1. Fecal Microbiota Transplantation for Recurrent C difficile Infection During the COVID-19 Pandemic
- Author
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Stacy A. Kahn, Darrell S. Pardi, David T. Rubin, Aaron J. Tande, Alexander Khoruts, and Sahil Khanna
- Subjects
medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,030204 cardiovascular system & hematology ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,Serology ,03 medical and health sciences ,ACE, angiotensin converting enzyme ,PCR, polymerase chain reaction ,0302 clinical medicine ,Internal medicine ,Pandemic ,Medicine ,030212 general & internal medicine ,Young adult ,rCDI, recurrentClostridioides difficile infection ,FMT, fecal microbiota transplantation ,Transmission (medicine) ,business.industry ,Retrospective cohort study ,General Medicine ,Fecal bacteriotherapy ,Institutional review board ,FDA, Food and Drug Administration ,CDI, Clostridioides difficile infection ,RNA, ribonucleic acid ,Original Article ,business ,IRB, institutional review board - Abstract
Objective To report experience with fecal microbiota transplantation (FMT) for recurrent Clostridioides difficile infection (rCDI) and provide recommendations for management of rCDI and donor testing during the COVID-19 pandemic. Methods A retrospective study of patients with rCDI who underwent FMT from May 26, 2020, to September 30, 2020, with stool from well-screened donors with health and infectious screening and a newly implemented strategy for COVID-19 screening with every 2-week bookend testing with stool quarantine. Patients were followed up for development of rCDI and COVID-19. Results Of the 57 patients who underwent FMT for rCDI, 29 were tested for COVID-19 via nasopharyngeal polymerase chain reaction (PCR) and 22 via serology. All results were negative, except for 1 positive serology. Donor testing every 2 weeks for COVID-19 via serology and nasopharyngeal swab PCR was negative, except for 2 donors at 1 center who were excluded. Three patients had rCDI after FMT, and 1 underwent repeat FMT. One patient developed respiratory symptoms suggestive of COVID-19 and tested negative via nasopharyngeal PCR. Eleven patients who underwent COVID-19 testing for elective procedures or hospitalizations tested negative. No SARS-CoV-2 transmission was noted. Conclusions With appropriate donor screening, FMT can be performed safely for rCDI during the COVID-19 pandemic. Development of a validated stool assay for SARS-CoV-2 will simplify this process further.
- Published
- 2021