| Background Washed microbiota transplantation(WMT)is the new stage in the development of fecal microbiota transplantation(FMT)methodology.This study aimed to evaluate the efficacy of safety of WMT for antibiotic-associated diarrhea(AAD),and analyze the risk factors of WMT response and WMT-related adverse events in patients with AAD.Methods This study prospectively collected data from patients who registered for rescue WMT from Chinese fmt Bank,from September 2015 to June 2020.Retrospective analysis was conducted.Inclusion criteria included 1)patients with abdominal symptoms including diarrhea,abdominal distension,abdominal pain and hematochezia,which was associated with antibiotic use;2)with C.difficile toxin test or culture,other microbiological culture or colonoscopy supporting the diagnosis of AAD;3)without response to standard antibiotic treatment and underwent WMT treatment;4)patients were followed up for at least three months.Patients without complete medical data or lost to follow-up were excluded.A new method named abdominal symptom score system(ASSS)was used to evaluate the efficacy of WMT.The primary outcomes included clinical response rate and clinical remission rate of WMT,and the incidence of WMT-related adverse events(AEs).Secondary outcomes included risk factors of clinical response and WMT-related AEs.Results A total of 83 AAD patients were included into analysis.Respectively,79.5%(66/83),38.6%(32/830,32.5%(27/83),13.3%(11/83)of patients were with diarrhea,abdominal distension,abdominal pain and hematochezia.According to the ASSS,67.5%of patients achieved clinical response within one week after WMT.Clinical response was showed in 69.7%(46/66),62.5%(20/32),59.3%(16/27),and 45.5%(5/11)of diarrhea,abdominal distention,abdominal pain and hematochezia,respectively.There were 50.6% of patients achieving clinical remission one month after WMT.28.9%(24/83)of patients had 31 WMT-related AEs during follow-up.Pseudomembranous colitis(PMC)and treatment with fluoroquinolones might be the positive and negative factors for WMT efficacy,respectively.Hematochezia and reusing antibiotics within one week after WMT may be the risk factors for WMT-related AEs.Conclusions The good clinical outcomes of WMT for AAD may encourage us to extend WMT indications to AAD without CDI diagnosis.Multiple clinical factors should be integrated into consideration on strategy of WMT for AAD in practice. |
