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Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection

Fecal microbiota transplantation (FMT) has become a common rescue therapy for recurrent Clostridium difficile infection, and encapsulated delivery (cFMT) of healthy donor microbiota shows similar clinical efficacy as more traditional routes of administration. In this study, we characterized long-ter...

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Autores principales: Staley, Christopher, Kaiser, Thomas, Vaughn, Byron P., Graiziger, Carolyn, Hamilton, Matthew J., Kabage, Amanda J., Khoruts, Alexander, Sadowsky, Michael J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: American Society for Microbiology 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650559/
https://www.ncbi.nlm.nih.gov/pubmed/31337728
http://dx.doi.org/10.1128/mBio.01586-19
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author Staley, Christopher
Kaiser, Thomas
Vaughn, Byron P.
Graiziger, Carolyn
Hamilton, Matthew J.
Kabage, Amanda J.
Khoruts, Alexander
Sadowsky, Michael J.
author_facet Staley, Christopher
Kaiser, Thomas
Vaughn, Byron P.
Graiziger, Carolyn
Hamilton, Matthew J.
Kabage, Amanda J.
Khoruts, Alexander
Sadowsky, Michael J.
author_sort Staley, Christopher
collection PubMed
description Fecal microbiota transplantation (FMT) has become a common rescue therapy for recurrent Clostridium difficile infection, and encapsulated delivery (cFMT) of healthy donor microbiota shows similar clinical efficacy as more traditional routes of administration. In this study, we characterized long-term patterns of bacterial engraftment in a cohort of 18 patients, who received capsules from one of three donors, up to 409 days post-FMT. Bacterial communities were characterized using Illumina sequencing of the V5-V6 hypervariable regions of the 16S rRNA gene, and engraftment was determined by using the Bayesian algorithm SourceTracker. All patients recovered clinically and were free of C. difficile infection following cFMT. The majority of patients (61%) showed high levels of engraftment after the first week following FMT, which were sustained throughout the year. A small subset, 22%, experienced a decline in donor engraftment after approximately 1 month, and a few patients (17%), two of whom were taking metformin, showed delayed and low levels of donor engraftment. Members of the genera Bacteroides, Parabacteroides, and Faecalibacterium were significantly and positively correlated with donor similarity (ρ = 0.237 to 0.373, P ≤ 0.017). Furthermore, throughout the year, patient fecal communities showed significant separation based on the donor fecal microbiota that they received (P < 0.001). Results of this study, which characterize long-term engraftment following cFMT, suggest that numerical donor similarity is not strictly related to clinical outcome and identify a persistent donor-specific effect on patient fecal microbial communities. Furthermore, results suggest that members of the Bacteroidetes may be important targets to improve engraftment via cFMT.
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spelling pubmed-66505592019-08-06 Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection Staley, Christopher Kaiser, Thomas Vaughn, Byron P. Graiziger, Carolyn Hamilton, Matthew J. Kabage, Amanda J. Khoruts, Alexander Sadowsky, Michael J. mBio Research Article Fecal microbiota transplantation (FMT) has become a common rescue therapy for recurrent Clostridium difficile infection, and encapsulated delivery (cFMT) of healthy donor microbiota shows similar clinical efficacy as more traditional routes of administration. In this study, we characterized long-term patterns of bacterial engraftment in a cohort of 18 patients, who received capsules from one of three donors, up to 409 days post-FMT. Bacterial communities were characterized using Illumina sequencing of the V5-V6 hypervariable regions of the 16S rRNA gene, and engraftment was determined by using the Bayesian algorithm SourceTracker. All patients recovered clinically and were free of C. difficile infection following cFMT. The majority of patients (61%) showed high levels of engraftment after the first week following FMT, which were sustained throughout the year. A small subset, 22%, experienced a decline in donor engraftment after approximately 1 month, and a few patients (17%), two of whom were taking metformin, showed delayed and low levels of donor engraftment. Members of the genera Bacteroides, Parabacteroides, and Faecalibacterium were significantly and positively correlated with donor similarity (ρ = 0.237 to 0.373, P ≤ 0.017). Furthermore, throughout the year, patient fecal communities showed significant separation based on the donor fecal microbiota that they received (P < 0.001). Results of this study, which characterize long-term engraftment following cFMT, suggest that numerical donor similarity is not strictly related to clinical outcome and identify a persistent donor-specific effect on patient fecal microbial communities. Furthermore, results suggest that members of the Bacteroidetes may be important targets to improve engraftment via cFMT. American Society for Microbiology 2019-07-23 /pmc/articles/PMC6650559/ /pubmed/31337728 http://dx.doi.org/10.1128/mBio.01586-19 Text en Copyright © 2019 Staley et al. https://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International license (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Staley, Christopher
Kaiser, Thomas
Vaughn, Byron P.
Graiziger, Carolyn
Hamilton, Matthew J.
Kabage, Amanda J.
Khoruts, Alexander
Sadowsky, Michael J.
Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title_full Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title_fullStr Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title_full_unstemmed Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title_short Durable Long-Term Bacterial Engraftment following Encapsulated Fecal Microbiota Transplantation To Treat Clostridium difficile Infection
title_sort durable long-term bacterial engraftment following encapsulated fecal microbiota transplantation to treat clostridium difficile infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6650559/
https://www.ncbi.nlm.nih.gov/pubmed/31337728
http://dx.doi.org/10.1128/mBio.01586-19
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