Disease Prevention Not Decolonization: A Model for Fecal Microbiota Transplantation in Patients Colonized With Multidrug-resistant Organisms

Author:

Ghani Rohma12,Mullish Benjamin H13ORCID,McDonald Julie A K14,Ghazy Anan2,Williams Horace R T13,Brannigan Eimear T2,Mookerjee Siddharth2,Satta Giovanni2,Gilchrist Mark2,Duncan Neill5,Corbett Richard5,Innes Andrew J6,Pavlů Jiří6,Thursz Mark R13,Davies Frances2,Marchesi Julian R17

Affiliation:

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

2. Department of Infection, Imperial College Healthcare NHS Trust, London, United Kingdom

3. Department of Gastroenterology and Hepatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom

4. MRC Centre for Molecular Bacteriology and Infection, Imperial College London, London, United Kingdom

5. Department of Renal Medicine, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom

6. Centre for Haematology, Imperial College London, and Hammersmith Hospital, Imperial College London NHS Trust, London, United Kingdom

7. School of Biosciences, Cardiff University, Cardiff, United Kingdom

Abstract

Abstract Fecal microbiota transplantation (FMT) yields variable intestinal decolonization results for multidrug-resistant organisms (MDROs). This study showed significant reductions in antibiotic duration, bacteremia, and length of stay in 20 patients colonized/infected with MDRO receiving FMT (compared with pre-FMT history, and a matched group not receiving FMT), despite modest decolonization rates.

Funder

National Institute for Health Research

Imperial Biomedical Research Centre

Medical Research Council

Wellcome Trust

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Microbiology (medical)

Reference11 articles.

1. Duodenal infusion of donor feces for recurrent clostridium difficile;van Nood,2013

2. Fecal microbial transplants reduce antibiotic-resistant genes in patients with recurrent clostridium difficile infection;Millan,2016

3. The use of faecal microbiota transplant as treatment for recurrent or refractory Clostridium difficile infection and other potential indications: Joint British Society of Gastroenterology (BSG) and Healthcare Infection Society (HIS) guidelines;Mullish,2018

4. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA);McDonald;Clin Infect Dis,2018

5. The role of fecal microbiota transplantation in reducing intestinal colonization with antibiotic-resistant organisms: the current landscape and future directions;Woodworth;Open Forum Infect Dis,2019

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