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Updated: Nov 9, 2025
Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
Faecalibacterium prausnitzii increases following fecal microbiota transplantation in recurrent Clostridioides
Olle Björkqvist1, Ignacio Rangel2, Lena Serrander3
1Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Objective:
Fecal microbiota transplantation (FMT) is a highly effective treatment for Clostridioides difficile infection (CDI). However, the fecal transplant's causal components translating into clearance of the CDI are yet to be identified. The commensal bacteria Faecalibacterium prausnitzii may be of great interest in this context, since it is one of the most common species of the healthy gut microbiota and produces metabolites with anti-inflammatory properties. Although there is mounting evidence that F. prausnitzii is an important regulator of intestinal homeostasis, data about its role in CDI and FMT are relatively scarce.
Methods:
Stool samples from patients with recurrent CDI were collected to investigate the relative abundance of F. prausnitzii before and after FMT. Twenty-one patients provided fecal samples before the FMT procedure, at 2 weeks post-FMT, and at 2-4 months post-FMT. The relative abundance of F. prausnitzii was determined using quantitative polymerase chain reaction.
Results:
The abundance of F. prausnitzii was elevated in samples (N = 9) from donors compared to pre-FMT samples (N = 15) from patients (adjusted P<0.001). No significant difference in the abundance of F. prausnitzii between responders (N = 11) and non-responders (N = 4) was found before FMT (P = 0.85). In patients with CDI, the abundance of F. prausnitzii significantly increased in the 2 weeks post-FMT samples (N = 14) compared to the pre-FMT samples (N = 15, adjusted P<0.001). The increase persisted 2-4 months post-FMT (N = 15) compared to pre-FMT samples (N = 15) (adjusted P<0.001).
Conclusions:
FMT increases the relative abundance of F. prausnitzii in patients with recurrent CDI, and this microbial shift remains several months later. The baseline abundance of F. prausnitzii in donors or recipients was not associated with future treatment response, although a true predictive capacity cannot be excluded because of the limited sample size. Further studies are needed to discern whether F. prausnitzii plays an active role in the resolution of CDI.
Insights
Fecal microbiota transplantation (FMT) significantly increases the abundance of Faecalibacterium prausnitzii in patients with recurrent Clostridioides difficile infection (CDI). This beneficial gut bacteria increase persists for months, though its direct role in CDI resolution requires further investigation.
Area of Science:
- Microbiology
- Gastroenterology
- Infectious Diseases
Background:
- Clostridioides difficile infection (CDI) is a significant healthcare challenge.
- Fecal microbiota transplantation (FMT) is a highly effective CDI treatment.
- The specific microbial components responsible for FMT's success remain largely unidentified.
Purpose of the Study:
- To investigate the role of Faecalibacterium prausnitzii in FMT for recurrent CDI.
- To quantify changes in F. prausnitzii abundance before and after FMT.
- To explore the association between F. prausnitzii levels and treatment response.
Main Methods:
- Collected stool samples from 21 patients with recurrent CDI before and after FMT.
- Quantified F. prausnitzii relative abundance using quantitative polymerase chain reaction.
- Analyzed F. prausnitzii levels in donors and compared pre- and post-FMT samples from recipients.
Main Results:
- F. prausnitzii abundance was significantly higher in donors than in pre-FMT patient samples.
- A significant increase in F. prausnitzii was observed in patients 2 weeks post-FMT.
- This elevated F. prausnitzii abundance was sustained for 2-4 months post-FMT.
Conclusions:
- FMT effectively increases F. prausnitzii levels in CDI patients, a change that lasts for months.
- Baseline F. prausnitzii abundance did not predict FMT treatment response in this study.
- Further research is needed to confirm F. prausnitzii's active role in resolving CDI.
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