Page 205 - Hospital Authority Convention 2018

Service Enhancement Presentations

F5.5 Healthcare Advances, Research and Innovations 09:00 Room 421

Initial Experience of Faecal Microbiota Transplantation for the Treatment of Clostridium difficile Infection in
Hong Kong
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Lui RNS , Wong SH ,2, Lau LHS , Chan TT , Lam KLY , Cheung KCY , Tang W , Ching JYL , Chan PKS , Wu JCY ,2, Chan
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FKL ,2, Sung JJY ,2, Ng SC ,2 HOSPITAL AUTHORITY CONVENTION 2018
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1 Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Institute of
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Digestive Disease, Department of Microbiology, The Chinese University of Hong Kong, Hong Kong
Introduction
Clostridium difficile infection (CDI) is a leading cause of healthcare-associated infection with significant morbidity and
mortality. In Hong Kong, the incidence increased from 15.41 to 36.3 cases per 100,000 persons from 2006 to 2014,
representing an annual increase of 26%. Difficult-to-treat cases are associated with extended hospital stay and may result in
widespread nosocomial outbreaks. By replacing the gut microbiota from a healthy donor, faecal microbiota transplantation
(FMT) has been shown to be effective for the treatment of recurrent or refractory CDI.
Objectives
In close collaboration with the healthy donor stool biobank established by the Faculty of Medicine, The Chinese University of
Hong Kong which employs rigorous donor screening, we initiated a pilot FMT service using infusion of fresh or frozen donor
faecal suspensions via upper or lower gastrointestinal routes to patients with CDI.
Methodology
We retrospectively reviewed all cases with FMT done for CDI to assess the technical and logistical feasibility, as well as
efficacy and safety of this intervention.
Results
A total of 26 FMTs were performed for the treatment of CDI since 2013. Four of 26 patients (15.4%) required a second FMT.
The mean age was 64.3 years (Interquartile range 52.0-80.8) with males consisting 61.5% of cases. Resolution of diarrhea
without relapse within eight weeks was achieved in 19 of 26 patients (73.1%), which was comparable with rates reported in
the literature. No deaths occurred at 30 days. The procedure was generally well tolerated with no serious adverse events
attributable to FMT. The most commonly reported side effects included abdominal pain, discomfort or bloating.

Conclusion
To the best of our knowledge, this is the first case series using FMT to treat CDI in Hong Kong. The delivery of FMT was
shown to be feasible, safe and effective. FMT will likely play an important role in managing patients with difficult-to-treat CDI.
The rapidly growing body of research suggests that timely use of FMT is associated with reduced mortality, shorter hospital
stay and cost savings. We propose that a territory-wide FMT service is required to address the increasing clinical demand. Tuesday, 8 May 2018

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