Christian Lodberg (2021)
    Background: Faecal microbiota transplantation (FMT) is an emerging treatment modality, but its current clinical use and organisation are unknown. We aimed to describe the clinical use, conduct, and potential for FMT in Europe. Methods: We invited all hospital-based FMT centres within the European Council member states to answer a web-based questionnaire covering their clinical activities, organisation, and regulation of FMT in 2019. Responders were identified from trials registered at clinicaltrials.gov and from the United European Gastroenterology (UEG) working group for stool banking and FMT. Findings: In 2019, 31 FMT centres from 17 countries reported a total of 1,874 (median 25, quartile 10–64) FMT procedures; 1,077 (57%) with Clostridioides difficile infection (CDI) as indication, 791 (42%) with experimental indications, and 6 (0•3%) unaccounted for. Adjusted to population size, 0•257 per 100,000 population received FMT for CDI and 0•189 per 100,000 population for experimental indications. With estimated 12,400 (6,100–28,500) annual cases of multiple, recurrent CDI and indication for FMT in Europe, the current European FMT activity covers approximately 10% of the patients with indication. The participating centres demonstrated high safety standards and adherence to international consensus guidelines. Formal or informal regulation from health authorities was present at 21 (68%) centres. Interpretation: FMT is a widespread routine treatment for multiple, recurrent CDI and an experimental treatment. Embedded within hospital settings, FMT centres operate with high standards across Europe to provide safe FMT. A significant gap in FMT coverage suggests the need to raise clinical awareness and increase the FMT activity in Europe by at least 10-fold to meet the true, indicated need. Funding: NordForsk under the Nordic Council and Innovation Fund Denmark (j.no. 8056–00006B).