Long-Term Efficacy and Safety of Fecal Microbiota Transplantation for C. difficile Infections Across Academic and Private Clinical Settings.

PURPOSE: Fecal microbiota transplant (FMT) is increasingly performed for Clostridioides difficile infection (CDI), although long-term efficacy and safety data are limited and are focused on results from academic medical centers rather than private settings where most patients receive care. METHODS: Medical records of 165 patients who received FMTs for CDI were reviewed from an academic medical center and an adjacent, unaffiliated private practice. Of these patients, 68 also completed a survey regarding their long-term disease course and interval health. RESULTS: CDI resolution occurred in 81.3% (100/123) at the academic center and 95.2% (40/42) in the private setting. Private practice patients were more likely to present with recurrent, rather than refractory, CDI (92.9% vs. 66.7% P <0.001). Those from the academic center were more likely to have comorbid IBD, recent hospitalization, recent proton pump inhibitor use, ongoing immunosuppression, and inpatient FMT (all P values <0.05).Among surveyed patients, 29.4% developed interval comorbidities or changes to pre-existing conditions after a median follow-up of 33.7 months (IQR 13.2 to 44.3 mo). Of 30 patients requiring subsequent antibiotics, 13.3% suffered CDI relapse. All subjects who had initially responded to FMT but had a subsequent CDI (17.9%, 10/56) responded to another FMT. CONCLUSIONS: In a real-world setting, patients who underwent FMT at academic centers differed significantly in clinical characteristics from those treated at a private practice. In both settings, FMT is an effective treatment for CDI not responding to standard therapies, even after subsequent antibiotic use. New diagnoses following FMT, however, are common and merit further exploration.

A family of main-chain polymeric Lewis acids: synthesis and fluorescent sensing properties of boron-modified polythiophenes.

A new family of main-chain organoborane polymeric Lewis acids (PTh-BAr) that contain Lewis acidic boron groups embedded into a polythiophene backbone has been prepared under mild conditions through tin-boron exchange reaction. When phenyl and pentafluorophenyl groups are attached to boron, blue and green luminescence is observed, respectively, while the attachment of ferrocenyl substituents leads to a characteristic red color. The incorporation of readily accessible highly Lewis acidic groups into the conjugated polymer backbone provides an opportunity for sensing of Lewis basic substrates. For instance, treatment of the polymer containing phenyl substituents on boron with pyridine leads to efficient quenching of the fluorescence, while the polymer containing ferrocenyl groups changes color from dark red to light orange.