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Updated: Aug 17, 2025
Therapeutic Evaluation of Fecal Microbiota Transplantation in an Interleukin 10-Deficient Mouse Model
Published on: April 6, 2022
Double-edged sword: impact of fecal microbiome transplants on the gut resistome
Haley Anne Hallowell1, Anne Lulu Gao, Jotham Suez
1W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Purpose Of Review:
Fecal microbiome transplants (FMT) show promise in treating various diseases, such as Clostridioides difficile infections. FMT have also demonstrated the capacity to modulate the collection of antibiotic resistance genes (ARGs), termed the resistome, within the gut. The purpose of this review was to critically evaluate the literature regarding the interaction between FMT and the gut resistome and determine whether FMT could be used specifically to reduce ARG carriage in the gut.
Recent Findings:
Several studies have demonstrated a decrease in ARG carriage post-FMT administration in various disease states, including recurrent C. difficile infection and after antibiotic usage. However, other studies have reported an expansion of the resistome following FMT. Most studies contained small patient cohorts regardless of the outcome and showed heterogeneity in responses.
Summary:
Research on resistome modulation by FMT is preliminary, and human studies currently lack consensus regarding benefits and risks. From a safety perspective, screening donor samples for ARGs in addition to antibiotic-resistant organisms may be advisable. Additional studies on the mechanisms underlying heterogeneity between studies and individuals are required before FMT is considered an efficient approach for resistome amelioration.
Insights
Fecal microbiome transplants (FMT) show potential for altering gut antibiotic resistance genes (ARGs). However, current research is preliminary, with mixed results on reducing ARG carriage and inconsistent findings across studies.
Area of Science:
- Microbiology
- Gastroenterology
- Genetics
Background:
- Fecal microbiome transplants (FMT) are emerging as a therapeutic option for various conditions, including Clostridioides difficile infections.
- FMT has the potential to influence the gut resistome, which is the collection of antibiotic resistance genes (ARGs).
Approach:
- This review critically evaluates existing literature on the interaction between FMT and the gut resistome.
- The review aims to determine if FMT can be specifically utilized to decrease ARG carriage in the gut.
Key Points:
- Studies show conflicting results regarding FMT's effect on ARG carriage, with some reporting decreases and others reporting increases in the resistome.
- Most studies involve small patient cohorts and exhibit significant heterogeneity in outcomes.
- The mechanisms driving these varied responses remain unclear.
Conclusions:
- Current research on FMT-mediated resistome modulation is preliminary, with a lack of consensus on benefits and risks in human studies.
- Screening donor samples for ARGs is a potential safety measure.
- Further research is needed to understand the heterogeneity in responses before FMT can be recommended for resistome amelioration.
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