Fecal Transplantation for CDI Is Safe and Effective in Immunocompromised Patients

Given that immunocompromised patients are at increased risk for infection, is it safe to perform fecal microbiota transplantation for treatment of Clostridium difficile infection (CDI) in this population? Researchers addressed this question — as well as the effectiveness of fecal transplantation in this setting — in a multicenter, retrospective trial of 99 patients at 16 centers.

In the 80 patients eligible for inclusion, reasons for immunocompromised status were immunosuppressive therapy for inflammatory bowel disease (36 patients), organ transplantation (19), cancer (7), HIV/AIDS (3), and other medical conditions or medications (15). A single fecal transplantation resulted in cure in 62 patients (78%), who had no recurrence at 12 weeks posttransplantation. A second transplantation was performed in 12 patients, of whom 8 were cured, for an overall cure rate of 89%. Twelve patients experienced serious adverse events within 12 weeks; 10 patients were hospitalized, and 2 died. One death resulted from aspiration during sedation for fecal transplantation administered by colonoscopy. No infections were definitely attributed to colonoscopy.