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Lui RN, Wong SH, Lau LHS, Chan TT, Cheung KCY, Li A, Chin ML, Tang W, Ching JYL, Lam KLY, Chan PKS, Wu JCY, Sung JJY, Chan FKL, Ng SC. Faecal microbiota transplantation for treatment of recurrent or refractory Clostridioides difficile infection in Hong Kong. Hong Kong Med J 2019; 25:178-182. [PMID: 31178437 DOI: 10.12809/hkmj197855] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Clostridioides difficile infection (CDI) is a leading cause of healthcare-associated infection globally, causing significant morbidity and mortality. Faecal microbiota transplantation (FMT) has emerged as a promising option for recurrent and refractory CDI. This study aimed to assess the safety, efficacy, and feasibility of FMT for CDI in Hong Kong. METHODS We conducted a single-centre, retrospective study for all consecutive cases of recurrent or refractory CDI who underwent FMT from 2013 to 2018. Clinical demographics, outcome, and safety parameters were collected. RESULTS A total of 24 patients with recurrent or refractory CDI (median age 70 years, interquartile range=45.0-78.3 years; 67% male) were included. Over 80% had been recently hospitalised or were long-term care facility residents. Faecal microbiota transplantation was delivered by feeding tube in 11 (45.8%), oesophagogastroduodenoscopy in eight (33.3%), and colonoscopy in six (25%) of the patients. Resolution of diarrhoea without relapse within 8 weeks was achieved in 21 out of 24 patients (87.5%) after FMT. No deaths occurred within 30 days. The FMT was well tolerated and no serious adverse events attributable to FMT were reported. CONCLUSION Our results confirm that FMT is a safe, efficacious, and feasible intervention for patients with refractory or recurrent CDI in Hong Kong. Given the increasing disease burden and the lack of effective alternatives in Hong Kong for difficult-to-treat cases of CDI, we recommend that a territory-wide FMT service be established to address increasing demand for this treatment.
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Affiliation(s)
- R N Lui
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - S H Wong
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - L H S Lau
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - T T Chan
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - K C Y Cheung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - A Li
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - M L Chin
- Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - W Tang
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J Y L Ching
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - K L Y Lam
- Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
| | - P K S Chan
- Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong.,Department of Microbiology, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J C Y Wu
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - J J Y Sung
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - F K L Chan
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - S C Ng
- Institute of Digestive Disease, The Chinese University of Hong Kong, Shatin, Hong Kong.,Centre for Gut Microbiota Research, The Chinese University of Hong Kong, Shatin, Hong Kong
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