scholarly journals The Role of Fecal Microbiota Transplantation in Reducing Intestinal Colonization With Antibiotic-Resistant Organisms: The Current Landscape and Future Directions

2019 ◽  
Vol 6 (7) ◽  
Author(s):  
Michael H Woodworth ◽  
Mary K Hayden ◽  
Vincent B Young ◽  
Jennie H Kwon

Abstract The intestinal tract is a recognized reservoir of antibiotic-resistant organisms (ARO), and a potential target for strategies to reduce ARO colonization. Microbiome therapies such as fecal microbiota transplantation (FMT) have been established as an effective treatment for recurrent Clostridioides difficile infection and may be an effective approach for reducing intestinal ARO colonization. In this article, we review the current published literature on the role of FMT for eradication of intestinal ARO colonization, review the potential benefit and limitations of the use of FMT in this setting, and outline a research agenda for the future study of FMT for intestinal ARO colonization.

2020 ◽  
Vol 15 (12) ◽  
pp. 1173-1183
Author(s):  
Gianluca Ianiro ◽  
Jonathan P Segal ◽  
Benjamin H Mullish ◽  
Mohammed N Quraishi ◽  
Serena Porcari ◽  
...  

Fecal microbiota transplantation (FMT) is the infusion of feces from a healthy donor into the gut of a recipient to treat a dysbiosis-related disease. FMT has been proven to be a safe and effective treatment for Clostridioides difficile infection, but increasing evidence supports the role of FMT in other gastrointestinal and extraintestinal diseases. The aim of this review is to paint the landscape of current evidence of FMT in different fields of application (including irritable bowel syndrome, inflammatory bowel disease, liver disorders, decolonization of multidrug-resistant bacteria, metabolic disorders and neurological disorders), as well as to discuss the current regulatory scenario of FMT, and hypothesize future directions of FMT.


2019 ◽  
Vol 73 ◽  
pp. 316-324
Author(s):  
Aleksandra Kwiatkowska ◽  
Karolina Skonieczna-Żydecka ◽  
Maria Marlicz ◽  
Wojciech Marlicz

The knowledge of the role of the digestive tract in human physiology and pathology has expanded tremendously in recent years. The human intestine is a habitat for a host complex of bacteria, fungi, viruses and Acheaea, all contributing to food digestion, fermentation, metabolism of xenobiotics as well as immune and neuroendocrine functions. Moreover, evidence is mounting that many environmental factors such as diet, drugs, stress and infection may potentially disrupt intestinal microbial milieu. Therefore, methods aimed to modulate gut microbiota are eagerly investigated and applied into daily clinical practice. Fecal microbiota transplantation (FMT) is a transplant of gut bacteria from a healthy donor to a recipent. Usually, the stool bacteria are introduced by means of colonoscopy, gastroduodenoscopy, enema, orogastric tube or orally in the form of a capsule containing freeze-dried material. The effectivness of FMT in the treatment of recurrent Clostridioides difficile infection (CDI) has been confirmed in a numer of high quality studies and is currently recommended as evidence-based therapy in clinical settings. However, FMT is promising in the treatment of other diseases, as it has proven to be an effective method of treating ulcerative colitis (UC) and is of promise in treating Crohn’s disease (CD), metabolic and neuropsychiatric disorders. Many questions related to FMT remain unanswered. A better understanding of fecal and mucosal microbial composition is needed, followed by the optimisation of regulatory issues and selection of best possible donor. Novel protocols based on a new class of probiotics as emerging alternatives to FMT in CDI are also briefly disscussed.


2020 ◽  
Vol 8 (12) ◽  
pp. 2012
Author(s):  
Marzanna Łusiak-Szelachowska ◽  
Beata Weber-Dąbrowska ◽  
Maciej Żaczek ◽  
Jan Borysowski ◽  
Andrzej Górski

The presence of bacteriophages (phages) in the human body may impact bacterial microbiota and modulate immunity. The role of phages in human microbiome studies and diseases is poorly understood. However, the correlation between a greater abundance of phages in the gut in ulcerative colitis and diabetes has been suggested. Furthermore, most phages found at different sites in the human body are temperate, so their therapeutic effects and their potential beneficial effects remain unclear. Hence, far, no correlation has been observed between the presence of widespread crAssphage in the human population and human health and diseases. Here, we emphasize the beneficial effects of phage transfer in fecal microbiota transplantation (FMT) in Clostridioides difficile infection. The safety of phage use in gastrointestinal disorders has been demonstrated in clinical studies. The significance of phages in the FMT as well as in gastrointestinal disorders remains to be established. An explanation of the multifaceted role of endogenous phages for the development of phage therapy is required.


2021 ◽  
Vol 14 (01) ◽  
pp. 016-020
Author(s):  
Juliana Peloso Signorette ◽  
Rômulo Tadeu Dias de Oliveira ◽  
José Maria Montiel ◽  
Priscila Larcher Longo

Abstract Objective This study aimed to perform a comprehensive review of clinical trials using fecal microbiota transplantation in cases of Clostridioides difficile infection. Methods This manuscript reviews clinical studies published from 2003 to 2020 at the Scientific Electronic Library Online (SciELO Brazil), Latin American and Caribbean Health Sciences Literature (LILACS) and US National Library of Medicine (MedLine/PubMed) databases using the descriptors antibiotic/antimicrobial, Clostridium difficile/Clostridioides difficile, intestinal microbiota/intestinal microbiome and fecal transplantation. Results Interventions on microbiota include the use of probiotics, prebiotics, and fecal microbiota transplantation as therapeutic methods. Results show that fecal microbiota transplantation is an excellent alternative for the treatment of recurrent C. difficile infections.


2021 ◽  
Vol 10 (3) ◽  
pp. 389
Author(s):  
Eleftheria Kampouri ◽  
Antony Croxatto ◽  
Guy Prod’hom ◽  
Benoit Guery

Clostridioides difficile is an increasingly common pathogen both within and outside the hospital and is responsible for a large clinical spectrum from asymptomatic carriage to complicated infection associated with a high mortality. While diagnostic methods have considerably progressed over the years, the optimal diagnostic algorithm is still debated and there is no single diagnostic test that can be used as a standalone test. More importantly, the heterogeneity in diagnostic practices between centers along with the lack of robust surveillance systems in all countries and an important degree of underdiagnosis due to lack of clinical suspicion in the community, hinder a more accurate evaluation of the burden of disease. Our improved understanding of the physiopathology of CDI has allowed some significant progress in the treatment of CDI, including a broader use of fidaxomicine, the use of fecal microbiota transplantation for multiples recurrences and newer approaches including antibodies, vaccines and new molecules, already developed or in the pipeline. However, the management of CDI recurrences and severe infections remain challenging and the main question remains: how to best target these often expensive treatments to the right population. In this review we discuss current diagnostic approaches, treatment and potential prevention strategies, with a special focus on recent advances in the field as well as areas of uncertainty and unmet needs and how to address them.


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