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Summary Background Shortening the duration of antibiotic therapy for patients admitted to hospital with community-acquired pneumonia should help reduce antibiotic consumption and thus bacterial resistance, adverse events, and related costs. We aimed to assess the need for an additional 5-day course of β-lactam therapy among patients with community-acquired pneumonia who were stable after 3 days of treatment. Methods We did this double-blind, randomised, placebo-controlled, non-inferiority trial (the Pneumonia Short Treatment [PTC]) in 16 centres in France. Adult patients (aged ≥18 years) admitted to hospital with moderately severe community-acquired pneumonia (defined as patients admitted to a non-critical care unit) and who met prespecified clinical stability criteria after 3 days of treatment with β-lactam therapy were randomly assigned (1:1) to receive β-lactam therapy (oral amoxicillin 1 g plus clavulanate 125 mg three times a day) or matched placebo for 5 extra days. Randomisation was done using a web-based system with permuted blocks with random sizes and stratified by randomisation site and Pneumonia Severity Index score. Participants, clinicians, and study staff were masked to treatment allocation. The primary outcome was cure 15 days after first antibiotic intake, defined by apyrexia (temperature ≤37·8°C), resolution or improvement of respiratory symptoms, and no additional antibiotic treatment for any cause. A non-inferiority margin of 10 percentage points was chosen. The primary outcome was assessed in all patients who were randomly assigned and received any treatment (intention-to-treat [ITT] population) and in all patients who received their assigned treatment (per-protocol population). Safety was assessed in the ITT population. This study is registered with ClinicalTrials.gov, NCT01963442, and is now complete. Findings Between Dec 19, 2013, and Feb 1, 2018, 706 patients were assessed for eligibility, and after 3 days of β-lactam treatment, 310 eligible patients were randomly assigned to receive either placebo (n=157) or β-lactam treatment (n=153). Seven patients withdrew consent before taking any study drug, five in the placebo group and two in the β-lactam group. In the ITT population, median age was 73·0 years (IQR 57·0–84·0) and 123 (41%) of 303 participants were female. In the ITT analysis, cure at day 15 occurred in 117 (77%) of 152 participants in the placebo group and 102 (68%) of 151 participants in the β-lactam group (between-group difference of 9·42%, 95% CI −0·38 to 20·04), indicating non-inferiority. In the per-protocol analysis, 113 (78%) of 145 participants in the placebo treatment group and 100 (68%) of 146 participants in the β-lactam treatment group were cured at day 15 (difference of 9·44% [95% CI −0·15 to 20·34]), indicating non-inferiority. Incidence of adverse events was similar between the treatment groups (22 [14%] of 152 in the placebo group and 29 [19%] of 151 in the β-lactam group). The most common adverse events were digestive disorders, reported in 17 (11%) of 152 patients in the placebo group and 28 (19%) of 151 patients in the β-lactam group. By day 30, three (2%) patients had died in the placebo group (one due to bacteraemia due to Staphylococcus aureus, one due to cardiogenic shock after acute pulmonary oedema, and one due to heart failure associated with acute renal failure) and two (1%) in the β-lactam group (due to pneumonia recurrence and possible acute pulmonary oedema). Interpretation Among patients admitted to hospital with community-acquired pneumonia who met clinical stability criteria, discontinuing β-lactam treatment after 3 days was non-inferior to 8 days of treatment. These findings could allow substantial reduction of antibiotic consumption. Funding French Ministry of Health.

