Fecal Microbiota Transplantation for multidrug-resistant organism: Efficacy and Response prediction

Hye Seong, Sang Kil Lee, Jae Hee Cheon, Dong Eun Yong, Hong Koh, Yun Koo Kang, Woo Young Jeong, Woon Ji Lee, Yujin Sohn, Yunsuk Cho, Jong Hoon Hyun, Yae Jee Baek, Moo Hyun Kim, Jung Ho Kim, Jin Young Ahn, Nam Su Ku, Su Jin Jeong, Joon Sup Yeom, Min Seok Cho, Je Hee LeeByung Yong Kim, Jun Yong Choi

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Objectives: The increasing prevalence of multidrug-resistant microorganisms (MDRO) is increasing the frequency of poor clinical outcomes, prolonging hospitalizations, and raising healthcare costs. This study evaluated the eradication efficacy of fecal microbiota transplantation (FMT) and identified microbial and functional biomarkers of MDRO decolonization. Methods: Fecal solution obtained from healthy unrelated donors was infused in the participants’ guts which had been colonized with carbapenemase-producing enterobacteriacea (CPE), vancomycin-resistant enterococci (VRE), or both CPE and VRE. Fecal samples from recipients were collected and microbiome changes before and after FMT were assessed. Results: Twenty-four (68.6%) out of 35 patients were decolonized within one year of receiving FMT. Multivariate analysis showed that FMT (FMT: hazard ratio (HR) = 5.343, 95% confidence interval (CI) = 1.877-15.212, p = 0.002) and MDRO types (CPE: HR = 11.146, 95% CI = 2.420-51.340, p = 0.002; CPE/VRE: HR = 2.948, 95% CI = 1.200-7.246, p = 0.018; VRE served as the reference) were significant independent factors associated with time to decolonization. Microbiota analysis showed higher richness and biodiversity before FMT resulted in VRE decolonization. The species Clostridium ramosum and the genuses Anaerostipes and Eisenbergiella could serve as taxonomic biomarkers and K02017 could serve as a functional biomarker for VRE clearance. Conclusion: FMT is an effective way to decolonize MDRO and its effectiveness may be predicted by microbiome analysis.

Original languageEnglish
Pages (from-to)719-725
Number of pages7
JournalJournal of Infection
Volume81
Issue number5
DOIs
Publication statusPublished - 2020 Nov

Bibliographical note

Funding Information:
This research was supported by the Severance Hospital Research fund for Clinical excellence (SHRC), the Research Program funded by the Korea Centers for Disease Control and Prevention (2019-ER5408-00), research grants for discovering major clinical and epidemiological indicators for people with HIV (Korea HIV/AIDS Cohort Study, 2019-ER5101-00), and a grant from the Ministry of Health & Welfare, Republic of Korea (grant number: HI14C1324).

Publisher Copyright:
© 2020 The British Infection Association

All Science Journal Classification (ASJC) codes

  • Microbiology (medical)
  • Infectious Diseases

Fingerprint

Dive into the research topics of 'Fecal Microbiota Transplantation for multidrug-resistant organism: Efficacy and Response prediction'. Together they form a unique fingerprint.

Cite this