Show simple item record

dc.contributor.authorCamacho-Ortiz, Adrian
dc.contributor.authorGutierrez-Delgado, Eva Maria
dc.contributor.authorGarcia-Mazcorro, Jose F
dc.contributor.authorMendoza-Olazaran, Soraya
dc.contributor.authorAdrian Martinez-Melendez, Adrian
dc.contributor.authorPalau-Davila, Laura
dc.contributor.authorBaines, Simon
dc.contributor.authorMaldonado-Garza, Hector
dc.contributor.authorGarza-Gonzalez, Elvira
dc.date.accessioned2018-07-31T12:29:46Z
dc.date.available2018-07-31T12:29:46Z
dc.date.issued2017-12-20
dc.identifier.citationCamacho-Ortiz , A , Gutierrez-Delgado , E M , Garcia-Mazcorro , J F , Mendoza-Olazaran , S , Adrian Martinez-Melendez , A , Palau-Davila , L , Baines , S , Maldonado-Garza , H & Garza-Gonzalez , E 2017 , ' Randomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiome ' , PLoS ONE , vol. 12 , no. 12 , e0189768 . https://doi.org/10.1371/journal.pone.0189768
dc.identifier.issn1932-6203
dc.identifier.otherPURE: 13184156
dc.identifier.otherPURE UUID: 023c0b50-820a-4f22-b480-743907942d5a
dc.identifier.otherScopus: 85038859154
dc.identifier.urihttp://hdl.handle.net/2299/20296
dc.description.abstractObjective The aim of this study was to evaluate the impact of fecal donor-unrelated donor mix (FMT-FURM) transplantation as first-line therapy for C. difficile infection (CDI) in intestinal microbiome. Methods We designed an open, two-arm pilot study with oral vancomycin (250mg every 6 h for 10–14 days) or FMT-FURM as treatments for the first CDI episode in hospitalized adult patients in Hospital Universitario “Dr. Jose Eleuterio Gonzalez”. Patients were randomized by a closed envelope method in a 1: 1 ratio to either oral vancomycin or FMT-FURM. CDI resolution was considered when there was a reduction on the Bristol scale of at least 2 points, a reduction of at least 50% in the number of bowel movements, absence of fever, and resolution of abdominal pain (at least two criteria). From each patient, a fecal sample was obtained at days 0, 3, and 7 after treatment. Specimens were cultured to isolate C. difficile, and isolates were characterized by PCR. Susceptibility testing of isolates was performed using the agar dilution method. Fecal samples and FMT-FURM were analyzed by 16S rRNA sequencing. Results We included 19 patients; 10 in the vancomycin arm and 9 in the FMT-FURM arm. However, one of the patients in the vancomycin arm and two patients in the FMT-FURM arm were eliminated. Symptoms resolved in 8/9 patients (88.9%) in the vancomycin group, while symptoms resolved in 4/7 patients (57.1%) after the first FMT-FURM dose (P = 0.26) and in 5/7 patients (71.4%) after the second dose (P = 0.55). During the study, no adverse effects attributable to FMT-FURM were observed in patients. Twelve isolates were recovered, most isolates carried tcdB, tcdA, cdtA, and cdtB, with an 18-bp deletion in tcdC. All isolates were resistant to ciprofloxacin and moxifloxacin but susceptible to metronidazole, linezolid, fidaxomicin, and tetracycline. In the FMT-FURM group, the bacterial composition was dominated by Firmicutes, Bacteroidetes, and Proteobacteria at all-time points and the microbiota were remarkably stable over time. The vancomycin group showed a very different pattern of the microbial composition when comparing to the FMT-FURM group over time. Conclusion The results of this preliminary study showed that FMT-FURM for initial CDI is associated with specific bacterial communities that do not resemble the donors’ sample.en
dc.language.isoeng
dc.relation.ispartofPLoS ONE
dc.rightsOpen
dc.titleRandomized clinical trial to evaluate the effect of fecal microbiota transplant for initial Clostridium difficile infection in intestinal microbiomeen
dc.contributor.institutionDepartment of Biological and Environmental Sciences
dc.contributor.institutionAgriculture, Veterinary and Food Sciences
dc.contributor.institutionGeography, Environment and Agriculture
dc.contributor.institutionMicrobiology and Biotechnology
dc.contributor.institutionSchool of Life and Medical Sciences
dc.contributor.institutionBiosciences Research Group
dc.description.statusPeer reviewed
dc.relation.schoolSchool of Life and Medical Sciences
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2017-12-20
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1371/journal.pone.0189768
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record