This was a retrospective chart review of all 89 FMT courses
provided to 87 patients in our facility between January 2003 and
December 2010. FMT recipients included both patients referred by
clinicians within Essentia Health e Duluth Clinic (EHDC) in
northeastern Minnesota and northwestern Wisconsin, and patients
referred from outside of the EHDC catchment area who traveled to
Duluth for the procedure. The medical records included information
provided by patients and their referring institutions; approximately
two-thirds of patients came from outside of the Duluth
area. In some cases referring physicians, patients or their family
members were contacted to obtain documentation of laboratory
results or clinical follow up information. All FMT courses were
provided by two of the authors (either JA or TAR) of the Gastroenterology
Section at EHDC, Duluth, MN. Patients were included in
the case series if they (1) had an initial laboratory-confirmed
diagnosis of C. difficile infection (CDI); (2) had 2 or more
laboratory-confirmed recurrences of CDI (RCDI) following standard
recommended treatment with oral metronidazole or vancomycin
prior to the FMT [12]; (3) received FMT in accordance with the FMT
protocol (see below); and (4) had evaluable clinical and laboratory
follow up during a period of 60 days or longer following FMT.
Patients were excluded from the case series if (1) the FMT had been
provided for conditions other than RCDI; (2) documentation of
eligibility or follow up was incomplete; (3) the FMT protocol had
not been followed; (4) the patient had a surgically shortened GI
tract; or (5) FMT course had been reported in an earlier case series
published by our group in Clinical Infectious Diseases in 2003 [19].