Key Points Question What are the risk factors for treatment failure in patients with community-acquired pneumonia (CAP) who reached clinical stability after 3 days of β-lactam treatment? Findings In this secondary analysis of a randomized clinical trial that included 291 adults, only male sex and age were associated with failure in the multivariable analysis. These results were independent of antibiotic treatment duration and biomarker levels. Meaning In this study, among patients with CAP who reached clinical stability after 3 days of antibiotic treatment, male sex and age were associated with higher risk of failure, suggesting that these factors should be taken in account in the treatment of patients with the condition., Importance Failure of treatment is the most serious complication in community-acquired pneumonia (CAP). Objective To assess the potential risk factors for treatment failure in clinically stable patients with CAP. Design, Setting, and Participants This secondary analysis assesses data from a randomized clinical trial on CAP (Pneumonia Short Treatment [PTC] trial) conducted from December 19, 2013, to February 1, 2018. Data analysis was performed from July 18, 2019, to February 15, 2020. Patients hospitalized at 1 of 16 centers in France for moderately severe CAP who were clinically stable at day 3 of antibiotic treatment were included in the PTC trial and analyzed in the per-protocol trial population. Interventions Patients were randomly assigned (1:1) on day 3 of antibiotic treatment to receive β-lactam (amoxicillin-clavulanate [1 g/125 mg] 3 times daily) or placebo for 5 extra days. Main Outcomes and Measures The main outcome was failure at 15 days after first antibiotic intake, defined as a temperature greater than 37.9 °C and/or absence of resolution or improvement of respiratory symptoms and/or additional antibiotic treatment for any cause. The association among demographic characteristics, baseline clinical and biological variables available (ie, at the first day of β-lactam treatment), and treatment failure at day 15 among the per-protocol trial population was assessed by univariate and multivariable logistic regressions. Results Overall, 310 patients were included in the study; this secondary analysis comprised 291 patients (174 [59.8%] male; mean [SD] age, 69.6 [18.5] years). The failure rate was 26.8%. Male sex (odds ratio [OR], 1.74; 95% CI, 1.01-3.07), age per year (OR, 1.03; 95% CI, 1.01-1.05), Pneumonia Severe Index score (OR, 1.01; 95% CI, 1.00-1.02), the presence of chronic lung disease (OR, 1.85; 95% CI, 1.03-3.30), and creatinine clearance (OR, 0.99; 95% CI, 0.98-1.00) were significantly associated with failure in the univariate analysis. When the Pneumonia Severe Index score was excluded to avoid collinearity with age and sex in the regression model, only male sex (OR, 1.92; 95% CI, 1.08-3.49) and age (OR, 1.02; 95% CI, 1.00-1.05) were associated with failure in the multivariable analysis. Conclusions and Relevance In this secondary analysis of a randomized clinical trial, among patients with CAP who reached clinical stability after 3 days of antibiotic treatment, only male sex and age were associated with higher risk of failure, independent of antibiotic treatment duration and biomarker levels. Another randomized clinical trial is needed to evaluate the impact of treatment duration in populations at higher risk for treatment failure., This secondary analysis of a randomized clinical trial assesses treatment failure risk factors in patients with community-acquired pneumonia who reached clinical stability after 3 days of β-lactam treatment.

Objective To compare the impact of a care bundle including medication reconciliation at discharge by a pharmacist versus standard of care, on continuity of therapeutic changes between hospital and primary care and outcome of patients, within 1 month after discharge. Methods Randomised controlled trial in 120 adult patients with at least one chronic disease and three current medications before admission, hospitalised in an infectious disease department of a tertiary hospital and discharged home. Patients were randomly assigned (1:1) to receive a discharge care bundle including medication reconciliation, counselling session and documentation transfer to primary care physician (PCP) (intervention group) or standard of care (control group). Primary outcome was the proportion of in-hospital prescription changes, not maintained by the PCP, 1 month after discharge. Secondary outcome measures included the proportion of patients experiencing early PCP's consultation, hospital readmissions or adverse reactions within 1-month postdischarge and cost of discharge prescriptions. Results Baseline characteristics were comparable between the two groups. One month after discharge, the proportion of in-hospital prescription changes, not maintained by the PCP, was 11% in the intervention group versus 24% in the control group (P = .007). The median delay before PCP's consultation was longer in the intervention group (30.5 vs 19.5 days, P = .013), there were fewer patients readmitted to hospital (3.4% vs 20.7%, P = .009, odds ratio (OR) = 0.13 [0.02-0.53]) and fewer patients who suffered from adverse drug reaction (7.0% vs 22.8%, P = .04, OR = 0.26 [0.07-0.78]). Conclusion This care bundle resulted in the reduction of treatment changes between hospital discharge and primary care.

