Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial
Fecal microbiota transplantation (FMT) could decolonize multidrug-resistant organisms. We investigated FMT effectiveness and safety in the eradication of carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) and vancomycin-resistant enterococci (VRE) intestinal colonization. A prospective...
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MDPI AG
2022-09-01
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| Online Access: | https://www.mdpi.com/2227-9059/10/10/2404 |
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| author | Jongbeom Shin Jung-Hwan Lee Soo-Hyun Park Boram Cha Kye Sook Kwon Hyungkil Kim Yong Woon Shin |
| author_facet | Jongbeom Shin Jung-Hwan Lee Soo-Hyun Park Boram Cha Kye Sook Kwon Hyungkil Kim Yong Woon Shin |
| author_sort | Jongbeom Shin |
| collection | DOAJ |
| description | Fecal microbiota transplantation (FMT) could decolonize multidrug-resistant organisms. We investigated FMT effectiveness and safety in the eradication of carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) and vancomycin-resistant enterococci (VRE) intestinal colonization. A prospective non-randomized comparative study was performed with 48 patients. FMT material (60 g) was obtained from a healthy donor, frozen, and administered via endoscopy. The primary endpoint was 1-month decolonization, and secondary endpoints were 3-month decolonization and adverse events. Microbiota analysis of fecal samples was performed using 16S rRNA sequencing. Intention-to-treat analysis revealed overall negative conversion between the FMT and control groups at 1 (26% vs. 10%, <i>p</i> = 0.264) and 3 (52% vs. 24%, <i>p</i> = 0.049) months. The 1-month and 3-month CRE clearance did not differ significantly by group (36% vs. 10%, <i>p</i> = 0.341; and 71% vs. 30%, <i>p</i> = 0.095, respectively). Among patients with VRE, FMT was ineffective for 1-month or 3-month negative conversion (13% vs. 9%, <i>p</i> > 0.999; and 36% vs. 18%, <i>p</i> = 0.658, respectively) However, cumulative overall negative-conversion rate was significantly higher in the FMT group (<i>p</i> = 0.037). <i>Enterococcus</i> abundance in patients with VRE significantly decreased following FMT. FMT may be effective at decolonizing multidrug-resistant organisms in the intestinal tract. |
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| last_indexed | 2024-03-09T20:39:00Z |
| publishDate | 2022-09-01 |
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| series | Biomedicines |
| spelling | doaj.art-7ff8a7a96b064dd08be49358b66d26b62023-11-23T23:02:33ZengMDPI AGBiomedicines2227-90592022-09-011010240410.3390/biomedicines10102404Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative TrialJongbeom Shin0Jung-Hwan Lee1Soo-Hyun Park2Boram Cha3Kye Sook Kwon4Hyungkil Kim5Yong Woon Shin6Division of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDepartment of Hospital Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaDivision of Gastroenterology, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 22332, KoreaFecal microbiota transplantation (FMT) could decolonize multidrug-resistant organisms. We investigated FMT effectiveness and safety in the eradication of carbapenem-resistant <i>Enterobacteriaceae</i> (CRE) and vancomycin-resistant enterococci (VRE) intestinal colonization. A prospective non-randomized comparative study was performed with 48 patients. FMT material (60 g) was obtained from a healthy donor, frozen, and administered via endoscopy. The primary endpoint was 1-month decolonization, and secondary endpoints were 3-month decolonization and adverse events. Microbiota analysis of fecal samples was performed using 16S rRNA sequencing. Intention-to-treat analysis revealed overall negative conversion between the FMT and control groups at 1 (26% vs. 10%, <i>p</i> = 0.264) and 3 (52% vs. 24%, <i>p</i> = 0.049) months. The 1-month and 3-month CRE clearance did not differ significantly by group (36% vs. 10%, <i>p</i> = 0.341; and 71% vs. 30%, <i>p</i> = 0.095, respectively). Among patients with VRE, FMT was ineffective for 1-month or 3-month negative conversion (13% vs. 9%, <i>p</i> > 0.999; and 36% vs. 18%, <i>p</i> = 0.658, respectively) However, cumulative overall negative-conversion rate was significantly higher in the FMT group (<i>p</i> = 0.037). <i>Enterococcus</i> abundance in patients with VRE significantly decreased following FMT. FMT may be effective at decolonizing multidrug-resistant organisms in the intestinal tract.https://www.mdpi.com/2227-9059/10/10/2404multidrug resistancefecal microbiota transplantationdysbiosiscarbapenem-resistant <i>Enterobacteriaceae</i>vancomycin-resistant enterococci |
| spellingShingle | Jongbeom Shin Jung-Hwan Lee Soo-Hyun Park Boram Cha Kye Sook Kwon Hyungkil Kim Yong Woon Shin Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial Biomedicines multidrug resistance fecal microbiota transplantation dysbiosis carbapenem-resistant <i>Enterobacteriaceae</i> vancomycin-resistant enterococci |
| title | Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial |
| title_full | Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial |
| title_fullStr | Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial |
| title_full_unstemmed | Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial |
| title_short | Efficacy and Safety of Fecal Microbiota Transplantation for Clearance of Multidrug-Resistant Organisms under Multiple Comorbidities: A Prospective Comparative Trial |
| title_sort | efficacy and safety of fecal microbiota transplantation for clearance of multidrug resistant organisms under multiple comorbidities a prospective comparative trial |
| topic | multidrug resistance fecal microbiota transplantation dysbiosis carbapenem-resistant <i>Enterobacteriaceae</i> vancomycin-resistant enterococci |
| url | https://www.mdpi.com/2227-9059/10/10/2404 |
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