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Disease Prevention Not Decolonization: A Model for Fecal Microbiota Transplantation in Patients Colonized With

Rohma Ghani1,2, Benjamin H Mullish1,3, Julie A K McDonald1,4

  • 1Division of Digestive Diseases, Department of Metabolism, Digestion, and Reproduction, Imperial College London, London, United Kingdom.

Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America
|July 19, 2020
PubMed

Insights

Fecal microbiota transplantation (FMT) shows promise for multidrug-resistant organisms (MDROs). FMT reduced antibiotic use, bacteremia, and hospital stays in patients with MDROs, despite limited decolonization.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Gastroenterology

Background:

  • Multidrug-resistant organisms (MDROs) pose a significant healthcare challenge.
  • Fecal microbiota transplantation (FMT) is explored for MDRO decolonization with variable success.

Purpose of the Study:

  • To evaluate the clinical impact of FMT in patients colonized or infected with MDROs.
  • To assess FMT's effectiveness beyond direct decolonization rates.

Main Methods:

  • Retrospective analysis of 20 patients receiving FMT for MDROs.
  • Comparison with pre-FMT history and a matched control group without FMT.

Main Results:

  • Significant reductions in antibiotic duration, bacteremia incidence, and hospital length of stay were observed post-FMT.
  • Modest rates of intestinal decolonization were noted.

Conclusions:

  • FMT may offer clinical benefits in MDRO management, including reduced complications and resource utilization.
  • Further research is needed to optimize FMT protocols for enhanced MDRO decolonization.
Keywords:
allogeneic hematopoietic cell transplantationantimicrobial resistancefecal microbiota transplantgut microbiomemultidrug-resistant bacteria

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