Competitively Selected Donor Fecal Microbiota Transplantation: Butyrate Concentration and Diversity as Measures of Donor Quality

Journal of Pediatric Gastroenterology and Nutrition
Danielle BarnesK T Park

Abstract

In this prospective cohort study, we examine the feasibility of a protocol to optimize microbiota for fecal microbiota transplantation (FMT). Donor stool metrics generally accepted as markers of gut health were used to select a stool donor based on superior microbial diversity, balanced constitution of Bacteroidetes versus Firmicutes and high concentration of fecal butyrate. Selected donor microbiota was then administered via FMT. A total of 10 patients with median age of 12 years with recurrent Clostridium difficile infection received the intervention. The rate of recurrence-free resolution with 1-2 FMTs was 100% at Week 10. With a single FMT, 80% of patients cleared Clostridium difficile infection without recurrence, whereas 20% of patients required a single re-treatment. No serious adverse events occurred. Microbiota sequencing revealed that recipients' gut microbiota phylogenic diversity increased by 72-hours post-transplantation, with sustainment over 10-week follow-up. This study highlights the feasibility of purposefully selecting the most ideal microbiota for transplantation.

References

Apr 13, 2010·Nature Methods·J Gregory CaporasoRob Knight
Jan 18, 2013·The New England Journal of Medicine·Els van NoodJosbert J Keller
Dec 18, 2013·Nature·Lawrence A DavidPeter J Turnbaugh
Mar 16, 2017·Current Gastroenterology Reports·Danielle Barnes, K T Park

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Citations

Aug 19, 2020·Journal of Crohn's & Colitis·Scott W Olesen, Ylaine Gerardin
Sep 30, 2020·United European Gastroenterology Journal·Elisabeth M TerveerJosbert J Keller
Nov 16, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Elisabeth M TerveerUNKNOWN Netherlands Donor Feces Bank (NDFB) Study Group
Jun 11, 2020·Journal of Clinical Medicine·Stefano BibbòAntonio Gasbarrini
Sep 24, 2020·Microorganisms·Frederik ColdLars Hestbjerg Hansen
Oct 21, 2021·Journal of Gastroenterology and Hepatology·Joseph J Y Sung, Sunny H Wong
Dec 11, 2021·Pediatric Annals·Jacob M ParnellStacy A Kahn

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