A Norfolk and Norwich University Hospital consultant microbiologist and senior research fellow at the Quadram Institute has played a key role in the development of updated national clinical guidelines for the use of faecal microbiota transplant (FMT).

Dr Ngozi Elumogo, consultant medical microbiologist, has been part of a joint Healthcare Infection Society and British Society of Gastroenterology working group updating guidelines for the use of FMT for patients with recurrent Clostridiodes difficile (C. diff) infection.

Working with Prof Arjan Narbad at the Quadram Institute, Dr Elumogo has successfully managed FMT use in patients with recurrent C. diff. on the Norwich Research Park.

Clostridioides difficile (formerly Clostridium) – also called C. difficile, or informally just C. diff – is a major cause of healthcare associated diarrhoea, and is increasingly present in the community. Since its recognition as a significant healthcare associated infection, multiple infection control measures and treatment modalities have been explored and this remains an evolving field.

Faecal Microbiota Transplant (FMT) is a procedure involving the transfer of screened healthy donor faeces into an affected patient’s gastrointestinal tract, has gained increasing attention in recent years for its potential to treat various gastrointestinal disorders (especially recurrent or refractory CDI), and even disorders beyond the gut.

Dr Ngozi Elumogo said: “I am very proud to have been a member of the UK’s FMT guideline working party, representing both NNUH and the Quadram Institute. The expertise we have underlines that Norwich is an important centre for FMT research and clinical practice in the UK, and globally.”

The guideline serves as an update to the joint BSG/HIS FMT guidelines, first published in 2018, and reflects fast-moving updates in the literature since this point. It has been developed through extensive collaboration between experts in the field and provides a comprehensive framework for healthcare professionals to understand and evaluate the use of FMT for treatment of C. difficile and, potentially, for other conditions.

The primary focus of these guidelines is to standardise the clinical and research aspects of FMT to ensure its safety and efficacy. Key points addressed in the guideline include:

• Patient Selection: Recommendations for identifying suitable candidates for FMT, particularly for those with recurrent or refractory difficile infection.
• Donor Screening: Protocols for donor screening and selection to minimise potential risks and ensure recipient safety.
• FMT Procedure: Protocols for the procedure itself, including preparation, when it should be offered, and the best ways to administer it.
• Research: Encouraging further research to expand FMT applications and improve its effectiveness.

The updated full guideline can be found on the Healthcare Infection Society website at https://www.journalofhospitalinfection.com/article/S0195-6701(24)00080-X/fulltext