Letter to the Editor
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2023; 15(2): 303-306
Published online Feb 27, 2023. doi: 10.4240/wjgs.v15.i2.303
Fecal microbiota transplantation as potential first-line treatment for patients with Clostridioides difficile infection and prior appendectomy
Jing-Wen Zhao, Bing Chang, Li-Xuan Sang
Jing-Wen Zhao, Li-Xuan Sang, Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang 110022, Liaoning Province, China
Bing Chang, Department of Gastroenterology, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Zhao JW wrote the letter; Chang B and Sang LX supervised the manuscript drafting; All authors contributed important intellectual content during manuscript drafting and revision.
Conflict-of-interest statement: There are no conflicts of interest to report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li-Xuan Sang, MD, PhD, Professor, Department of Gastroenterology, Shengjing Hospital of China Medical University, No. 39 Gliding Road, Tiexi District, Shenyang 110022, Liaoning Province, China. sanglixuan2008@163.com
Received: November 19, 2022
Peer-review started: November 19, 2022
First decision: January 3, 2023
Revised: January 16, 2023
Accepted: February 9, 2023
Article in press: February 9, 2023
Published online: February 27, 2023
Processing time: 99 Days and 22.8 Hours
Abstract

Clostridioides difficile infection (CDI) is a global health problem. The association of appendectomy on the severity and prognosis of CDI has been reported in many literatures, but there are still contradictions. In a retrospective study entitled “Patients with Closterium diffuse infection and prior appendectomy may be prone to word outcomes” published in World J Gastrointest Surg 2021, the author found that prior appendectomy affects the severity of CDI. Appendectomy may be a risk factor for increasing the severity of CDI. Therefore, it is necessary to seek alternative treatment for patients with prior appendectomy when they are more likely to have severe or fulminant CDI.

Keywords: Clostridioides difficile infection; Appendectomy; Fecal microbiota transplantation; Intestinal microbiota; Toxic megacolon; Colectomy

Core Tip: The fecal microbiota transplantation (FMT) is a universally approved treatment plan for recurrent Clostridioides difficile infection (CDI). We believe that early FMT is a better choice for patients with CDI and prior appendectomy even if they are not diagnosed as recurrent CDI. FMT can change the composition of patients' intestinal microbiota in a lasting way to prevent worse outcomes.