Alteration of gut microbial composition associated with the therapeutic efficacy of fecal microbiota transplantation in Clostridium difficile infection
| Autor: | Kuei-Chuan Lee, Fen-Yau Li, Ueng-Cheng Yang, Jen-Jie Chiou, Hui-Chun Huang, Chi-Wei Huang, Tien-En Chang, Pei-Chang Lee, Yi-Tsung Lin, Yen-Po Wang, Ming-Chih Hou, Yi Hsiang Huang, Chun Ying Wu |
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| Rok vydání: | 2021 |
| Předmět: |
Enterobacteriales
medicine.medical_specialty Gut flora Gastroenterology Feces Recurrence Internal medicine medicine Humans In patient General hospital Enterocolitis Pseudomembranous Phylogeny biology business.industry Clostridioides difficile Microbial composition General Medicine Fecal bacteriotherapy Clostridium difficile Fecal Microbiota Transplantation biology.organism_classification Gastrointestinal Microbiome Treatment Outcome Clostridium Infections business |
| Zdroj: | Journal of the Formosan Medical Association = Taiwan yi zhi. 121(9) |
| ISSN: | 0929-6646 |
| Popis: | Background/purpose Clostridium difficile infection (CDI) leads to a significant cause of hospital-acquired morbidity and mortality. Fecal microbiota transplantation (FMT) is effective to treat recurrent or refractory CDI (rCDI). However, the change of microbial composition contributed by FMT and its association with treatment outcomes is not well determined in Taiwan. We aimed to investigate the efficacy of FMT and the association with microbial alteration endemically. Methods Twelve patients who received FMT for rCDI in Taipei Veterans General Hospital were prospectively enrolled from April 2019 to July 2020. The clinical assessments and fecal microbial analyses in comparison with fecal materials of unrelated donors were conducted before and after FMT. Results The overall success rate of FMT for rCDI was 91.7%. A prominence of Proteobacteria, Gammaproteobacteria and Enterobacteriales were observed in the feces of patients with rCDI. Increased fecal phylogenetic diversities and a significant microbial dissimilarity were provided by successful FMT compared to patients before treatment. However, the distinctness was not obvious between patients’ feces at baseline and after unsuccessful FMT. Moreover, dynamic change of fecal microbial composition after FMT was observed during follow-up but did not interrupt the treatment effects of FMT. Conclusion Gut dysbiosis commonly co-exists in patients with rCDI. Restoration of gut microbial communities by FMT provides a promising strategy to treat antibiotic-failed CDI, and the extent of microbial change would be related to the treatment outcomes of FMT. Besides, the effectiveness of FMT for CDI could be maintained even the gut microbiota has diverged over time. |
| Databáze: | OpenAIRE |
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