4.7 Article

Fecal Microbiota Transplantation for multidrug-resistant organism: Efficacy and Response prediction

期刊

JOURNAL OF INFECTION
卷 81, 期 5, 页码 719-725

出版社

W B SAUNDERS CO LTD
DOI: 10.1016/j.jinf.2020.09.003

关键词

fecal microbiota transplantation; carbapenemase-producing; enterobacteriaceae; vancomycin-resistant enterococci; disease eradication; gut microbiome

资金

  1. Severance Hospital Research fund for Clinical excellence (SHRC)
  2. Korea Centers for Disease Control and Prevention [2019-ER5408-00]
  3. research grants for discovering major clinical and epidemiological indicators for people with HIV (Korea HIV/AIDS Cohort Study) [2019-ER5101-00]
  4. Ministry of Health & Welfare, Republic of Korea [HI14C1324]
  5. Korea Health Promotion Institute [2019-ER5408-00] Funding Source: Korea Institute of Science & Technology Information (KISTI), National Science & Technology Information Service (NTIS)

向作者/读者索取更多资源

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. (C) 2020 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

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