Early Economic Assessment of Faecal Microbiota Transplantation for Patients with Urinary Tract Infections Caused by Multidrug-Resistant Organisms

• Published in: Infectious diseases and therapy Vol. 12; no. 5; pp. 1429 - 1436
• Main Authors: Baek, Olivia Dybro, Hjermitslev, Camilla K., Dyreborg, Line, Baunwall, Simon M. D., Høyer, Katrine L., Rågård, Nina, Hammeken, Lianna H., Povlsen, Johan V., Ehlers, Lars H., Hvas, Christian Lodberg
• Format: Journal Article
• Language: English
• Published: Cheshire Springer Healthcare 01.05.2023; Springer; Springer Nature B.V; Adis, Springer Healthcare
• Subjects: Analysis; Brief Report; Comorbidity; Drug resistance in microorganisms; Early economic assessment; Economic aspects; Faecal microbiota transplantation; Health aspects; Hospital cost; Hospital costs; Infectious Diseases; Internal Medicine; Kidney transplantation; MDRO; Medical care, Cost of; Medicine; Medicine & Public Health; Microbiota; Microbiota (Symbiotic organisms); Multidrug resistance; Multidrug resistant organisms; NCT; NCT03712722; Organ transplant recipients; Patients; Transplants & implants; Urinary tract diseases; Urinary tract infections; Urogenital system; Denmark; MDRO; Faecal microbiota transplantation; Hospital cost; Multidrug resistance; Early economic assessment
• ISSN: 2193-8229; 2193-6382
• DOI: 10.1007/s40121-023-00797-y

Introduction The use of faecal microbiota transplantation (FMT) to eradicate intestinal carriage of multidrug-resistant organisms (MDRO) has been described in case reports and small case series. Although few in numbers, these patients suffer from recurrent infections that may exacerbate both the patients’ comorbidities and their healths. In the current study, we hypothesized that FMT for MDRO-related urinary tract infections (UTIs) reduces hospitalisations and associated costs. Methods In a cohort of patients referred for FMT from 2015 to 2020, we selected all patients who had consecutively been referred for eradication of MRDO carriage with UTIs. An early economic assessment was performed to calculate hospital-related costs. The overall study cohort was registered at ClinicalTrials, study identifier NCT03712722. Results We consecutively included five patients with UTIs caused by MDROs. Four of the patients were renal transplant recipients. Patients were followed for median 126 days (range 60–320), where the follow-up duration for each patient was aligned with the number of days from the first UTI to FMT. The median number of UTIs per patient dropped from 4 to 0. Investigating hospital costs, hospital admission days dropped by 87% and monthly hospital costs by 79%. Conclusions FMT was effective in reducing the occurrence of UTIs and mediated a marked reduction in hospital costs. We suggest that this strategy is cost-effective. Trial Registration ClinicalTrials, study identifier NCT03712722. Graphical Abstract