Infect Chemother.  2016 Mar;48(1):31-35. 10.3947/ic.2016.48.1.31.

Fecal Transplantation using a Nasoenteric Tube during an Initial Episode of Severe Clostridium difficile Infection

• Jeon YD
• Hong N
• Kim JH
• Park SH
• Kim SB
• Song IJ
• Ann HW
• Ahn JY
• Kim SB
• Ku NS
• Lee K
• Yong D
• Kim JM
• Choi JY

• KMID: 2170514
• DOI: http://doi.org/10.3947/ic.2016.48.1.31

Abstract

The incidence of Clostridium difficile infection is increasing worldwide, and its severity and resulting mortality are also on the rise. Metronidazole and oral vancomycin remain the treatments of choice, but there are concerns about treatment failure and the appearance of resistant strains. Furthermore, antibiotic therapy results in recurrence rates of at least 20%. Fecal transplantation may be a feasible treatment option for recurrent C. difficile infection; moreover, it may be an early treatment option for severe C. difficile infection. We report a case of severe C. difficile infection treated with fecal transplantation using a nasoenteric tube during an initial episode. This is the first reported case of fecal transplantation using a nasoenteric tube during an initial episode of C. difficile infection in Korea.

Keyword

Fecal transplantation; Fecal microbiota; Clostridium difficile; Nasoenteric tube

MeSH Terms

Clostridium difficile*
Clostridium*
Incidence
Korea
Metronidazole
Mortality
Recurrence
Treatment Failure
Vancomycin
Metronidazole
Vancomycin

Figure

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  Figure 1 Method of fecal transplantation. (A) The tip of the nasoenteric tube was placed at the third portion of the duodenum by esophagogastroduodenoscopy. (B, C) Fifty grams stool collected from the donor was diluted with 500 mL normal saline, and the supernatant was filtered out with gauze. This solution was placed into the feeding bag and infused through a nasoenteric tube for 30 minutes.

• 

  Figure 2 Serum albumin level and platelet count during treatment. HOD, hospital day.

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