{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:25:00Z","timestamp":1786980300228,"version":"build-2736575974"},"reference-count":43,"publisher":"Elsevier BV","issue":"3","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","theclinics.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Gastroenterology Clinics of North America"],"published-print":{"date-parts":[[2026,9]]},"DOI":"10.1016\/j.gtc.2026.05.009","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T20:44:41Z","timestamp":1782161081000},"page":"493-501","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["Non-Fecal Microbiota Transplantation Strategies for Treatment of Recurrent Clostridioides difficile Infection"],"prefix":"10.1016","volume":"55","author":[{"given":"Athena","family":"Adamopoulos","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Stollman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"1","key":"10.1016\/j.gtc.2026.05.009_bib1","doi-asserted-by":"crossref","DOI":"10.1038\/nrdp.2016.20","article-title":"Clostridium difficile infection","volume":"2","author":"Smits","year":"2016","journal-title":"Nat Rev Dis Primers"},{"key":"10.1016\/j.gtc.2026.05.009_bib2","series-title":"Antibiotic resistance threats in the United States, 2019","year":"2019"},{"issue":"9","key":"10.1016\/j.gtc.2026.05.009_bib4","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1056\/NEJMoa1408913","article-title":"Burden of Clostridium difficile infection in the United States","volume":"372","author":"Lessa","year":"2015","journal-title":"N Engl J Med"},{"issue":"6","key":"10.1016\/j.gtc.2026.05.009_bib5","doi-asserted-by":"crossref","first-page":"e1010","DOI":"10.1093\/infdis\/jiaf233","article-title":"The impact of diet on Clostridioides difficile infection: a review","volume":"231","author":"Castro","year":"2025","journal-title":"J Infect Dis"},{"issue":"1","key":"10.1016\/j.gtc.2026.05.009_bib6","doi-asserted-by":"crossref","first-page":"16","DOI":"10.5009\/gnl18071","article-title":"Recurrent Clostridium difficile infection: risk factors, treatment, and prevention","volume":"13","author":"Song","year":"2019","journal-title":"Gut Liver"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib7","doi-asserted-by":"crossref","DOI":"10.1093\/ofid\/ofae127","article-title":"Characteristics of patients with initial clostridioides difficile infection (CDI) that are associated with increased risk of multiple CDI recurrences","volume":"11","author":"Guh","year":"2024","journal-title":"Open Forum Infect Dis"},{"issue":"5","key":"10.1016\/j.gtc.2026.05.009_bib8","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1093\/cid\/ciab549","article-title":"Clinical practice guideline by the infectious diseases society of America (IDSA) and society for healthcare epidemiology of America (SHEA): 2021 focused update guidelines on management of Clostridioides difficile infection in adults","volume":"73","author":"Johnson","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib9","doi-asserted-by":"crossref","first-page":"1119","DOI":"10.5740\/jaoacint.17-0352","article-title":"Clostridium difficile: epidemiology, pathogenicity, and an update on the limitations of and challenges in its diagnosis","volume":"101","author":"Alyousef","year":"2018","journal-title":"J AOAC Int"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib10","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1038\/nrgastro.2016.25","article-title":"Clostridium difficile infection: epidemiology, diagnosis and understanding transmission","volume":"13","author":"Martin","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1056\/NEJMoa1602615","article-title":"Bezlotoxumab for prevention of recurrent clostridium difficile infection","volume":"376","author":"Wilcox","year":"2017","journal-title":"N Engl J Med"},{"issue":"6","key":"10.1016\/j.gtc.2026.05.009_bib12","first-page":"305","article-title":"Fidaxomicin: a novel