Battipaglia, Giorgia (2019) FECAL MICROBIOTA TRANSPLANTATION BEFORE OR AFTER ALLOGENEIC HEMATOPOIETIC TRANSPLANTATION IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES CARRYING MULTIDRUG-RESISTANCE BACTERIA. [Tesi di dottorato]

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Tipologia del documento:	Tesi di dottorato
Lingua:	English
Titolo:	FECAL MICROBIOTA TRANSPLANTATION BEFORE OR AFTER ALLOGENEIC HEMATOPOIETIC TRANSPLANTATION IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES CARRYING MULTIDRUG-RESISTANCE BACTERIA
Autori:	Autore Email Battipaglia, Giorgia giorgicchia@gmail.com
Data:	7 Gennaio 2019
Numero di pagine:	61
Istituzione:	Università degli Studi di Napoli Federico II
Dipartimento:	Medicina Clinica e Chirurgia
Dottorato:	Terapie avanzate biomediche e chirirgiche
Ciclo di dottorato:	31
Coordinatore del Corso di dottorato:	nome email Di Minno, Giovanni diminno@unina.it
Tutor:	nome email Pane, Fabrizio [non definito]
Data:	7 Gennaio 2019
Numero di pagine:	61
Parole chiave:	fecal microbiota transplantation hematologic malignancies multidrug resistant bacteria
Settori scientifico-disciplinari del MIUR:	Area 06 - Scienze mediche > MED/07 - Microbiologia e microbiologia clinica Area 06 - Scienze mediche > MED/09 - Medicina interna Area 06 - Scienze mediche > MED/12 - Gastroenterologia Area 06 - Scienze mediche > MED/15 - Malattie del sangue Area 06 - Scienze mediche > MED/17 - Malattie infettive
Depositato il:	08 Gen 2019 08:35
Ultima modifica:	16 Giu 2020 10:03
URI:	http://www.fedoa.unina.it/id/eprint/12716

Abstract

Fecal microbiota transplantation is an effective treatment in recurrent Clostridium difficile infection. Promising results to eradicate multidrug-resistant bacteria have also been reported with this procedure, but there are safety concerns in immunocompromised patients. We report results in 10 adult patients colonized with multidrug-resistant bacteria, undergoing fecal microbiota transplantation before (n=4) or after (n=6) allogeneic hematopoietic stem cell transplantation for hematologic malignancies. Stools were obtained from healthy related or unrelated donors. Fecal material was delivered either by enema or via nasogastric tube. Patients were colonized or had infections from either carbapenemase-producing bacteria (n=8) or vancomycin-resistant enterococci (n=2). The median age at fecal microbiota transplantation was 48 (range 16-64) years. Three patients needed a second transplant from the same donor, due to initial failure of the procedure. With a median follow-up of 13 (range 4-40) months, decolonization was achieved in seven out of ten patients. In all patients, fecal microbiota transplantation was safe: one patient presented with constipation during the first 5 days after FMT and 2 patients had grade I diarrhea. One case of gut grade III acute graft-versus-host disease occurred after fecal microbiota transplantation. In patients carrying or infected by multidrug-resistant bacteria, fecal microbiota transplantation is an effective and safe decolonization strategy, even in those with hematologic malignancies undergoing hematopoietic stem cell transplantation.

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