Title : From gut to bladder: Fecal microbiota transplant for C. difficle yields surprising UTI remedy in immunosuppressed patient
Abstract:
Recurrent urinary tract infections (UTIs) present significant management challenges, especially when caused by multidrug-resistant (MDR) bacteria, due to the limited availability of effective oral and intravenous (IV) antibiotics. Patients with these infections often undergo multiple courses of antibiotics, which increases the risk of Clostridioides difficile infection (CDI). We report the case of a lung transplant recipient who experienced recurrent UTIs caused by extended-spectrum beta-lactamase (ESBL) producing Klebsiella pneumoniae. This patient developed recurrent CDI, which necessitated a fecal microbiota transplant (FMT). Following the FMT procedure, the patient experienced resolution of both the CDI and UTIs for nearly two years, despite ongoing antimicrobial treatment primarily for respiratory tract infections. However, two years later, he again developed recurrent CDI and UTIs, for which he underwent two additional courses of FMT to control the CDI. As of two years after the repeated FMT, the patient remains free of both UTI and CDI. Our findings show that FMT is a safe and effective treatment when administered on three occasions to an immunosuppressed patient, providing protection against recurrent CDI and UTIs for nearly two years. Further research is needed to evaluate the efficacy of FMT in managing recurrent UTIs caused by multidrug-resistant (MDR) pathogens.