agent for the treatment of Clostridium difficile infection","volume":"26","author":"Zhanel","year":"2015","journal-title":"Can J Infect Dis Med Microbiol J Can Mal Infect Microbiol Medicale"},{"issue":"Suppl 2","key":"10.1016\/j.gtc.2026.05.009_bib13","first-page":"S1","article-title":"European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults","volume":"27","author":"van Prehn","year":"2021","journal-title":"Clin Microbiol Infect Off Publ Eur Soc Clin Microbiol Infect Dis"},{"issue":"6","key":"10.1016\/j.gtc.2026.05.009_bib14","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.14309\/ajg.0000000000001278","article-title":"ACG clinical guidelines: prevention, diagnosis, and treatment of clostridioides difficile infections","volume":"116","author":"Kelly","year":"2021","journal-title":"Am J Gastroenterol"},{"key":"10.1016\/j.gtc.2026.05.009_bib15","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijid.2020.11.004","article-title":"Fidaxomicin versus metronidazole, vancomycin and their combination for initial episode, first recurrence and severe Clostridioides difficile infection - an observational cohort study","volume":"103","author":"Polivkova","year":"2021","journal-title":"Int J Infect Dis"},{"issue":"3","key":"10.1016\/j.gtc.2026.05.009_bib16","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/S1473-3099(17)30751-X","article-title":"Extended-pulsed fidaxomicin versus vancomycin for Clostridium difficile infection in patients 60 years and older (EXTEND): a randomised, controlled, open-label, phase 3b\/4 trial","volume":"18","author":"Guery","year":"2018","journal-title":"Lancet Infect Dis"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib17","first-page":"694","article-title":"The use of vancomycin with its therapeutic and adverse effects: a review","volume":"19","author":"Bruniera","year":"2015","journal-title":"Eur Rev Med Pharmacol Sci"},{"issue":"5","key":"10.1016\/j.gtc.2026.05.009_bib18","doi-asserted-by":"crossref","first-page":"e1029","DOI":"10.1093\/cid\/ciab549","article-title":"Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults","volume":"73","author":"Johnson","year":"2021","journal-title":"Clin Infect Dis"},{"key":"10.1016\/j.gtc.2026.05.009_bib19","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2021.761192","article-title":"Rifaximin modulates the gut microbiota to prevent hepatic encephalopathy in liver cirrhosis without impacting the resistome","volume":"11","author":"Yu","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib20","article-title":"Rifaximin therapy for patients with metronidazole-unresponsive clostridium difficile infection","volume":"14","author":"Waqas","year":"2022","journal-title":"Cureus"},{"issue":"12","key":"10.1016\/j.gtc.2026.05.009_bib21","doi-asserted-by":"crossref","first-page":"2850","DOI":"10.1093\/jac\/dkr377","article-title":"A randomized, double-blind, placebo-controlled pilot study to assess the ability of rifaximin to prevent recurrent diarrhoea in patients with Clostridium difficile infection","volume":"66","author":"Garey","year":"2011","journal-title":"J Antimicrob Chemother"},{"issue":"12","key":"10.1016\/j.gtc.2026.05.009_bib22","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1111\/j.1469-0691.2009.03099.x","article-title":"European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI)","volume":"15","author":"Bauer","year":"2009","journal-title":"Clin Microbiol Infect"},{"issue":"3","key":"10.1016\/j.gtc.2026.05.009_bib23","first-page":"270","article-title":"Current treatments for recurrent Clostridium difficile infection","volume":"18","author":"Kowalewski","year":"2024","journal-title":"J Pre-Clin Clin Res"},{"issue":"3","key":"10.1016\/j.gtc.2026.05.009_bib24","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1093\/cid\/ciu313","article-title":"Vancomycin, metronidazole, or tolevamer for clostridium difficile infection: results from two