Hye Seong1, Sang Kil Lee2, Jae Hee Cheon2, Dong Eun Yong3, Hong Koh4, Yun Koo Kang5, Woo Young Jeong6, Woon Ji Lee6, Yujin Sohn6, Yunsuk Cho6, Jong Hoon Hyun6, Yae Jee Baek6, Moo Hyun Kim6, Jung Ho Kim6, Jin Young Ahn6, Nam Su Ku6, Su Jin Jeong6, Joon Sup Yeom6, Min Seok Cho7, Je Hee Lee7, Byung-Yong Kim7, Jun Yong Choi8. 1. Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, South Korea. 2. Division of Gastroenterology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. 3. Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea. 4. Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Severance Children's Hospital, Severance Pediatric Liver Disease Research Group, Yonsei University College of Medicine, Seoul, South Korea. 5. Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Yonsei University Wonju College of Medicine, Wonju, South Korea. 6. Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. 7. ChunLab, Inc., JW Tower, 2477, Nambusunhwan-ro, Seocho-gu, Seoul, South Korea. 8. Division of Infectious Diseases, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. Electronic address: seran@yuhs.ac.
Abstract
OBJECTIVES: The increasing prevalence of multidrug-resistant microorganisms (MDRO) is increasing the frequency of poor clinical outcomes, prolonging hospitalizations, and raising healthcare costs. This study evaluated the eradication efficacy of fecal microbiota transplantation (FMT) and identified microbial and functional biomarkers of MDRO decolonization. METHODS: Fecal solution obtained from healthy unrelated donors was infused in the participants' guts which had been colonized with carbapenemase-producing enterobacteriacea (CPE), vancomycin-resistant enterococci (VRE), or both CPE and VRE. Fecal samples from recipients were collected and microbiome changes before and after FMT were assessed. RESULTS: Twenty-four (68.6%) out of 35 patients were decolonized within one year of receiving FMT. Multivariate analysis showed that FMT (FMT: hazard ratio (HR) = 5.343, 95% confidence interval (CI) = 1.877-15.212, p = 0.002) and MDRO types (CPE: HR = 11.146, 95% CI = 2.420-51.340, p = 0.002; CPE/VRE: HR = 2.948, 95% CI = 1.200-7.246, p = 0.018; VRE served as the reference) were significant independent factors associated with time to decolonization. Microbiota analysis showed higher richness and biodiversity before FMT resulted in VRE decolonization. The species Clostridium ramosum and the genuses Anaerostipes and Eisenbergiella could serve as taxonomic biomarkers and K02017 could serve as a functional biomarker for VRE clearance. CONCLUSION: FMT is an effective way to decolonize MDRO and its effectiveness may be predicted by microbiome analysis.
OBJECTIVES: The increasing prevalence of multidrug-resistant microorganisms (MDRO) is increasing the frequency of poor clinical outcomes, prolonging hospitalizations, and raising healthcare costs. This study evaluated the eradication efficacy of fecal microbiota transplantation (FMT) and identified microbial and functional biomarkers of MDRO decolonization. METHODS: Fecal solution obtained from healthy unrelated donors was infused in the participants' guts which had been colonized with carbapenemase-producing enterobacteriacea (CPE), vancomycin-resistant enterococci (VRE), or both CPE and VRE. Fecal samples from recipients were collected and microbiome changes before and after FMT were assessed. RESULTS: Twenty-four (68.6%) out of 35 patients were decolonized within one year of receiving FMT. Multivariate analysis showed that FMT (FMT: hazard ratio (HR) = 5.343, 95% confidence interval (CI) = 1.877-15.212, p = 0.002) and MDRO types (CPE: HR = 11.146, 95% CI = 2.420-51.340, p = 0.002; CPE/VRE: HR = 2.948, 95% CI = 1.200-7.246, p = 0.018; VRE served as the reference) were significant independent factors associated with time to decolonization. Microbiota analysis showed higher richness and biodiversity before FMT resulted in VRE decolonization. The species Clostridium ramosum and the genuses Anaerostipes and Eisenbergiella could serve as taxonomic biomarkers and K02017 could serve as a functional biomarker for VRE clearance. CONCLUSION: FMT is an effective way to decolonize MDRO and its effectiveness may be predicted by microbiome analysis.
Authors: Maria J G T Vehreschild; Annie Ducher; Thomas Louie; Oliver A Cornely; Celine Feger; Aaron Dane; Marina Varastet; Fabien Vitry; Jean de Gunzburg; Antoine Andremont; France Mentré; Mark H Wilcox Journal: J Antimicrob Chemother Date: 2022-03-31 Impact factor: 5.790
Authors: Elena Pérez-Nadales; Ángela Cano; Manuel Recio; María José Artacho; Julia Guzmán-Puche; Antonio Doblas; Elisa Vidal; Clara Natera; Luis Martínez-Martínez; Julian Torre-Cisneros; Juan José Castón Journal: BMJ Open Date: 2022-04-06 Impact factor: 2.692