Fecal Microbiota Transplant Reduces UTI Risk in Recurrent C difficile

New data from a team of Mayo Clinic investigators suggest fecal microbiota transplantation (FMT) is associated with a significantly reduced risk of urinary tract infections (UTIs) among patients with recurrent Clostridioides difficile infection (CDI).

The findings published in June show FMT—an increasingly standardized method of treating CDI in patients—was more likely to result in reduced comorbid UTIs than antibiotic therapies.

In an interview with HCPLive regarding her team’s findings, investigator Raseen Tariq, MBBS, a gastroenterology fellow at the Mayo Clinic College of Medicine and Science, discussed the impact of the data on the understood utility of FMT in patients with recurrent CDI.

Tariq noted that approximately 8 million outpatient visits in the US annually pertain to UTIs—with standard-of-care strategies generally focusing on antibiotic regimens that may which put patients at heightened risk of developing CDI.

“So it’s not very uncommon that we see patients with C diff who had a UTI, got antibiotics, and have had this episode,” Tariq said. “It’s basically this vicious cycle where patients keep getting one infection after the other—both C diff and UTI.”

Most often, female patients with recurrent CDI receiving antibiotics and of older age are at a greater risk of UTI development.

Regarding her team’s research, Tariq noted the causative benefit of FMT on UTI risk reduction in patients with recurrent CDI was evidenced by a controlled group assessment of patients treated with antibiotics; this group showed no improvement in UTI reductions.

“At least this is a foundational study that establishes a hypothesis for future clinical trials to look if FMT could be a potential option to manage recurrent UTIs,” Tariq said.

While the data are encouraging, interpretation into clinical use—such as with patients with recurrent infection or multidrug-resistant burdens—needs to be extrapolated from more research.

“There have been discussions over a potential clinical trial,” Tariq said. “We would want to evaluate this in a prospective setting, utilizing only patients who have UTIs and not necessarily CDI, and evaluating their outcome. We should have some concreate data in the next few years.”

Reference

Tariq R, Tosh PK, Pardi DS, Khanna S. Reduction in urinary tract infections in patients treated with fecal microbiota transplantation for recurrent Clostridioides difficile infection. Eur J Clin Microbiol Infect Dis. 2023;42(8):1037-1041. doi:10.1007/s10096-023-04635-4