Fecal Microbiota Transplantation
Introduction
More than 3 million new cases of Clostridium difficile infection (CDI) occur each year in acute-care and long-term care facilities in this country. A spore-forming bacterium most commonly found in the GI tract, C. difficile produces toxins noxious to the intestinal lining, where it alters epithelial cells. Disturbance of these cells can cause a wide range of signs and symptoms, from mild abdominal pain with watery diarrhea to painful abdominal cramping, fever, and bloody stool, possibly progressing to toxic megacolon. CDI accounts for roughly 14,000 deaths each year in the United States.
Traditional treatment varies with disease severity. For mild CDI, initial treatment includes metronidazole; for severe CDI, patients typically receive vancomycin. The newest drug used in CDI therapy is fidaxomicin. This drug may be superior to vancomycin in decreasing CDI recurrence, although it's significantly more expensive.