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Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection

BACKGROUND: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI) that often fails standard antibiotic therapy. Despite its widespread recent use, however, little is known about the stability of the fecal microbiota following FMT. RESULT...

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Autores principales: Weingarden, Alexa, González, Antonio, Vázquez-Baeza, Yoshiki, Weiss, Sophie, Humphry, Gregory, Berg-Lyons, Donna, Knights, Dan, Unno, Tatsuya, Bobr, Aleh, Kang, Johnthomas, Khoruts, Alexander, Knight, Rob, Sadowsky, Michael J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378022/
https://www.ncbi.nlm.nih.gov/pubmed/25825673
http://dx.doi.org/10.1186/s40168-015-0070-0
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author Weingarden, Alexa
González, Antonio
Vázquez-Baeza, Yoshiki
Weiss, Sophie
Humphry, Gregory
Berg-Lyons, Donna
Knights, Dan
Unno, Tatsuya
Bobr, Aleh
Kang, Johnthomas
Khoruts, Alexander
Knight, Rob
Sadowsky, Michael J
author_facet Weingarden, Alexa
González, Antonio
Vázquez-Baeza, Yoshiki
Weiss, Sophie
Humphry, Gregory
Berg-Lyons, Donna
Knights, Dan
Unno, Tatsuya
Bobr, Aleh
Kang, Johnthomas
Khoruts, Alexander
Knight, Rob
Sadowsky, Michael J
author_sort Weingarden, Alexa
collection PubMed
description BACKGROUND: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI) that often fails standard antibiotic therapy. Despite its widespread recent use, however, little is known about the stability of the fecal microbiota following FMT. RESULTS: Here we report on short- and long-term changes and provide kinetic visualization of fecal microbiota composition in patients with multiply recurrent CDI that were refractory to antibiotic therapy and treated using FMT. Fecal samples were collected from four patients before and up to 151 days after FMT, with daily collections until 28 days and weekly collections until 84 days post-FMT. The composition of fecal bacteria was characterized using high throughput 16S rRNA gene sequence analysis, compared to microbiota across body sites in the Human Microbiome Project (HMP) database, and visualized in a movie-like, kinetic format. FMT resulted in rapid normalization of bacterial fecal sample composition from a markedly dysbiotic state to one representative of normal fecal microbiota. While the microbiome appeared most similar to the donor implant material 1 day post-FMT, the composition diverged variably at later time points. The donor microbiota composition also varied over time. However, both post-FMT and donor samples remained within the larger cloud of fecal microbiota characterized as healthy by the HMP. CONCLUSIONS: Dynamic behavior is an intrinsic property of normal fecal microbiota and should be accounted for in comparing microbial communities among normal individuals and those with disease states. This also suggests that more frequent sample analyses are needed in order to properly assess success of FMT procedures. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40168-015-0070-0) contains supplementary material, which is available to authorized users.
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spelling pubmed-43780222015-03-31 Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection Weingarden, Alexa González, Antonio Vázquez-Baeza, Yoshiki Weiss, Sophie Humphry, Gregory Berg-Lyons, Donna Knights, Dan Unno, Tatsuya Bobr, Aleh Kang, Johnthomas Khoruts, Alexander Knight, Rob Sadowsky, Michael J Microbiome Research BACKGROUND: Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI) that often fails standard antibiotic therapy. Despite its widespread recent use, however, little is known about the stability of the fecal microbiota following FMT. RESULTS: Here we report on short- and long-term changes and provide kinetic visualization of fecal microbiota composition in patients with multiply recurrent CDI that were refractory to antibiotic therapy and treated using FMT. Fecal samples were collected from four patients before and up to 151 days after FMT, with daily collections until 28 days and weekly collections until 84 days post-FMT. The composition of fecal bacteria was characterized using high throughput 16S rRNA gene sequence analysis, compared to microbiota across body sites in the Human Microbiome Project (HMP) database, and visualized in a movie-like, kinetic format. FMT resulted in rapid normalization of bacterial fecal sample composition from a markedly dysbiotic state to one representative of normal fecal microbiota. While the microbiome appeared most similar to the donor implant material 1 day post-FMT, the composition diverged variably at later time points. The donor microbiota composition also varied over time. However, both post-FMT and donor samples remained within the larger cloud of fecal microbiota characterized as healthy by the HMP. CONCLUSIONS: Dynamic behavior is an intrinsic property of normal fecal microbiota and should be accounted for in comparing microbial communities among normal individuals and those with disease states. This also suggests that more frequent sample analyses are needed in order to properly assess success of FMT procedures. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s40168-015-0070-0) contains supplementary material, which is available to authorized users. BioMed Central 2015-03-30 /pmc/articles/PMC4378022/ /pubmed/25825673 http://dx.doi.org/10.1186/s40168-015-0070-0 Text en © Weingarden et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Weingarden, Alexa
González, Antonio
Vázquez-Baeza, Yoshiki
Weiss, Sophie
Humphry, Gregory
Berg-Lyons, Donna
Knights, Dan
Unno, Tatsuya
Bobr, Aleh
Kang, Johnthomas
Khoruts, Alexander
Knight, Rob
Sadowsky, Michael J
Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title_full Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title_fullStr Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title_full_unstemmed Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title_short Dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent Clostridium difficile infection
title_sort dynamic changes in short- and long-term bacterial composition following fecal microbiota transplantation for recurrent clostridium difficile infection
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378022/
https://www.ncbi.nlm.nih.gov/pubmed/25825673
http://dx.doi.org/10.1186/s40168-015-0070-0
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