@article{PAR00013492,
  title = {{D}ramatic reduction in {C}lostridium difficile ribotype 027-associated mortality with early fecal transplantation by the nasogastric route : a preliminary report},
  author = {{L}agier, {J}. {C}. and {D}elord, {M}. and {M}illion, {M}. and {P}arola, {P}. and {S}tein, {A}. and {B}rouqui, {P}. and {R}aoult, {D}idier},
  editor = {},
  language = {{ENG}},
  abstract = {{C}lostridium difficile ribotype 027 ({CD}027)-associated diarrhea preferentially affects elderly patients and causes a high mortality rate. {F}ecal microbiota transplantation has become an alternative treatment for recurrent {C} dflieile infections. {A}n outbreak of {CD}027 infections has occurred in {M}arseille since {M}arch 2013, {F}rom {M}arch to {N}ovember 2013, we treated patients using only antibiotics or fecal microbiota transplantation after at least three relapses. {B}eginning in {N}ovember 2013, we performed early transplantation using a nasogastric tube during the first week of infection, in combination with antibiotic treatment. {S}ixty-one patients with a mean age of 84 years were hospitalized, including 42 patients treated only with antibiotics, three with tardive transplantation, and 16 with early transplantation. {T}he patients were comparable in clinical involvement. {T}he global mortality rate was 3/16 (18.75 {A}) among the patients treated by early transplantation and 29/45 (64.4 {A}) among the patients only treated by antibiotics or by tardive transplantation (p<0.01). {A}mong these 45 patients, 23 (51 {A}) died at day 31, including 17 who died at day 7. {E}arly fecal transplantation was associated with a significantly reduced mortality rate, with only one patient dead at day 31(6.25 %). {I}n a {C}ox model, early transplantation was the only independent predictor of survival (hazard ratio 0.18, 95 % confidence interval 0.05-0.61, p=0.006). {S}ix of the 16 patients (37.5 %) needed a second transplantation before symptom resolution. {E}arly fecal microbiota transplantation in combination with antibiotics should be the first-line treatment for {CD}027 infections.},
  keywords = {{FRANCE}},
  booktitle = {},
  journal = {{E}uropean {J}ournal of {C}linical {M}icrobiology and {I}nfectious {D}iseases},
  volume = {34},
  numero = {8},
  pages = {1597--1601},
  ISSN = {0934-9723},
  year = {2015},
  DOI = {10.1007/s10096-015-2394-x},
  URL = {https://www.documentation.ird.fr/hor/{PAR}00013492},
}