Study may show ways to improve fecal microbiota transplantation

Study may provide new strategy to treat recurrent Clostridium difficile infections in patients.
By Amy Wallace   |   Dec. 20, 2016 at 12:11 PM

WASHINGTON, Dec. 20 (UPI) -- A new report provides a strategy for improving fecal microbiota transplantation, or FMT, to help doctors better treat patients with recurrent Clostridium difficile infections.

The study, published in the open-access journal of the American Society of Microbiology called mBio, identified microorganisms key to FMT.

Symptoms of C. difficile infection include diarrhea and abdominal cramping. Recurrent C. difficile infections can cause quality of life issues in patients.

About 20 to 30 percent of patients treated with antibiotics for C. difficile get a recurrent infection, which is caused by a dysbiosis, or microbial imbalance. The collection of microorganisms found in the gut are necessary to health, and exposure to antibiotics can alter that balance.

"This paper provides us data with which microbes to supplement into our preparations," Michael Sadowsky, Ph.D., principal investigator of the study and director of the BioTechnology Institute at the University of Minnesota, St. Paul, said in a press release.

FMT is the more common treatment for recurring C. difficile infections over the past decade with cure rates more than 90 percent.

Researchers used fecal matter from healthy donors and purified the microbiota from the feces mixing it with saline solution and transplanting it into patients through colonoscopy. Scientists also used microbes from the patients' own stool as a placebo.

In the clinical trials using 27 patients with recurrent C. difficile infection, cure rates of FMT from healthy donors was the expected 90 percent. However, several patients who received the FMT from their own stool were also cured.

Researchers used Illumina-based next-generation sequencing to characterize bacterial communities found that patients that were cured by the placebo had more Clostridium Xia clade and Holdemania before treatment, which significantly increases after FMT.

"As opposed to what we thought, complete engraftment of microbiota is not required to cure a patient," Sadowsky said. "The study provides insight into which microorganisms are the most important for curing C. difficile and may allow clinicians to better tailor therapy, by improving donor material to facilitate a more rapid, effective, and lasting cure."

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