PhD Scientific Days 2025

Conservative Medicine I.

Clinical Experience with Fecal Microbiota Transplantation among Critically Ill Adult Patients Admitted to the Intensive Care Unit

Előadó neve

Dr. Korózs Dorina

Neptun code

Z1KOQ7

Előadó munkahelye

Semmelweis University, Doctoral School of Clinical Medicine, DPC-OHII

Előadó telefonszáma

+36205688766

Előadó e-mail címe

korozs.dorina@gmail.com

Az előadás címe

Clinical Experience with Fecal Microbiota Transplantation among Critically Ill Adult Patients Admitted to the Intensive Care Unit

Szerző(k) neve és munkahelye

Dr. Korózs Dorina¹, Dr. Szabó Bálint Gergely PhD²

1: Semmelweis University, Doctoral School of Clinical Medicine, DPC-OHII
2: Semmelweis University, Doctoral School of Clinical Medicine, DPC-OHII, Semmelweis University, Department of Haematology and Internal Medicine, Division of Infectology

Bemutatás módja

Szóbeli

Szekció

Conservative Medicine I.

Language of the presentation

Hungarian

Preferred session

Conservative Medicine

Összefoglaló szövege

Introduction
For severe-refractory Clostridioides difficile infection (CDI), international guidelines recommend fecal microbiota transplantation (FMT) as a salvage option. In contrast, current guidance does not provide recommendations regarding FMT for the decolonization of multidrug-resistant Gram-negative (MDR-GN) bacteria. Furthermore, data on the application of FMT in critically ill adult patients admitted to intensive care units (ICU) remain limited.
Aims
This study aimed to evaluate the safety and efficacy of FMT for various clinical indications in critically ill adult patients admitted to the ICU of South Pest Central Hospital, National Institute of Hematology and Infectious Diseases.
Methods
FMT was administered via the nasogastric route using freshly processed, cryopreserved stool samples stored at -80 °C, derived from an unrelated donor. Donor eligibility required an unremarkable medical history and adherence to comprehensive screening protocols. Recipients were selected based on indications of either CDI or colonization with MDR-GN bacteria. In CDI cases, stool frequency and consistency were assessed daily to monitor clinical response. For MDR-GN colonization, conventional microbiological cultures of perianal, urine, and stool specimens were obtained weekly. The outcome for CDI was defined as clinical cure by day +14 post-FMT, successful eradication of MDR-GN colonization was assessed by day +21.
Results
In 2024, FMT was performed at our center in four critically ill patients. Patients P1 and P2 presented with CDI refractory to combined high-dose oral vancomycin and intravenous tigecycline (P2), or progressed to toxic megacolon despite standard therapy (P1). In both cases, FMT was administered as an urgent, life-saving intervention, and resulted sustained clinical cure of CDI by day +10 post-FMT. In contrast, patients P3 and P4 underwent elective FMT targeting decolonization of MDR Pseudomonas aeruginosa (P3), and MDR Acinetobacter baumannii and extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumonia (P4). In both MDR cases, successful decolonization was achieved by day +14 post-FMT. No FMT-related adverse events were observed in any of the patients.
Conclusion
FMT may be safe and effective for critically ill adult patients in ICUs, both for the management of severe-refractory CDI and eradication of MDR-GN bacterial colonization.

University

Semmelweis University

Supervisor

Dr. Szabó Bálint Gergely PhD

Publication of my abstract

I do not give consent to the publication of my abstract on the website of the congress.

phd.section.field

in doctoral studies before complex exam (PhD)

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

9134

Start

12:15

End

12:30