[HTML][HTML] Transmission and clearance of potential procarcinogenic bacteria during fecal microbiota transplantation for recurrent Clostridioides difficile
JL Drewes, A Corona, U Sanchez, Y Fan… - JCI insight, 2019 - ncbi.nlm.nih.gov
JCI insight, 2019•ncbi.nlm.nih.gov
BACKGROUND Fecal microbiota transplantation (FMT) is an effective treatment for recurrent
Clostridioides difficile infection (rCDI) in adults and children, but donor stool samples are
currently screened for only a limited number of potential pathogens. We sought to determine
whether putative procarcinogenic bacteria (enterotoxigenic Bacteroides fragilis,
Fusobacterium nucleatum, and Escherichia coli harboring the colibactin toxin) could be
durably transmitted from donors to patients during FMT. METHODS Stool samples were …
Clostridioides difficile infection (rCDI) in adults and children, but donor stool samples are
currently screened for only a limited number of potential pathogens. We sought to determine
whether putative procarcinogenic bacteria (enterotoxigenic Bacteroides fragilis,
Fusobacterium nucleatum, and Escherichia coli harboring the colibactin toxin) could be
durably transmitted from donors to patients during FMT. METHODS Stool samples were …
Abstract
BACKGROUND
Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridioides difficile infection (rCDI) in adults and children, but donor stool samples are currently screened for only a limited number of potential pathogens. We sought to determine whether putative procarcinogenic bacteria (enterotoxigenic Bacteroides fragilis, Fusobacterium nucleatum, and Escherichia coli harboring the colibactin toxin) could be durably transmitted from donors to patients during FMT.
METHODS
Stool samples were collected from 11 pediatric rCDI patients and their respective FMT donors prior to FMT as well as from the patients at 2–10 weeks, 10–20 weeks, and 6 months after FMT. Bacterial virulence factors in stool DNA extracts and stool cultures were measured by quantitative PCR: Bacteroides fragilis toxin (bft), Fusobacterium adhesin A (fadA), and Escherichia coli colibactin (clbB).
RESULTS
Four of 11 patients demonstrated sustained acquisition of a procarcinogenic bacteria. Whole genome sequencing was performed on colony isolates from one of these donor/recipient pairs and demonstrated that clbB+ E. coli strains present in the recipient after FMT were identical to a strain present in the donor, confirming strain transmission. Conversely, 2 patients exhibited clearance of procarcinogenic bacteria following FMT from a negative donor.
CONCLUSION
Both durable transmission and clearance of procarcinogenic bacteria occurred following FMT, suggesting that additional studies on appropriate screening measures for FMT donors and the long-term consequences and/or benefits of FMT are warranted.
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