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Figure 2: C. difficile infection and the role of faecal microbiota transplantation

Faecal microbiota transplant (FMT) aims to restore the gut microbiome and function, although the exact mechanism is unclear. Current Public Health England guidance recommends FMT should be considered in recurrent C. difficile infection (CDI). 1) Ingesting antibiotics results in a reduction of microbial species and diversity. 2) Spores picked up from the environment are ingested. 3) The C. difficile spores germinate resulting in dysbiosis of the gut microbiota. 4) This can result in the development of CDI (characterised by severe diarrhoea, abdominal pain, nausea and fever). Inflammation and cell death occurs due to presence of toxins. Severe CDI can cause pseudomembranous colitis. 5) Faecal microbiota transplant (FMT): The faecal sample is filtered and administered by enema, transcolonic infusion or nasoduodenal infusion. 6) The result is restoration of stable, healthy microbiota.