{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T01:40:16Z","timestamp":1790300416242,"version":"4.1.0"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T00:00:00Z","timestamp":1732147200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100014717","name":"National Outstanding Youth Science Fund Project of National Natural Science Foundation of China","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100014717","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:p>\n                    Ulcerative colitis (UC) is a chronic colonic mucosal inflammation characterized by reduced gut microbial diversity. Patients with UC at pregnancy are prone to suffer from severe disease progression due to the changes of hormone and immune regulation. Fecal microbiota transplant (FMT) is a promising therapy for UC and recurrent\n                    <jats:italic>Clostridium difficile<\/jats:italic>\n                    infection (CDI). However, acute severe ulcerative colitis (ASUC) treatment especially in patients at pregnancy is clinically challenging. Herein, we report a 34-year-old pregnant woman who manifested with numerous bloody stools and markedly elevated serological inflammatory indicators and was diagnosed with ASUC and concurrent CDI. The use of intravenous injection steroids and anti-TNF-\u03b1 therapy failed to improve her condition. Frozen encapsulated FMT therapy was finally performed to this patient with clearly improved symptoms and indications of safe delivery without UC flares or complications, and markedly increased diversity of the gut microbiota was also shown in this patient after FMT. This report firstly describes FMT as a safe salvage therapy for a pregnant patient with CDI and ASUC refractory to intravenous steroids and anti-TNF therapy.\n                  <\/jats:p>","DOI":"10.3389\/fimmu.2024.1417003","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T09:17:23Z","timestamp":1732180643000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Case report: Fecal microbiota transplant for Clostridium difficile infection in a pregnant patient with acute severe ulcerative colitis"],"prefix":"10.3389","volume":"15","author":[{"given":"Hanyu","family":"Wang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feihong","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Luo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuehong","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"bcr2017223540","DOI":"10.1136\/bcr-2017-223540","article-title":"Salvage therapy for acute severe ulcerative colitis during pregnancy","volume":"2018","author":"Raval","year":"2018","journal-title":"BMJ Case Rep"},{"key":"B2","doi-asserted-by":"publisher","first-page":"734","DOI":"10.1053\/j.gastro.2015.12.003","article-title":"The toronto consensus statements for the management of inflammatory bowel disease in pregnancy","volume":"150","author":"Nguyen","year":"2016","journal-title":"Gastroenterology"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1097\/MIB.0000000000001228","article-title":"Systematic review and meta-analysis: fecal microbiota transplantation for treatment of active ulcerative colitis","volume":"23","author":"Narula","year":"2017","journal-title":"Inflammation Bowel Dis"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e1251380","DOI":"10.1080\/21597081.2016.1251380","article-title":"Fecal microbiota transplantation to fight Clostridium difficile infections and other intestinal diseases","volume":"6","author":"Moelling","year":"2016","journal-title":"Bacteriophage"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2016.116","article-title":"Acute severe ulcerative colitis: from pathophysiology to clinical management","volume":"13","author":"Hindryckx","year":"2016","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v21.i19.6060","article-title":"Fulminant ulcerative colitis in a healthy pregnant woman","volume":"21","author":"Orabona","year":"2015","journal-title":"World J Gastroenterol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4161\/gmic.23571","article-title":"High-throughput DNA sequence analysis reveals stable engraftment of gut microbiota following transplantation of previously frozen fecal bacteria","volume":"4","author":"Hamilton","year":"2013","journal-title":"Gut Microbes"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/19490976.2017.1290757","article-title":"Intestinal microbiota, fecal microbiota transplantation, and inflammatory bowel disease","volume":"8","author":"Weingarden","year":"2017","journal-title":"Gut Microbes"},{"key":"B9","doi-asserted-by":"publisher","first-page":"e00009","DOI":"10.14309\/ctg.0000000000000009","article-title":"Modulatory effects of pregnancy on inflammatory bowel disease","volume":"10","author":"van der Giessen","year":"2019","journal-title":"Clin Transl Gastroenterol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2022-328406","article-title":"Gestational diabetes is driven by microbiota-induced inflammation months before diagnosis","volume":"72","author":"Pinto","year":"2023","journal-title":"Gut"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.11.038","article-title":"Pregnancy and neonatal outcomes after fetal exposure to biologics and thiopurines among women with inflammatory bowel disease","volume":"160","author":"Mahadevan","year":"2021","journal-title":"Gastroenterology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-019-05668-6","article-title":"Acute severe ulcerative colitis: the oxford criteria no longer predict in-hospital colectomy rates","volume":"65","author":"Moore","year":"2020","journal-title":"Dig Dis Sci"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1093\/ecco-jcc\/jjx008","article-title":"Third european evidence-based consensus on diagnosis and management of ulcerative colitis. Part 1: definitions, diagnosis, extra-intestinal manifestations, pregnancy, cancer surveillance, surgery, and ileo-anal pouch disorders","volume":"11","author":"Magro","year":"2017","journal-title":"J Crohns Colitis"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000001911","article-title":"Fecal microbiota transplant for clostridium difficile infection in a pregnant patient","volume":"129","author":"Saeedi","year":"2017","journal-title":"Obstetrics Gynecol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1186\/s12934-021-01513-6","article-title":"Long-term efficacy and safety of monotherapy with a single fresh fecal microbiota transplant for recurrent active ulcerative colitis: a prospective randomized pilot study","volume":"20","author":"Fang","year":"2021","journal-title":"Microb Cell Fact"},{"key":"B16","doi-asserted-by":"publisher","first-page":"14494","DOI":"10.1038\/s41598-023-41182-6","article-title":"Efficacy and safety of fecal microbiota transplantation in the treatment of ulcerative colitis: a systematic review and meta-analysis","volume":"13","author":"Feng","year":"2023","journal-title":"Sci Rep"},{"key":"B17","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3748\/wjg.v24.i1.5","article-title":"Relationship between intestinal microbiota and ulcerative colitis: Mechanisms and clinical application of probiotics and fecal microbiota transplantation","volume":"24","author":"Shen","year":"2018","journal-title":"World J Gastroenterol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-022-01257-0","article-title":"Early fecal microbiome transfer after donor defecation determines response in patients with moderate to severe ulcerative colitis","volume":"41","author":"Singh","year":"2022"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.5217\/ir.2018.16.1.142","article-title":"Fecal microbiota transplantation for recurrent Clostridium difficile infection in a patient with ulcerative colitis","volume":"16","author":"Nanki","year":"2018","journal-title":"Intest Res"},{"key":"B20","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1186\/s12876-021-01856-9","article-title":"Daily, oral FMT for long-term maintenance therapy in ulcerative colitis: results of a single-center, prospective, randomized pilot study","volume":"21","author":"Crothers","year":"2021","journal-title":"BMC Gastroenterol"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1417003\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T09:17:26Z","timestamp":1732180646000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2024.1417003\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,21]]},"references-count":20,"alternative-id":["10.3389\/fimmu.2024.1417003"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2024.1417003","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,21]]},"article-number":"1417003"}}