International audience; Introduction: Eosinopenia as a criterion of sepsis has been the subject of debate for decades. Different authors have proposed different cut-off values.Methods: A prospective study was conducted from February to August 2016. Hospitalized adults suffering from a bacterial infection with eosinopenia, defined as an eosinophil count

The use of antibiotics, as any other drug, is regulated by the terms of its marketing authorisation, notified in the Summary of Product Characteristics (SPC). If a prescription is not in accordance with the SPC, the physician prescribes off-label. There is very little literature regarding off-label use of antibiotics in adult healthcare facilities. A prospective monocentric study was conducted during 11 days from February to June 2015 in hospitalised patients from a tertiary teaching hospital with a high prevalence of multidrug-resistant organism colonisation to evaluate off-label use of antibiotics. Two independent experts assessed whether prescriptions complied with the latest guidelines in infectious diseases and whether off-label use of antibiotics was associated with an increased risk of adverse events. In total, 160 antibiotic prescriptions were analysed, of which 76 (47.5%) were off-label. Of the 76 off-label prescriptions, 50 (65.8%) were off-label regarding indications and 26 (34.2%) regarding doses. Nevertheless, 46/50 off-label indications (92.0%) and only 14/26 off-label doses (53.8%) were approved by experts, especially because of dose adjustment requirements. During follow-up, the rate of reported adverse events was not statistically different between patients with (n = 76) and without (n = 84) off-label prescriptions (P = 0.35). In a context of multidrug resistance and a lack of new drugs, high rates (47.5%) of antibiotic off-label use were observed in our hospital, but without an increased rate of adverse events. Moreover, 78.9% of off-label uses were in accordance with guidelines. Therefore, the SPC is not the warrant of an appropriate use of antibiotics.

Background In France, Carbapenem-Resistant Enterobacteriaceae (CRE) and Vancomycin-Resistant Enterococci (VRE) are considered as Extensively Drug-Resistant (XDR) bacteria. Their management requires reinforcement of hospital’s hygiene policies, and currently there is few consistent data concerning the spontaneous decolonization in XDR colonized patients. Our aim is to study the natural history of decolonization of XDR carriers over time in a hospital setting in a low prevalence country. Material and methods Retrospective multicenter study over 2 years (2015–2016) in 2 different tertiary care hospital sites and units having an agreement for permanent cohorting of such XDR carriers. We gathered the type of microorganisms, risk factors for colonization and rectal swabs from patient’s follow-up. We also evaluated patient care considering isolation precautions. Results We included 125 patients, aged 63+/−19y, including 72.8% of CRE (n = 91), 24.8% of VRE (n = 31) and 2.4% (n = 3) co-colonized with CRE and VRE. CRE were mainly E. coli (n = 54), K. pneumoniae (n = 51) and E. cloacae (n = 6). Mechanisms of resistance were mainly OXA-48 (n = 69), NDM-1 (n = 11), OXA-232 (n = 8) and KPC (n = 3). Prior antibiotic therapy was reported in 38.4% (n = 48) of cases. Conversely, 17.6% (n = 22) received antibiotics during follow-up. Spontaneous decolonization occurred within the first 30 days in 16.4% (n = 19/116) of cases and up to 48.2% after day-90 with a median follow-up of 96 days (0–974). We estimated that XDR carriage was associated with a larger care burden in 13.6% (n = 17) of cases, especially due to a prolongation of hospitalization of 32.5 days (15–300). Conclusions Our study shows that spontaneous decolonization is increasing over time (up to 48.2%). We can regret that only few patients underwent screening after 1 year, emphasizing the need for more monitoring and prospective studies.

