Fecal microbiota transplantation as therapy for recurrent Clostridioides difficile infection is associated with amelioration of delirium and accompanied by changes in fecal microbiota and the metabolome

Kazuyoshi Gotoh, Yoshihiko Sakaguchi, Haru Kato, Hayato Osaki, Yasutaka Jodai, Mitsutaka Wakuda, Akira Také, Shunji Hayashi, Eri Morita, Takehiko Sugie, Yoichiro Ito, Naoki Ohmiya

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

Abstract

Recurrent Clostridioides difficile infection (rCDI) is a frustrating condition that may affect a person's quality of life for months. Microbiome-based therapy such as fecal microbiota transplantation (FMT) has been effective for the treatment of rCDI by correcting the imbalance of the gut microbiota. Appropriate antibiotic treatment is recommended for at least two recurrences before offering FMT. Here, we report the case of a 92-year-old woman who experienced five recurrences of Clostridioides difficile infection (CDI) (six episodes in total) complicated by dementia and delirium, both of which were dramatically improved by FMT, which was associated with alterations in fecal microbiota and the metabolome. Analyses of whole microbial communities and metabolomic analyses were performed on stool specimens collected from the patient on the first episode, the third episode, the day of FMT (before FMT), and 2, 8, and 23 weeks after the FMT and from the donor. The patient had various fecal dysbioses on the first and third episodes and on the day of FMT. Two weeks after FMT, diversity of the gut bacteriome as well as the virome increased dramatically and was reflected in a positive clinical outcome for this patient. Metabolomic analysis revealed that short-chain fatty acids, which have been reported to be associated with improved memory function, were increased after FMT.

Original languageEnglish
Article number102502
JournalAnaerobe
Volume73
DOIs
Publication statusPublished - Feb 2022

Keywords

  • Clostridioides difficile infection
  • Delirium
  • Fecal microbiota transplantation
  • Intestinal metabolome
  • Intestinal microbiome
  • Recurrence

ASJC Scopus subject areas

  • Microbiology
  • Infectious Diseases

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