Fulminant Clostridioides difficile Infection Following Fecal Microbiota Spores Compared to Fecal Microbiota Transplant (May 2025, n=130) Patients receiving VOUST's fecal microbiota spores live-brpk were more likely to develop severe disease, called fulminant C. diff infection FMT

[Michael Harrop]

https://www.newswise.com/articles/new-treatment-for-c-diff-infection-may-be-less-effective-than-traditional-therapy-study-finds/
https://www.cghjournal.org/article/S1542-3565(25)00420-3/abstract

Their center-based study found that both methods were efficient at preventing recurrent infection. However, in the rare patients who had a recurrence, the patients who received fecal spores were more likely to develop severe disease, called “fulminant C. diff infection.”

among the people who did recur, they had severe disease with sepsis

Of the 28 patients who received fecal spores, two were admitted to the hospital with fulminant infection. In comparison, there were zero cases of fulminant infection in the 102 patients who received fecal transplant via colonoscopy.

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Clostridiodes difficile infection (CDI) is a widespread public health problem, with symptoms ranging from diarrhea to fulminant infection, characterized by shock, ileus, or megacolon.1 Gut microbial composition is the major driver of CDI and its recurrence.

Fecal microbiota transplant (FMT), most commonly administered by colonoscopy, has been used as standard of care to prevent recurrence in patients with a history of multiple infections.2,3 FMT is also the only biotherapeutic studied and found to be effective in treating severe or fulminant infection.4–7 In 2023, the United States Food and Drug Administration approved an oral capsule-based treatment to prevent CDI recurrence, fecal microbiota spores live-brpk.5 Fecal microbiota spores are more convenient than colonoscopy-based treatment.

In clinical trials, 88% of participants who received spores to prevent CDI recurrence had no recurrence at 8 weeks.8 However, long term comparative efficacy data between colonoscopy-administered FMT and oral fecal microbiota spores is limited. Therefore, we aimed to compare the risk of repeat CDI within 1 year after treatment between fecal microbiota spores and colonoscopy FMT used to prevent CDI recurrence. We further distinguished repeat CDI into fulminant and non-fulminant cases.

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