Background Patients with ulcerative colitis (UC) who contract cytomegalovirus (CMV) infection tend to experience more severe symptoms, longer disease duration, and higher surgical risks. This study aims to assess the effectiveness and safety of washed microbiota transplantation (WMT) as a treatment for these patients.

Methods Patients with UC complicated with CMV infection were recruited from July 1, 2018, to November 30, 2022, for WMT. The partial Mayo score was used to evaluate the clinical response rate one month after WMT. The self-defined Left-Sided Colonic Endoscopic Activity Index, which comprises four items, was used to assess the proportion of endoscopic response. The exploratory outcome was the proportion of colon surgery within the entire study.

Results A total of 20 patients were enrolled in the analysis. The median hospitalization time was 20.5 (range 14.3–32.0) days, and 11 (55.0%) patients achieved clinical response one month after WMT. Nine (45%) patients achieved clinical remission at one month. Thirteen (65.0%) patients achieved endoscopic response after the first course of WMT (IDDF2024-ABS-0183 Figure 1. The endoscopic improvement after the first course of WMT). Symptoms commonly associated with UC, such as diarrhea, hematochezia, and abdominal pain, were significantly improved at 4 days, 7 days, 1 month, and 3 months after the first course of WMT (all p <0.05). Four adverse events were observed in three patients, with a rate of 7.3% (4/55). Two (10.0%) patients underwent colectomy during the minimum-1-year follow-up.

• Download figure
• Open in new tab
• Download powerpoint

Abstract IDDF2024-ABS-0183 Figure 1

The endoscopic improvement after the first course of WMT.

Conclusions WMT accelerated the clinical response and improved the prognosis of patients with UC who contracted CMV infection.