Fecal Microbial Transplants Show Lack of Predictability When no Prior Antibiotic Treatment is Given to Recipient
Published:27 Nov.2022 Source:University of Alabama at Birmingham
A fecal microbial transplant -- giving a recipient fecal matter from a donor to change the recipient's gut microbial community in the colon -- has been a successful last resort therapy for people with recurrent Clostridium difficile infection after multiple rounds of suppressive antibiotics have eliminated the recipient microbial community.
However, fecal microbial transplants have also been given to alter a recipient's metabolism to reduce obesity or alter immunity to fight cancer, and in those transplants recipients are not given suppressive antibiotics to eliminate the microbial community prior to the transplant. In these cases, the initial gut community after transplant is a consortium of donor and recipient microbes that have to compete as new microbial strains are introduced into an established community.
University of Alabama at Birmingham researchers now report in the journal PLOS One that there is a lack of predictability for fecal microbial transplants to change the gut microbial community to correspond to that of the donor when there is no preconditioning to reduce the recipient microbe community. This contrasts with the C. difficile fecal microbial transplants after suppressive antibiotic therapy, where stable long-term colonization of donor strains is seen as long as two years post-transplant.
"The practical translation of our analysis suggests the use of pre-fecal microbial transplant treatments to reduce recipient microbial communities to facilitate a donor microbial strain-dominated gut microbial community following fecal microbial transplant," said UAB researchers Hyunmin Koo, Ph.D., and Casey Morrow, Ph.D. "In addition, longitudinal sampling of individual fecal microbial transplant patients in combination with strain tracking analysis to monitor the status of the post-fecal microbial transplant microbial community would also be important to assess the stability and, ultimately, the success of the fecal microbial transplant."