From the Guidelines
For a successful fecal microbiota transplantation (FMT) setup, it is crucial to follow a standard protocol for stool collection, processing, and preparation, as outlined in the latest guidelines from the British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) 1. When setting up for FMT, consider the following key steps:
- Follow a standard protocol for stool collection, ensuring that stools are processed within 150 minutes of defecation 1.
- Use at least 50g of stool in each FMT preparation, mixed with sterile 0.9% saline as a diluent, with a minimum ratio of 1:5 stool to diluent 1.
- Consider homogenization and filtration of FMT in a closed disposable system to minimize contamination risk and ensure a uniform preparation 1.
- For frozen FMT, consider thawing at ambient temperature and using it within 6 hours of thawing to maintain viability of the microbiota 1. Key considerations for FMT setup include:
- Using sterile equipment and techniques to minimize the risk of contamination
- Ensuring proper donor screening and selection to reduce the risk of transmitting infectious diseases
- Carefully documenting the procedure, including donor information, preparation methods, and patient response, to monitor outcomes and address potential complications. By following these guidelines and taking a meticulous approach to FMT setup, healthcare providers can help ensure the safety and efficacy of this treatment for conditions like recurrent Clostridioides difficile infection, while also prioritizing patient morbidity, mortality, and quality of life 1.
From the Research
Fecal Microbiota Transplantation Setup
- Fecal microbiota transplantation (FMT) is a recommended treatment for recurrent Clostridium difficile infection (rCDI) 2
- FMT can be applied by colonoscopy or nasojejunal tube after 4-10 days of vancomycin 2
- The combination of FMT and vancomycin has been shown to be superior to fidaxomicin or vancomycin alone in achieving clinical and microbiological resolution of rCDI 2
Tips for Setup
- Patients with rCDI should be treated with FMT after 4-10 days of vancomycin 2
- FMT can be applied by colonoscopy or nasojejunal tube 2
- The use of FMT has been shown to be effective in patients with inflammatory bowel disease and C. difficile infection 3
- Fidaxomicin can be used as an alternative treatment for C. difficile infection, but it has been shown to have a higher rate of recurrence compared to FMT 2, 4
Considerations
- The choice of treatment for C. difficile infection should be based on the severity of the infection and the patient's medical history 5, 6
- FMT has been shown to be effective in reducing the rate of recurrence of C. difficile infection 2, 3
- The use of fidaxomicin has been shown to be effective in treating C. difficile infection, but it may not be as effective as FMT in reducing the rate of recurrence 4