Table 3.
Patient, donor and faecal suspension risk factors for Clostridioides difficile infection (CDI) relapse within two months after faecal microbiota transplantation (FMT).
| Characteristic | Patients with relapse within two months post-FMT | Patients cured at two months post-FMT | Results statistical analyses (OR (95% CI), p-value) |
|---|---|---|---|
| Patient sex (female) | 77% (10/13) | 58% (67/116) | OR 2.4 (0.6–9.3), p-value 0.24 |
| Donor sex (female) | 54% (7/13) | 50% (58/116) | OR 1.2 (0.4–3.7), p-value 0.79 |
| Donor – patient sex mismatch | 39% (5/13) | 47% (54/116) | OR 0.7 (0.2–2.3), p-value 0.58 |
| Patient’s age (at FMT) | 69 years (41–96) | 70 years (2–92) | p-value 0.76 |
| Donor’s age (at donation) | 36 years (24–46) | 35 years (24–46) | p-value 0.82 |
| Lower gastro-intestinal infusion of FMT (sigmo- or colonoscopy) | 23% (3/13) | 8% (9/116) | OR 3.6 (0.8–15.3), p-value 0.10 |
| Mean processing time of the faecal suspension (defaecation to freezer) | 163 min | 168 min | p-value 0.73 |
| Mean storage time of the faecal suspension (at –80°C) | 214 days | 275 days | p-value 0.27 |
| Severe CDI as indication for FMT | 8% (1/13) | 2% (2/116) | OR 4.8 (0.4–56.3), p-value 0.28 |
| Prior CDI relapses, before FMT is performed | 2.6 (13) | 2.8 (114) | p-value 0.69 |
| PPI use | 61% (8/13) | 51% (55/108) | OR 1.5 (0.5–5.0), p-value 0.47 |
| Comorbidity of IBD | 8% (1/13) | 11% (13/114) | OR 0.7 (0.1–5.4), p-value 1.0 |
| Severe kidney comorbidity: dialysis or kidney transplantation | 8% (1/13) | 9% (24/112) | OR 1.0 (0.1–8.2), p-value 1.0 |
| rUTI in medical history | 0% (0/13) | 8% (9/113) | p-value 0.60a |
| Use of non-CDI antibiotics in between the prior CDI episodes | 46% (6/13) | 38% (43/113) | OR 1.4 (0.4–4.4), p-value 0.57 |
| Immunocompromiseda | |||
| – Not | 61% (8/13) | 82% (93/114) | p-value 0.01 |
| – Moderate | 23% (3/13) | 18% (20/114) | |
| – Severe | 15% (2/13) | 1% (1/114) | |
| Hypervirulent cladeb | 25% (2/8) | 20% (13/65) | OR 1.3 (0.2–7.4), p-value 0.66 |
| Post-FMT hospitalization for non-CDI indications post-FMTc | 23% (3/13) | 14% (14/102) | OR 1.9 (0.5–7.7), p-value 0.41 |
| Post-FMT infection (other than CDI)c | 15% (2/13) | 17% (17/102) | OR 0.9 (0.2–4.5), p-value 1.00 |
| Post-FMT antibiotic use (non-CDI indications)c | 39% (5/13) | 15% (15/102) | OR 3.6 (1.0–12.6), p-value 0.03 |
CI: confidence interval; IBD: inflammatory bowel disease; OR: odds ratio; PPI: proton pump inhibitor; rCDI: recurrent Clostridioides difficile infection; rUTI: recurrent urinary tract infection.
Percentages and final odds ratio with 95% CIs of FMT-treated patients with or without early CDI relapse.
aImmunocompromised classified as: not, moderate or severe. Patients are regarded as severely immunocompromised when: neutropenic, (scheduled or received last 100 days) an allogenic stem cell transplantation, active Graft-versus-host-disease requiring immunosuppressive agents, and moderately immunocompromised when: having <200 CD4 T-cells/µl, prolonged use of corticosteroids at a mean dose of 0.3 mg/kg/d of prednisone equivalent for >3 weeks, treatment with other recognized T-cell immunosuppressants during the last 90 days or have an inherited severe immunodeficiency.
bHypervirulent clade RT027 (016, 019, 0247, 036, 075, 111, 112, 153, 156, 176, 208, 273) and clade RT078 (033, 045, 066, 078, 126, 127).
cIn the first 3 weeks post-FMT.