Faecal enema as an adjunct in the treatment of Pseudomembranous Enterocolitis

Surgery (Impact Factor: 3.38). 12/1958; 44(5):854-9.
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    • "Le transfert de microbiote fécal (TMF) aussi appelé transplantation de microbiote fécal, bactériothérapie fécale ou transfert de flore, consiste à introduire une préparation constituée d'une dilution de selles d'un donneur sain dans le tube digestif d'un patient receveur, afin de rééquilibrer le microbiote altéré de l'hôte (dysbiose). Cette approche thérapeutique, décrite dans la médecine chinoise [1] dès le IV e siècle, a suscité un intérêt grandissant suite à la publication en 1958 de la guérison spectaculaire après un TMF de quatre patients atteints de colite pseudomembraneuse [2]. Depuis, cette technique a fait l'objet de très nombreuses études montrant son incontestable efficacité dans le traitement des infections récidivantes à Clostridium difficile (CD). "

    Annales Pharmaceutiques Françaises 03/2015; DOI:10.1016/j.pharma.2015.02.004
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    • "Restoring the normal colon microbiota was first described by Eiseman and coworkers in 1958 [20]. Results from case series [21] [22] [23] [24] [25] and a randomized clinical trial [26] have shown success rates above 80% for faecal transplantations. "
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    ABSTRACT: Clostridium difficile infection is one of the most common nosocomial infections. Among other alternatives to standard treatment with vancomycin for recurrent infection are faecal microbiota transplantation and rectal bacteriotherapy with a fixed mixture of intestinal bacterial strains isolated from faeces of healthy persons to mimic a theoretical normal microflora. Developed by Dr. Tvede and Dr. Rask-Madsen, the latter method has been in use for selected patients during the last 25 years in Denmark. In this study we reviewed the medical records of patients treated with rectal bacteriotherapy for relapsing C. difficile in Denmark, 2000-2012. The primary end point was recurrent diarrhoea within 30 days after treatment. A total of 55 patients were included in this case series. Thirty-five patients (64%) had no recurrence within 30 days of bacteriotherapy. Patients with recurrence tended to be older (75.8 years vs. 61.3 years; p 0.26), and more often have preexisting gastrointestinal illness and longer duration of time from the first CDI to bacteriotherapy (221.6 days vs. 175.3 days; p 0.18). Treatment success was 80% in the subgroup of patients with no known gastrointestinal illness and first C. difficile episode less than 6 months before bacteriotherapy. The most common adverse events were abdominal pain (10.9%) and worsening diarrhoea (4.3%). One patient was hospitalized 10 days after treatment with appendicitis, fever, and Escherichia coli bacteremia. The results from this study indicate that rectal bacteriotherapy is a viable alternative to faecal microbiota transplantation in patients with relapsing C. difficile-associated diarrhoea. Copyright © 2014 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.
    Clinical Microbiology and Infection 01/2015; 21(1):48-53. DOI:10.1016/j.cmi.2014.07.003 · 5.77 Impact Factor
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    • "A rudimentary fecal transplant was first described in China, around 500 A.D. (Zhang et al., 2012). However, FMT entered mainstream medicine only since 1958, when Eiseman and colleagues used fecal enemas to treat pseudomembranous colitis (Eiseman et al., 1958). Up to now, FMT has shown very high cure rates of recurrent C. difficile infection (Cammarota et al., 2014a), and is considered a promising approach for the management of diseases associated with gut microbiota alteration, including IBD (Cammarota et al., 2014b; Ianiro et al., 2014b). "
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    ABSTRACT: Over the past recent years, a great number of studies have been directed toward the evaluation of the human host-gut microbiota interaction, with the goal to progress the understanding of the etiology of several complex diseases. Alterations in the intestinal microbiota associated with inflammatory bowel disease are well supported by literature data and have been widely accepted by the research community. The concomitant implementation of high-throughput sequencing techniques to analyze and characterize the composition of the intestinal microbiota has reinforced the view that inflammatory bowel disease results from altered interactions between gut microbes and the mucosal immune system and has raised the possibility that some form of modulation of the intestinal microbiota may constitute a potential therapeutic basis for the disease. The aim of this review is to describe the changes of gut microbiota in inflammatory bowel disease, focusing the attention on its involvement in the pathogenesis of the disease, and to review and discuss the therapeutic potential to modify the intestinal microbial population with antibiotics, probiotics, prebiotics, synbiotics and fecal microbiota transplantation.
    Pharmacology [?] Therapeutics 01/2015; 149. DOI:10.1016/j.pharmthera.2014.12.006 · 9.72 Impact Factor
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