Microbiome changes associated with sustained eradication of Clostridium difficile after single faecal microbiota transplantation in children with and without inflammatory bowel disease. Issue 6 (21st July 2015)

• Record Type: Journal Article
• Authors: Hourigan, S. K.; Chen, L. A.; Grigoryan, Z.; Laroche, G.; Weidner, M.; Sears, C. L.; Oliva‐Hemker, M.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 42:Issue 6(2015)
• Page Start: 741
• Page End: 752
• Publication Date: 2015-07-21
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13326
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13326-abs-0001"> <title>Summary</title> <sec id="apt13326-sec-0001" sec-type="section"> <title>Background</title> <p>Little data are available regarding the effectiveness and associated microbiome changes of faecal microbiota transplantation (FMT) for <italic>Clostridium difficile</italic> infection (CDI) in children, especially in those with inflammatory bowel disease (IBD) with presumed underlying dysbiosis.</p> </sec> <sec id="apt13326-sec-0002" sec-type="section"> <title>Aim</title> <p>To investigate <italic>C. difficile</italic> eradication and microbiome changes with FMT in children with and without IBD.</p> </sec> <sec id="apt13326-sec-0003" sec-type="section"> <title>Methods</title> <p>Children with a history of recurrent CDI (≥3 recurrences) underwent FMT via colonoscopy. Stool samples were collected pre‐FMT and post‐FMT at 2–10 weeks, 10–20 weeks and 6 months. The v4 hypervariable region of the 16S rRNA gene was sequenced. <italic>C. difficile</italic> toxin B gene polymerase chain reaction was performed.</p> </sec> <sec id="apt13326-sec-0004" sec-type="section"> <title>Results</title> <p>Eight children underwent FMT for CDI; five had IBD. All had resolution of CDI symptoms. All tested had eradication of <italic>C. difficile</italic> at 10–20 weeks and 6 months post‐FMT. Pre‐FMT patient samples had significantly decreased bacterial richness compared with donors (<italic>P</italic> = 0.01), in those with IBD (<italic>P</italic> = 0.02) and without IBD (<italic>P</italic> = 0.01). Post‐FMT, bacterial diversity in patients increased. Six months post‐FMT, there was no significant difference between bacterial diversity of donors and patients without IBD; however, bacterial diversity in those with IBD returned to pre‐FMT baseline. Microbiome composition at 6 months in IBD‐negative patients more closely approximated donor composition compared to IBD‐positive patients.</p> </sec> <sec id="apt13326-sec-0005" sec-type="section"> <title>Conclusions</title> <p>FMT gives sustained <italic>C. difficile</italic> eradication in children with and without IBD. FMT‐restored diversity is sustained in children without IBD. In those with IBD, bacterial diversity returns to pre‐FMT baseline by 6 months, suggesting IBD host‐related mechanisms modify faecal microbiome diversity.</p> </sec> </abstract>