International audience; Nocardiosis is a rare cause of infection that usually affects immunocompromised adult patients and might not be recognized by pediatricians. We report a fatal case of disseminated nocardiosis in a previously healthy child initially admitted for an abdominal mass with suspicion of a renal malignant tumor. The patient, originating from Mali without any medical history, displayed abdominal pain with progressive altered general status. Laboratory and imaging findings revealed lymphocytic meningitis and disseminated abscesses in the brain and the cerebellum and a large number of cystic lesions of the kidney. Despite being administered wide-spectrum antibiotics and antituberculous and antifungal therapies with an external ventricular drainage for intracranial hypertension, the patient died 6 days after his admission. Nocardia spp was cultured from a renal biopsy and the cerebrospinal fluid. Species identification and antibiotic susceptibility were obtained later, revealing a multidrug-resistant isolate of the Nocardia elegans/aobensis/africana complex. This case reveals the difficulties of diagnosing nocardiosis, in particular in children not known to be immunocompromised, because we face multiple differential diagnoses and the importance of treating nocardiosis appropriately because of intrinsic resistance issues.

Introduction Les etablissements de sante doivent assurer la continuite du traitement medicamenteux, de l’admission jusqu’a la sortie, transfert inclus. La conciliation medicamenteuse (CM) peut etre un moyen pour y parvenir. Ce travail a pour but d’analyser l’impact clinique et financier de la conciliation medicamenteuse des prescriptions de sortie, associee a un entretien pharmaceutique. Materiels et methode Lors de leur sortie, les patients ayant au moins une pathologie chronique et rentrant a domicile, sont randomises pour beneficier ou non de la CM de leur ordonnance de sortie (etude Conciville 2016-A01628-43). Pour les patients randomises dans le groupe CM, un entretien pharmaceutique expliquant les modifications de l’ordonnance, est associe a la correction des eventuelles erreurs de prescription (erreurs medicamenteuses et/ou reglementaires). De fevrier 2018 a aout 2018, les criteres suivants ont ete recueillis : pour les patients concilies : les types de problemes medicamenteux, les interventions pharmaceutiques, le devenir des interventions et pour tous les patients (concilies a la sortie ou non) le cout des ordonnances de sortie (pour un mois de traitement calcule sur la base des tarifs CEPS). Resultats et discussion Au total, 40 patients ont ete inclus. L’âge moyen etait comparable : 66,8 ± 11,5 ans dans le groupe non concilie (n = 21) vs 69,0 ± 10,7 ans dans le groupe concilie (n = 19), le sexe ratio etait de 2,5 vs 2,2 respectivement. Au total lors de la conciliation. Dix-huit prescriptions de sortie sur 19 (94,7 %) comportaient au moins un probleme (erreur medicamenteuse ou probleme reglementaire). Sur 172 lignes de prescription analysees, 65 problemes ont ete identifies dont 54 concernaient des erreurs medicamenteuses, notamment des prescriptions sur une duree trop longue (n = 18), des indications non traitees (n = 6), un plan de prise non optimal (n = 6), des medicaments non indiques (n = 5). Le taux d’acceptation des interventions pharmaceutiques etait de 50/65 (77 %). Le cout moyen des ordonnances de sortie etait de 345,1 ± 356,5 € pour le groupe concilie vs 545,9 ± 619,5 € dans le groupe non concilie. Conclusion La CM a permis d’eviter certaines erreurs de prescription et a permis de reduire les couts de l’ordonnance de sortie. L’analyse de l’ensemble des donnees de l’etude est necessaire pour confirmer cette tendance.

