Intestinal Research  
Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis
Kosaku Nanki1, Shinta Mizuno1, Katsuyoshi Matsuoka2, Keiko Ono1, Shinya Sugimoto1, Hiroki Kiyohara1, Mari Arai1, Moeko Nakashima1, Kozue Takeshita1, Keiichiro Saigusa1, Mitsutoshi Senoh3, Tadashi Fukuda3, Makoto Naganuma1, Haru Kato3, Wataru Suda4, Masahira Hattori5, Takanori Kanai1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, 2Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, 3Department of Bacteriology II, National Institute of Infectious Diseases, Tokyo, 4Graduate School of Frontier Sciences, University of Tokyo, Chiba, 5Faculty of Science and Engineering, Waseda University, Tokyo, Japan
Correspondence to: Takanori Kanai, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan. Tel: +81-3-3353-1211, Fax: +81-3-3341-3631, E-mail: takagast@keio.jp
Received: February 6, 2017; Revised: March 28, 2017; Accepted: April 5, 2017; Published online: August 31, 2017.
© Korean Association for the Study of Intestinal Diseases. All rights reserved.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent Clostridium difficile infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient’s diarrhea and eradicated C. difficile bacteriologically without any severe complications. Molecular biological analysis of the patient’s fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.
Keywords: Fecal microbiota transplantation; Clostridium difficile; Colitis, ulcerative


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