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OC-014 A regional frozen faecal transplant service for the treatment of chronic recurrent clostridium difficile infection: a review
  1. K Bicknell1,
  2. C Fogg2,
  3. A Fowell3,
  4. R Porter4,
  5. O Bannister1,
  6. A Flatt1
  1. 1Medical Microbiology, Portsmouth Hospitals NHS Trust
  2. 2Research and Innovation, University of Portsmouth
  3. 3Gastroenterology, Portsmouth Hospitals NHS Trust, Portsmouth
  4. 4Medical Microbiology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK

Abstract

Introduction In July 2015, the Wessex Faecal Microbiota Bank was funded to provide frozen faecal microbiota transplant (FMT) service to patients with recurrent Clostridium difficile infection (CDI). FMTs have a reported cure rate of 94% (1), but barriers to widespread use include logistics, patient perception and a lack of local expert clinical advice (2). Frozen FMT shows non-inferiority to fresh in a randomised controlled trial (3). The frozen Wessex FMT service was designed to overcome these issues and provide an accessible, timely, widespread service.

The aims of the service evaluation are to describe the demographics of FMT patients, establish whether the clinical outcomes are comparable to those described in the literature, evaluate patient’s acceptance of FMT and determine if an FMT bank can provide a regional service.

Method The service has been evaluated using clinical outcomes, patient satisfaction surveys, and quality of life (EuroQol Group EQ-5D) surveys. Data is collected pre-procedure, immediately post-procedure, and at 6 weeks and 6 months post procedure.

Results 50 patients have been treated to date; 23 of who have completed 6 month follow up, 27 are not yet 6 months post procedure and remain in follow up. Preliminary data shows the demographics of patients receiving FMT are similar to those with chronic CDI (mean age 69, Charlson comorbidity index 4 M:F ratio 1:1). Outcomes are similar to those reported in the literature; 80% of patients resolving symptoms following first FMT, 95% cure rate after a second FMT. Patient feedback is reassuring; with perceived quality of life increasing significantly (mean 20 point increase on EuroQol Group EQ-5D). Information and the procedure have received primarily positive feedback. FMT uptake in Wessex; All regional hospitals perform FMTs locally.

Conclusion The service is achieving promising clinical and quality of life outcomes, patients are positive about FMTs and the uptake shows a regional bank is a desirable resource.

References

  1. Van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor faeces for recurrent Clostridium difficile. N Engl J Med2013;368:407–15.

  2. Porter RJet al. Faecal microbiota transplantation for Clostridium difficile infection in the United Kingdom. Clin Microbiol Infect. 2016;6:578–582

  3. Lee CHet al. Frozen vs Fresh Faecal Microbiota Transplantation and Clinical Resolution of Diarrhoea in Patients with Recurrent Clostridium difficile Infection. A Randomised Control Trial. JAMA 149-142: (2) 315:2016

Disclosure of Interest None Declared

  • clostridium difficile
  • Faecal Microbiota Transplant
  • Review
  • Service

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