Antimicrobial stewardship programmes (ASPs) have been effective in optimizing antibiotic use for inpatients. However, an emergency department's fast-paced clinical setting can be challenging for a successful ASP.In April 2015, an ASP was implemented in our emergency department and we aimed to determine its impact on antimicrobial use for outpatients.This was a single-centre study comparing the quality of antibiotic prescriptions between a one-year period before ASP implementation (November 2012 to October 2013) and a one-year period after its implementation (June 2015 to May 2016). For each period, antimicrobial prescriptions for all adult outpatients (hospitalized for24h) were evaluated by an infectious disease specialist and an emergency department physician to assess compliance with local prescribing guidelines. Inappropriate prescriptions were then classified.Before and after ASP, 34,671 and 35,925 consultations were registered at our emergency department, of which 25,470 and 26,208 were outpatients. Antimicrobials were prescribed in 769 (3.0%) and 580 (2.2%) consultations, respectively (P 0.0001). There were 484 (62.9%) and 271 (46.7%) (P 0.0001) instances of non-compliance with guidelines before and after ASP implementation. Non-compliance included unnecessary antimicrobial prescriptions, 197 (25.6%) vs 101 (17.4%) (P0.0005); inappropriate spectrum, 108 (14.0%) vs 54 (9.3%) (P=0.008); excessive treatment duration, 87 (11.3%) vs 53 (9.1%) (P0.05); and inappropriate choices, 11 (1.4%) vs 15 (2.6%) (P0.05).The implementation of an ASP markedly decreased the number of unnecessary antimicrobial prescriptions, but had little impact on most other aspects of inappropriate prescribing.

In 1994, the original Duke criteria introduced the usefulness of echocardiography for the diagnosis of definitive infective endocarditis (IE). Recently, the European Society of Cardiology (ESC) highlighted the need of complementary imaging to support the diagnosis of embolic events and cardiac involvement when echocardiography findings are negative or doubtful. We decided to study the usefulness of transthoracic and transesophageal echocardiography (TTE/TEE) for the diagnosis of definitive IE in patients who already benefited from complementary investigations. A retrospective bicentric study was conducted among patients hospitalized for an IE (2006–2017). Modified Duke criteria were calculated for each patient before and after findings of TTE/TEE. Thereafter, patients were classified by the local task force into three groups: excluded, possible, and definitive IE. Overall, 86 episodes were studied. The median patient age was 72 years (18–95). Microorganisms involved were mostly Staphylococcus aureus (32.5%) and Streptococcus spp. (40.7%). The mortality rate was 17.4%. Before echocardiography, there were 3 excluded IE (3.5%), 51 possible IE (59.3%), and 32 definitive IE (37.2%). After echocardiography findings, we observed 62 definitive (72.1%) and 24 possible IE (27.9%) (p

Background Physicians are facing a worldwide increase in multidrug-resistant (MDR) organisms. Eradication of such bacteria, including so called superbugs (XDR), may cause physicians to prescribe last-resort antibiotics. However, experience with these drugs is limited and few data are available. Methods A before and after retrospective study was conducted from January 2008 to June 2016. Prescriptions of parenteral antimicrobials considered as last-resort antibiotics (colistin, fosfomycin, tigecycline and temocillin) were reviewed by 4 infectious disease specialists (according to microbiology results, susceptibility testing, clinical situation and alternative agents), while doses were analysed by a pharmacist. As a second step, the cohort was split before and after 2013 coinciding with the arrival of a referent in antimicrobial stewardship. Results The treatment of 77 patients with a mean age of 55.4 ± 18.7 years was analysed. The majority were treated for gram-negative rods (69.2%), especially Pseudomonas and Klebsiella spp. and Escherichia coli while 20.0% of patients were treated for gram-positive cocci (mainly Staphylococcus aureus ) and the remainder were polymicrobial. Of 84 prescriptions, fosfomycin was the most frequently prescribed (47.6%), followed by colistin (40.5%), tigecycline (10.7%) and temocillin (1.2%). Outcomes were favorable in 75.3% of patients. In patients with MDR and XDR infections (n = 54), the mortality rate was 11.1%. After 2013, there were significantly fewer prescriptions of last-resort antibiotics for susceptible microorganisms (29.2% vs 6.9%), in the absence of supporting microbiology results (22.9% vs 3.5%) and fewer dose errors (56.2% vs 27.6%) ( P = 0.02). Conclusion Reinforcement of the antimicrobial stewardship task force seems to be valuable for promoting the better use of last-resort antibiotics.

