Penn Microbiome Therapy (PMT) for Severe-Clostridium Difficile Infection (CDI)

Inclusion Criteria: * 1\. One or more episodes of CDI with symptoms including bowel movements altered in frequency or consistency from baseline. * 2\. Stool test positive for Clostridium difficile by enzyme immunoassay (EIA) by FDA-cleared assay within 7 days prior to enrollment. * 3\. Age ≥ 18 years * 4\. Meets any one of the listed criteria for severe or severe-complicated/fulminant disease within 72 hours of enrollment. * 5\. Receiving antibiotic treatment for S/SC(Severe-complicatedcategory)/F-CDI per current Infectious Diseases Society of America(IDSA) guidelines. Enrollment criteria details: * 1\. Must either meet ≥1 criteria in severe category or in severe complicated category to be enrolled * 2\. If the subject meets criteria in both categories, stratify to the higher severity category (severe complicated) * 3\. Detailed enrollment criteria definitions: * a. white blood cells (WBC) ≥15,000 cells/uL - if any value in the time period meets this definition * b. Hypotension with systolic blood pressure sustained \< 90mmHg for three or more hours or requiring vasopressors (epinephrine, norepinephrine, phenylephrine, or vasopressin) * c. Acute kidney injury - increase in serum creatinine level by ≥50% or new dialysis initiation * i. If a baseline serum creatinine value is not available, acute kidney injury will be defined as a serum creatinine \>1.5 mg/dL * d. Temperature ≥38.5 °C or \<35.6°C - one value needed in time period - * e. Ileus, bowel dilation or megacolon * i. Ileus: If noted in any provider documentation or problem list (search words "ileus") OR * ii. If the words "dilated" "dilation" or "ileus" are noted in a radiology report on intestines/colon, or if "megacolon" noted * f. Lactate \>2.2 mmol/L - if any value in the time period meets this definition * g. Systemic inflammatory response syndrome(SIRS) criteria * i. Heart rate \> 90 beats per minute * ii. Respiratory rate \> 20 breaths per minute or PaCO2 \< 32 mmHg * iii. Temperature \>38ºC or \<36ºC * iv. WBC \> 12,000 cells/uL, \<4,000 cells/uL, or \>10% immature (band) forms Exclusion Criteria: * 1\. Evidence of colon/small bowel perforation at the time of study screening. * 2\. Goals of care are directed to comfort rather than curative measures. * 3\. Moderate (ANC \< 1000 cells/uL) or severe (ANC \< 500 cells/uL) neutropenia. * 4\. Known food allergy that could lead to anaphylaxis. * 5\. Pregnancy * a. For subjects of childbearing potential (ages 18 to 55), the subject must have a negative urine pregnancy test within 48 hours of consent and no more than 48 hours prior to first product administration. * 6 Receipt of Fecal Microbiota Transplantation (FMT) or enrollment in a clinical trial for FMT within the last 3 months. * 7 COVID-19 infection, as defined by a positive nucleic acid or antigen test within the prior 14 days and symptoms consistent with COVID-19 infection