EAU 2019: Faecal transplant to treat recurrent urinary tract infections

  • European Association of Urology

  • curated by Dawn O'Shea
  • UK Medical News
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Research led by Imperial College London suggests faecal microbiota transplantation (FMT) could prevent recurrent extended-spectrum beta-lactamase (ESBL) urinary tract infections (UTIs) in patients with underlying urological diagnoses.

In a retrospective analysis, presented at the European Association of Urology 2019 conference at the weekend, culture positive urine isolates were obtained from 2015-2018 at a tertiary level urology service. Clinical profiles of patients with recurrent extended-spectrum beta-lactamase (ESBL) producing isolates was performed.

From June 2015 to January 2018, 2059 urology patients had a positive urine culture. Of these, 128 (6%) were ESBL positive. A total of 456 patients had multiple positive urine cultures and of these, 62 (14%) had multiple ESBL UTIs.

Of these 62 patients, 84 per cent (52/62) had underlying urological diagnoses, while 10 patients (16%) were purely managed for recurrent UTIs. Nineteen of 62 patients had more than one underlying diagnosis.

Seven (11%) patients had urological reconstruction and 40 (65%) had prosthetic devices in situ.

Four patients received FMT via nasogastric tube. None of the patients experienced complications during or immediately after FMT. Two patients, both of whom had an underlying diagnosis of Clostridium difficile, experienced no further UTI over a six-month period. In one patient, a further UTI occurred but no multidrug-resistant organisms (MDRO) was isolated. In the final patient, a further MDRO UTI was recorded but hospital admission reduced from months to days.