Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation

ABSTRACT Bacterial communities from subjects treated for recurrent Clostridium difficile infection (rCDI) by fecal microbiota transplantation (FMT), using either heterologous donor stool samples or autologous stool samples, were characterized by Illumina next-generation sequencing. As previously rep...

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Autores principales:	Christopher Staley, Colleen R. Kelly, Lawrence J. Brandt, Alexander Khoruts, Michael J. Sadowsky
Formato:	article
Lenguaje:	EN
Publicado:	American Society for Microbiology 2016
Materias:	Microbiology QR1-502
Acceso en línea:	https://doaj.org/article/3310be38804c496a96615ccdd2b8da9d
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spelling	oai:doaj.org-article:3310be38804c496a96615ccdd2b8da9d2021-11-15T15:50:15ZComplete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation10.1128/mBio.01965-162150-7511https://doaj.org/article/3310be38804c496a96615ccdd2b8da9d2016-12-01T00:00:00Zhttps://journals.asm.org/doi/10.1128/mBio.01965-16https://doaj.org/toc/2150-7511ABSTRACT Bacterial communities from subjects treated for recurrent Clostridium difficile infection (rCDI) by fecal microbiota transplantation (FMT), using either heterologous donor stool samples or autologous stool samples, were characterized by Illumina next-generation sequencing. As previously reported, the success of heterologous FMT (90%) was superior to that of autologous FMT (43%) (P = 0.019), and post-FMT intestinal bacterial communities differed significantly between treatment arms (P < 0.001). Subjects cured by autologous FMT typically had greater abundances of the Clostridium XIVa clade and Holdemania bacteria prior to treatment, and the relative abundances of these groups increased significantly after FMT compared to heterologous FMT and pre-FMT samples. The typical shift to post-FMT, donor-like assemblages, featuring high relative abundances of genera within the Bacteroidetes and Firmicutes phyla, was not observed in the autologous FMT subjects. Autologous FMT patient bacterial communities were significantly different in composition than those for heterologous FMT patients and donors (P < 0.001). The SourceTracker program, which employs a Bayesian algorithm to determine source contributions to sink communities, showed that patients initially treated by heterologous FMT had significantly higher percentages of engraftment (i.e., similarity to donor communities, mean value of 74%) compared to those who suffered recurrence following autologous FMT (1%) (P ≤ 0.013). The findings of this study suggest that complete donor engraftment may be not necessary if functionally critical taxa are present in subjects following antibiotic therapy. IMPORTANCE This study provides a detailed characterization of fecal bacterial communities in subjects who participated in a previously published randomized clinical trial to treat recurrent C. difficile infection (rCDI). Bacterial communities were characterized to determine differences between subjects who received fecal bacteria either from healthy donor stool samples or their own stool samples as “placebo” in order to determine which groups of bacteria were most important in achieving a cure. The results of this study suggested that bacteria associated with secondary bile acid metabolism could potentially provide resistance to infection and that complete transfer of healthy donor microorganisms was not necessary to resolve CDI following unsuccessful antibiotic treatment.Christopher StaleyColleen R. KellyLawrence J. BrandtAlexander KhorutsMichael J. SadowskyAmerican Society for MicrobiologyarticleMicrobiologyQR1-502ENmBio, Vol 7, Iss 6 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Microbiology QR1-502
spellingShingle	Microbiology QR1-502 Christopher Staley Colleen R. Kelly Lawrence J. Brandt Alexander Khoruts Michael J. Sadowsky Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
description	ABSTRACT Bacterial communities from subjects treated for recurrent Clostridium difficile infection (rCDI) by fecal microbiota transplantation (FMT), using either heterologous donor stool samples or autologous stool samples, were characterized by Illumina next-generation sequencing. As previously reported, the success of heterologous FMT (90%) was superior to that of autologous FMT (43%) (P = 0.019), and post-FMT intestinal bacterial communities differed significantly between treatment arms (P < 0.001). Subjects cured by autologous FMT typically had greater abundances of the Clostridium XIVa clade and Holdemania bacteria prior to treatment, and the relative abundances of these groups increased significantly after FMT compared to heterologous FMT and pre-FMT samples. The typical shift to post-FMT, donor-like assemblages, featuring high relative abundances of genera within the Bacteroidetes and Firmicutes phyla, was not observed in the autologous FMT subjects. Autologous FMT patient bacterial communities were significantly different in composition than those for heterologous FMT patients and donors (P < 0.001). The SourceTracker program, which employs a Bayesian algorithm to determine source contributions to sink communities, showed that patients initially treated by heterologous FMT had significantly higher percentages of engraftment (i.e., similarity to donor communities, mean value of 74%) compared to those who suffered recurrence following autologous FMT (1%) (P ≤ 0.013). The findings of this study suggest that complete donor engraftment may be not necessary if functionally critical taxa are present in subjects following antibiotic therapy. IMPORTANCE This study provides a detailed characterization of fecal bacterial communities in subjects who participated in a previously published randomized clinical trial to treat recurrent C. difficile infection (rCDI). Bacterial communities were characterized to determine differences between subjects who received fecal bacteria either from healthy donor stool samples or their own stool samples as “placebo” in order to determine which groups of bacteria were most important in achieving a cure. The results of this study suggested that bacteria associated with secondary bile acid metabolism could potentially provide resistance to infection and that complete transfer of healthy donor microorganisms was not necessary to resolve CDI following unsuccessful antibiotic treatment.
format	article
author	Christopher Staley Colleen R. Kelly Lawrence J. Brandt Alexander Khoruts Michael J. Sadowsky
author_facet	Christopher Staley Colleen R. Kelly Lawrence J. Brandt Alexander Khoruts Michael J. Sadowsky
author_sort	Christopher Staley
title	Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
title_short	Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
title_full	Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
title_fullStr	Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
title_full_unstemmed	Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation
title_sort	complete microbiota engraftment is not essential for recovery from recurrent <named-content content-type="genus-species">clostridium difficile</named-content> infection following fecal microbiota transplantation
publisher	American Society for Microbiology
publishDate	2016
url	https://doaj.org/article/3310be38804c496a96615ccdd2b8da9d
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Complete Microbiota Engraftment Is Not Essential for Recovery from Recurrent <named-content content-type="genus-species">Clostridium difficile</named-content> Infection following Fecal Microbiota Transplantation

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