Patient Perspectives on Fecal Microbiota Transplantation for Clostridium Difficile Infection

被引:21
作者
Zellmer C. [1 ,2 ]
De Wolfe T.J. [1 ,2 ]
Van Hoof S. [1 ,2 ]
Blakney R. [1 ,2 ]
Safdar N. [1 ,2 ]
机构
[1] William S. Middleton Veterans Hospital, Madison, WI
[2] Section of Infectious Diseases, Department of Medicine, University of Wisconsin, Madison, WI
关键词
Clostridium difficile infection; Fecal microbiota; Fecal transplant; Patient perspectives; Patient reported outcomes; Questionnaire;
D O I
10.1007/s40121-016-0106-1
中图分类号
学科分类号
摘要
Introduction: Clostridium difficile infection (CDI) is a severe and increasingly frequent healthcare-associated infection that develops after disruption of the gut microbiota. Immunocompromised, hospitalized patients have an increased likelihood of acquiring CDI, leading to lengthened hospital stays, increased medical fees, and higher rates of morbidity and mortality. Treatment of CDI is challenging because of limited treatment options and a 19–20% recurrence rate. Thus, there is a need for effective, affordable and safe treatments for CDI. Fecal microbiota transplantation (FMT) is the transplantation of donor stool into the intestine of a CDI patient to restore the structure and function of the gut microbiota and eradicate CDI. Recently, FMT has become an attractive alternative treatment for CDI due to its overwhelming success rate. However, the patient perspective on the effect of CDI and the role of FMT in that context is lacking. Methods: We undertook a patient survey to gather qualitative and quantitative data on the short-term social, physical, emotional outcomes for patients with CDI who have undergone FMT. Results: We found in all patients interviewed that the social implications of CDI were generally more severe than the emotional and physical aspects. Conclusion: Future studies should consider evaluating these important patient-centered factors as outcomes. Moreover, patients are willing to undergo FMT as treatment for CDI. © 2016, The Author(s).
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页码:155 / 164
页数:9
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共 23 条
[1]  
Bartlett J.G., Chang T.W., Gurwith M., Et al., Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia, N Eng J Med., 298, 10, pp. 531-534, (1978)
[2]  
Pant C.H., Sferra T.J., Deshpande A., Et al., Clinical approach to severe Clostridium difficile infection: update for the hospital practitioner, Eur J Intern Med., 22, pp. 561-568, (2011)
[3]  
McFarland L.V., Antibiotic-associated diarrhea: epidemiology, trends and treatment, Future Microbiol., 3, 5, pp. 563-578, (2008)
[4]  
Johanesen P.A., Mackin K.E., Hutton M.L., Et al., Disruption of the Gut Microbiome: Clostridium difficile infection and the threat of antibiotic resistance, Genes (Basel)., 6, 4, pp. 1347-1360, (2015)
[5]  
Johnson S., Recurrent Clostridium difficile infection: a review of risk factors, treatments, and outcomes, J Infect, 58, pp. 403-410, (2009)
[6]  
Miller B.A., Chen L.F., Sexton D.J., Anderson D.J., Comparison of the burdens of hospital-onset, healthcare facility–associated Clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals, Infect Control Hosp Epidemiol, 32, 4, pp. 387-390, (2011)
[7]  
Dubberke E.R., Butler A.M., Reske K.A., Et al., Attributable outcomes of endemic Clostridium difficile—associated disease in nonsurgical patients, Emerg Infect Dis, 14, 7, pp. 1031-1038, (2008)
[8]  
Dubberke E.R., Olsen M.A., Burden of Clostridium difficile on the healthcare system, Clin Infect Dis, 55, pp. S88-S92, (2012)
[9]  
Kwon J.H., Olsen M.A., Dubberke E.R., The morbidity, mortality, and costs associated with Clostridium difficile infection, Infect Dis Clin North Am, 29, 1, pp. 123-134, (2015)
[10]  
Kassam Z., Lee C.H., Yuan Y., Hunt R.H., Fecal microbiota transplantation for Clostridium difficile infection: systematic review and meta-analysis, Am J Gastroenterol, 108, 4, pp. 500-508, (2013)