multinational, randomized, controlled trials","volume":"59","author":"Johnson","year":"2014","journal-title":"Clin Infect Dis"},{"issue":"9","key":"10.1016\/j.gtc.2026.05.009_bib25","doi-asserted-by":"crossref","first-page":"2686","DOI":"10.1128\/AEM.03888-15","article-title":"Environmental contamination in households of patients with recurrent Clostridium difficile infection","volume":"82","author":"Shaughnessy","year":"2016","journal-title":"Appl Environ Microbiol"},{"issue":"3 1 Suppl","key":"10.1016\/j.gtc.2026.05.009_bib26","doi-asserted-by":"crossref","first-page":"S12","DOI":"10.1097\/PTS.0000000000000749","article-title":"Environmental cleaning and decontamination to prevent Clostridioides difficile infection in health care settings: a systematic review","volume":"16","author":"Schoyer","year":"2020","journal-title":"J Patient Saf"},{"key":"10.1016\/j.gtc.2026.05.009_bib27","author":"Punzalan"},{"key":"10.1016\/j.gtc.2026.05.009_bib28","doi-asserted-by":"crossref","first-page":"1698","DOI":"10.3389\/fmicb.2016.01698","article-title":"Chemical and stress resistances of Clostridium difficile spores and vegetative cells","volume":"7","author":"Edwards","year":"2016","journal-title":"Front Microbiol"},{"key":"10.1016\/j.gtc.2026.05.009_bib29","article-title":"Using synthetic activity to design ultra-potent antibody cocktails","author":"Zhao","year":"2022","journal-title":"bioRxiv"},{"issue":"2","key":"10.1016\/j.gtc.2026.05.009_bib30","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.00517-23","article-title":"Effective colonization by nontoxigenic Clostridioides difficile REA strain M3 (NTCD-M3) spores following treatment with either fidaxomicin or vancomycin","volume":"11","author":"Sambol","year":"2023","journal-title":"Microbiol Spectr"},{"issue":"10","key":"10.1016\/j.gtc.2026.05.009_bib31","doi-asserted-by":"crossref","first-page":"5224","DOI":"10.1128\/AAC.00913-12","article-title":"Evaluation of an oral suspension of VP20621, spores of nontoxigenic Clostridium difficile strain M3, in healthy subjects","volume":"56","author":"Villano","year":"2012","journal-title":"Antimicrob Agents Chemother"},{"issue":"16","key":"10.1016\/j.gtc.2026.05.009_bib32","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1001\/jama.2023.4314","article-title":"VE303, a defined bacterial consortium, for prevention of recurrent clostridioides difficile infection: a randomized clinical trial","volume":"329","author":"Louie","year":"2023","journal-title":"JAMA"},{"issue":"3","key":"10.1016\/j.gtc.2026.05.009_bib33","doi-asserted-by":"crossref","DOI":"10.1128\/AAC.02197-16","article-title":"The oral \u03b2-Lactamase SYN-004 (Ribaxamase) degrades ceftriaxone excreted into the intestine in phase 2a clinical studies","volume":"61","author":"Kokai-Kun","year":"2017","journal-title":"Antimicrob Agents Chemother"},{"issue":"5","key":"10.1016\/j.gtc.2026.05.009_bib34","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/S1473-3099(18)30731-X","article-title":"Use of ribaxamase (SYN-004), a \u03b2-lactamase, to prevent Clostridium difficile infection in \u03b2-lactam-treated patients: a double-blind, phase 2b, randomised placebo-controlled trial","volume":"19","author":"Kokai-Kun","year":"2019","journal-title":"Lancet Infect Dis"},{"key":"10.1016\/j.gtc.2026.05.009_bib35","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.2147\/IDR.S260258","article-title":"Ribaxamase, an orally administered \u03b2-lactamase, diminishes changes to acquired antimicrobial resistance of the gut resistome in patients treated with ceftriaxone","volume":"13","author":"Kokai-Kun","year":"2020","journal-title":"Infect Drug Resist"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib36","doi-asserted-by":"crossref","first-page":"628","DOI":"10.1093\/infdis\/jix604","article-title":"Protection of the human gut microbiome from antibiotics","volume":"217","author":"de