without an alternative antibiotic (e.g., fi daxomicin, rifaximin) or at least two episodes of severe CDI resulting in hospitalization and associated with signifi cant ...
Suppl. Data Supp. Table 1 Standard operating procedures for fecal microbiota transfer • •
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Indication: severe CDI refractory to antibiotic treatment Donor criteria: a) Normal laboratory test for transaminases, gGT, CRP and full blood count b) negative serological testing for Hepatitis A, B, C, E, lues, HIV, TbC c) negative stool culture and microscopy for ova, cysts and parasites, negative stool ELISA for entamoeba and giardia d) no history of malignancies, metabolic syndrome, atopic, systemic autoimmune or inflammatory bowel diseases; no diarrhoea or use of antibiotics within three month; no current infection or treatment with immunosuppressive drugs e) no travel to areas with endemic diarrheal disease within 6 month; no drug use or sexual at-risk contacts Application of stool via endoscopy or by oral capsules was performed according to published protocols: a) Donated fecal matter was homogenized in about 1:1 proportion with 0.9% sodium chloride solution and filtered through gauze. b) Fecal suspension was directly applied via endoscope. c) For FMT via oral capsules, fecal suspension was centrifuged (3000 g, 10 min) and the concentrated suspension was stored in 10 % glycerol at -80°C. After thawing, the suspension was double- encapsulated in hypromellose capsules (Capsugel, Cambridge, MA) and 15 capsules were immediately given to the patient with apple juice.
Supp. Table 2 Recurrent/relapsing CDI
At least three episodes of mild-to- moderate CDI and failure of a 6- to 8-week taper with vancomy- cin with or without an alternative antibiotic (e.g., fi daxomicin, rifaximin) or at least two episodes of severe CDI resulting in hospitalization and associated with signifi cant morbidity
Refractory CDI
Moderate CDI not responding to standard therapy (vancomycin) for at least a week
Severe CDI
White blood cells ≥ 15,000 cells / mm 3 , albumin < 3g / dl, and abdominal tenderness.
Complicated CDI
Admission to the intensive care unit, hypotension with or without the use of vasopressors, fever ≥ 38.5 ° C, ileus or signifi cant abdominal distention, mental status changes, white blood cells ≥ 35,000 cells / mm 3 , or < 2 cells / mm 3 , serum lactate > 2.2 mmol / l, or any evidence of end-organ failure.
