Improving Risk–Benefit in Faecal Transplantation through Microbiome Screening. Issue 5 (May 2020)

• Record Type: Journal Article
• Authors: Papanicolas, Lito E.; Gordon, David L.; Wesselingh, Steve L.; Rogers, Geraint B.
• Is Part Of: Trends in microbiology. Volume 28:Issue 5(2020)
• Page Start: 331
• Page End: 339
• Publication Date: 2020-05
• Subjects: faecal microbiota transplantation -- microbiome -- sepsis -- infection; Microbiology -- Periodicals; Infection -- Periodicals; Virulence (Microbiology) -- Periodicals; Infection -- Periodicals; Microbiology -- Periodicals; Virulence -- Periodicals; Microbiologie -- Périodiques; Infection -- Périodiques; Virulence (Microbiologie) -- Périodiques; Infection; Microbiology; Virulence (Microbiology); 579
• DOI: 10.1016/j.tim.2019.12.009
• Languages: English
• ISSNs: 0966-842X

Abstract

Abstract : Faecal microbiota transplantation (FMT) has been shown to be effective in the treatment of a growing number of conditions, and its clinical use continues to rise. However, recent cases of antibiotic-resistant pathogen transmission through FMT, resulting in at least one case of fatal sepsis, highlight the need to reevaluate current donor screening practices. Commensal gut microbes profoundly influence infection risk but are not routinely assessed in donor stool. Extending the assessment of donor material beyond pathogen populations to include the composition and structure of the wider faecal microbiota has the potential to reduce infectious complications in FMT recipients. Highlights: FMT has demonstrated clinical efficacy for a growing number of conditions. High rates of systemic infection in transplant recipients, and recent cases of sepsis caused by antibiotic-resistant pathogens transmitted through FMT, highlight the need to improve FMT safety. Commensal gut microbes can substantially reduce sepsis risk through interactions with both pathogens and the host. In addition to screening for pathogens, assessment of donor material should consider the composition and structure of the wider faecal microbiota. Measures to protect commensal microbes during transplant preparation, and to deplete pathogen populations, could substantially improve the safety of FMT.