Gunzburg","year":"2018","journal-title":"J Infect Dis"},{"issue":"4","key":"10.1016\/j.gtc.2026.05.009_bib37","doi-asserted-by":"crossref","first-page":"1155","DOI":"10.1093\/jac\/dkab474","article-title":"An open randomized multicentre phase 2 trial to assess the safety of DAV132 and its efficacy to protect gut microbiota diversity in hospitalized patients treated with fluoroquinolones","volume":"77","author":"Vehreschild","year":"2022","journal-title":"J Antimicrob Chemother"},{"issue":"1","key":"10.1016\/j.gtc.2026.05.009_bib38","doi-asserted-by":"crossref","DOI":"10.1128\/msystems.00765-19","article-title":"A high-fat\/high-protein, atkins-type diet exacerbates clostridioides (Clostridium) difficile infection in mice, whereas a high-carbohydrate diet protects","volume":"5","author":"Mefferd","year":"2020","journal-title":"mSystems"},{"issue":"6","key":"10.1016\/j.gtc.2026.05.009_bib39","doi-asserted-by":"crossref","DOI":"10.1016\/j.jcmgh.2025.101474","article-title":"Citrulline inhibits clostridioides difficile infection with anti-inflammatory effects","volume":"19","author":"Xie","year":"2025","journal-title":"Cell Mol Gastroenterol Hepatol"},{"issue":"1","key":"10.1016\/j.gtc.2026.05.009_bib40","doi-asserted-by":"crossref","DOI":"10.1016\/S0016-5085(25)01035-2","article-title":"118: oral citrulline treatment and citrulline-rich watermelon supplementation prevented c.difficile recurrence in animals and patients","volume":"169","author":"Xie","year":"2025","journal-title":"Gastroenterology"},{"issue":"6","key":"10.1016\/j.gtc.2026.05.009_bib41","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1038\/s41564-018-0150-6","article-title":"Microbiota-accessible carbohydrates suppress Clostridium difficile infection in a murine model","volume":"3","author":"Hryckowian","year":"2018","journal-title":"Nat Microbiol"},{"key":"10.1016\/j.gtc.2026.05.009_bib42","doi-asserted-by":"crossref","DOI":"10.3389\/fcimb.2022.1028267","article-title":"The impact of dietary fibers on Clostridioides difficile infection in a mouse model","volume":"12","author":"Wu","year":"2022","journal-title":"Front Cell Infect Microbiol"},{"key":"10.1016\/j.gtc.2026.05.009_bib43","doi-asserted-by":"crossref","DOI":"10.1016\/j.foodhyd.2025.111911","article-title":"Prebiotic potential and in vitro fermentation of pectin and pectin-oligosaccharides derived from kinnow waste through microwave-assisted extraction","volume":"172","author":"Bhaiyya","year":"2026","journal-title":"Food Hydrocoll"},{"key":"10.1016\/j.gtc.2026.05.009_bib44","doi-asserted-by":"crossref","DOI":"10.1016\/j.medmic.2025.100121","article-title":"Potential therapeutic solution for Clostridioides difficile infection: current scenario and future prospects","volume":"24","author":"Singh","year":"2025","journal-title":"Med Microecol"}],"container-title":["Gastroenterology Clinics of North America"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889855326000373?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0889855326000373?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:31:30Z","timestamp":1786977090000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0889855326000373"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":43,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["S0889855326000373"],"URL":"https:\/\/doi.org\/10.1016\/j.gtc.2026.05.009","relation":{},"ISSN":["0889-8553"],"issn-type":[{"value":"0889-8553","type":"print"}],"subject":[],"published":{"date-parts":[[2026,9]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Non-Fecal Microbiota Transplantation Strategies for Treatment of Recurrent Clostridioides difficile Infection","name":"articletitle","label":"Article Title"},{"value":"Gastroenterology Clinics of North America","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.gtc.2026.05.009","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.","name":"copyright","label":"Copyright"}]}}