Introduction Cotrimoxazole (Sulfamethoxazole-Trimethoprim, SXT) has interesting characteristics for the treatment of bone and joint infection (BJI): a broad spectrum of activity with adequate bone diffusion and oral and intravenous formulations. However, its efficacy and safety in BJIs are poorly documented and its use remains limited. Methods We conducted a retrospective study in 2 reference centers for BJIs from 2013 to 2018 among patients treated with SXT for a BJI. Data were collected from patient's medical charts. Outcomes and adverse events were evaluated at day (D)7, D45 and D90. Results We analyzed 51 patients with a mean age of 60 ± 20 (SD) years of which 76% presented with an orthopedic device infection (ODI). Gram-negative bacilli (GNB) were involved in 47% of BJIs (n = 24). Moreover, they were often polymicrobial infections (41%). Doses of SXT ranged from 800/160mg bid (61%; n = 31) to 800/160mg tid (39%; n = 20). Median SXT treatment duration was 45 days (IQR 40-45). SXT was part of a dual therapy in 84% of patients (n = 43), associated mainly with fluoroquinolones (n = 17) or rifampicin (n = 14). Outcome was favorable at D7 in 98% (n = 50), at D45 in 88.2% (n = 45) and at D90 in 78.4% (n = 40). The second agent combined with SXT was not an independent factor of favorable outcome (p = 0.97). Adverse events were reported in 8% (n = 4) of patients, with a median of 21 days (IQR 20-30) from SXT initiation and led to discontinuation (n = 3). Conclusion SXT appears to be effective for treatment of BJIs as a salvage therapy, even in GNB or polymicrobial infection, including ODI. Further data are needed to confirm SXT efficacy as an alternative oral regimen in BJIs.

In attempt to identify the factors associated with delayed diagnosis during HIV infection, we studied retrospectively the epidemiological profile of HIV-infected patients diagnosed between January 1, 2012 and December 31, 2013 and followed in our clinical center in Paris. Data were compared to those obtained at the same site during the year 2003. One hundred eighty-six patients fulfilled the inclusion criteria: 49 (26%) had a CD4 count

Introduction: Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by extended-spectrum beta-lactamases and is a good candidate for the treatment of urinary tract infection. However, data are scarce regarding its use in clinical practice. Methods: We conducted a retrospective study from September 2014 to November 2017, in a tertiary care hospital in Garches (France). We gathered all prescriptions of cefoxitin for urinary tract infection due to extended-spectrum beta-lactamase isolates. We compared the clinical outcomes between Escherichia coli and Klebsiella pneumoniae extended-spectrum-beta-lactamase-producing isolates after a 90-day follow-up. When available, we assessed whether cefoxitin-based regimen was associated with an emergence of resistance. Results: The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure of 96.7% ( n = 30/31) at day 30 and of 81.2% ( n = 13/16) and 85.7% (12/14) at day 90 for extended-spectrum beta-lactamase Escherichia coli and Klebsiella pneumoniae isolates, respectively ( p = 0.72). No adverse events were reported. One patient who relapsed carried a Klebsiella pneumoniae isolate that became intermediate to cefoxitin in the follow-up. Conclusion: In a period of major threat with a continuous increase of extended-spectrum beta-lactamase obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using cefoxitin for extended-spectrum beta-lactamase Enterobacteriaceae for the treatment of urinary tract infection while our data show its efficacy.

