Effects of fecal microbiota transplantation for recurrent Clostridium difficile infection in children on kidney replacement therapy: a pilot study.

Background: Recurrent Clostridium difficile infection (rCDI) is a rising problem in children with chronic diseases. Fecal microbiota transplantation (FMT) is a recent alternative for rCDI patients who do not respond to conventional treatment. FMT could have an additional positive effect on the intes...

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Publicado en:Pediatric Nephrology Vol. 39; no. 4; pp. 1201 - 1213
Autores principales: Samaey, An, Vázquez-Castellanos, Jorge Francisco, Caenepeel, Clara, Evenepoel, Pieter, Vermeire, Séverine, Raes, Jeroen, Knops, Noël
Formato: research tables/charts Journal Article
Publicado: Springer Nature Apr2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Apr2024
      vid: 39
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      pub: Springer Nature
      place: New York, New York
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        10.1007/s00467-023-06168-6
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        atl: Effects of fecal microbiota transplantation for recurrent Clostridium difficile infection in children on kidney replacement therapy: a pilot study.
      aug:
        au:
          Samaey, An
          Vázquez-Castellanos, Jorge Francisco
          Caenepeel, Clara
          Evenepoel, Pieter
          Vermeire, Séverine
          Raes, Jeroen
          Knops, Noël
        affil: https://ror.org/0424bsv16 Department of Pediatric Nephrology and Solid Organ Transplantation, UZ Leuven, Leuven, Belgium
      sug:
        subj:
          Fecal Microbiota Transplantation Methods
          Fecal Microbiota Transplantation Utilization
          Clostridioides Difficile Metabolism
          Uremia Metabolism
          Renal Replacement Therapy
          Treatment Outcomes
          Human
          Male
          Female
          Infant
          Child, Preschool
          Child
          Case Studies
          Descriptive Statistics
          Pilot Studies
          Alternative Therapies
          Intestinal Diseases
          Feces Analysis
          Uremic Toxins
          Kidney Failure, Chronic
          Hematologic Tests
          Inflammation
          Bacterial Infections
          Nephrotic Syndrome Diagnosis
          Vancomycin Therapeutic Use
          Metronidazole
          Hemodialysis
          Abdominal Pain Etiology
          Diarrhea Etiology
          Vomiting Etiology
          Pediatric Care
          Gut Microbiota
          Funding Source
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Male
          Female
      ab: Background: Recurrent Clostridium difficile infection (rCDI) is a rising problem in children with chronic diseases. Fecal microbiota transplantation (FMT) is a recent alternative for rCDI patients who do not respond to conventional treatment. FMT could have an additional positive effect on the intestinal dysbiosis and accumulation of uremic retention molecules (URM) associated with chronic kidney disease (CKD). Our aim was to investigate the clinical efficacy of FMT for rCDI in children with CKD together with the effect on dysbiosis and URM levels. Methods: We analyzed stool and blood samples before and until 3 months after FMT in 3 children between 4 and 8 years old with CKD and rCDI. The microbiome was analyzed by 16 s rRNA sequencing. URM were analyzed with ultra-performance liquid chromatography-tandem mass spectrometry. CRP and fecal calprotectin were analyzed as parameters for systemic and gut inflammation, respectively. Results: CDI resolved after FMT in all three without adverse events; one patient needed a second FMT. No significant effect on CRP and calprotectin was observed. Stool samples demonstrated a reduced richness and bacterial diversity which did not improve after FMT. We did observe a trend in the decrease of specific URM up to 3 months after FMT. Conclusion: FMT is an effective treatment for rCDI in patients with CKD. Analysis of the microbiome showed an important intestinal dysbiosis that, besides a significant reduction in Clostridium difficile, did not significantly change after FMT. A trend for reduction was seen in some of the measured URM after FMT.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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