Background Cefoxitin has a good in vitro activity and stability in resistance to hydrolysis by ESBLs, and is a good candidate for the treatment of urinary tract infection (UTI). However, data are scarce regarding its use in clinical practice, especially against K. pneumoniae deemed to be capable of the acquirement of porin-deficient mutant. Methods We conducted a retrospective study from September 2014 to November 2017, in a tertiary-care hospital. We gathered all prescriptions of Cefoxitin for UTI due to ESBL isolates. We compared the clinical outcomes between E. coli and K. pneumoniae ESBL-producing isolates after a 90-day follow-up. When available, we assessed whether Cefoxitin-based regimen was associated with an emergence of resistance. To our knowledge there is no clinical data supporting a real threat of development of resistance in UTI. Results The treatment of 31 patients with a mean age of 60 ± 18 years was analyzed. We observed a clinical cure at D90 in 81.2% (n = 13/16) of cases for ESBL E. coli isolates and 85.7% (12/14) for ESBL K. pneumoniae (P = 0.72). Overall, we noted an efficacy of FOX around 83.3% (n = 25/30). Median dose of Cefoxitin was 4 g (2–8). Only one patient infected by an ESBL E. coli received an oral relay with levofloxacin for 4 additional days. No adverse events were reported. One patient who relapsed, carried a K. pneumoniae isolate that became intermediate to Cefoxitin in the follow-up. Conclusion In a period of major threat with a continuous increase of ESBL obliging to a policy of carbapenem-sparing regimens, it seems detrimental to deprive physicians of using Cefoxitin for ESBL Enterobacteriaceae for the treatment of UTI while our data show its efficacy. Disclosures All authors: No reported disclosures.

Background Fecal Microbiota Transplantation (FMT) has proved to be an efficient therapy for recurrent C. difficile infection. Its indication is currently discussed for the decolonization of Multidrug-resistant organisms (MDRO) on the basis of mice experiments. Two recent publications suggest that it could be an efficient strategy for patients colonized with digestive MDRO colonization but few data are available for Carbapenem-Resistant Enterobacteria (CRE) and Vancomycin-Resistant Enterococcus (VRE) colonization. Methods We performed a FMT among patients colonized by CRE or VRE documented by at least 3 nonconsecutive positive swabs (including one in the week prior to the FMT). Procedure: 2 days prior to the FMT, patients received a proton pump inhibitor and a naso-duodenal tube was inserted to perform a bowel lavage with X-prep. FMT was performed with frozen feces from 4 donors previously screened for potential diseases using 5 syringes of 50 cc of feces diluted with saline. Patients were discharged after 24h and benefited of outpatient control swabs (PCR + culture) on day 7, 14, 21, 28 and each month during 3 months in order to assess the decolonization. The study is registered at ClinicalTrials.gov (NCT03029078). Results Seventeen individuals were included. Mean age was 69 ± 12.7 (SD) years. Eight patients were positive for CRE (KPC, OXA48 or NDM-1) and 9 for VRE. All suffered from severe underlying condition (hemodialysis, dementia, cirrhosis) or chronic wounds. Median functional autonomy scale was evaluated using the French Iso-Resources Groups (GIR)=4/6 IQR[3–6] supporting they were dependent persons. At 1-month follow-up, 3/8 patients were free from CRE and 5/9 from VRE. At 3-month follow-up, 3/8 patients were still free from CRE whereas 7/8 were free from VRE, considering one death from cirrhosis. Moreover, one of them received antibiotics during a week for a hospital-acquired infection a long time after FMT. No adverse events were reported. Conclusion FMT seems to be an attractive option to eradicate colonization of MDRO, especially for VRE. Limited data are available in the literature to determine response factors. Meanwhile its efficacy is moderate; it provides an alternative solution to quarantine for fragile and frequently hospitalized patients. More data and a controlled trial are required. Disclosures All authors: No reported disclosures.