Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D

Fecal microbiota transplantation (FMT) is an attractive strategy to correct microbial dysbiosis in diarrhea-predominant irritable bowel syndrome (IBS-D). Although the mechanism of FMT is thought to be bacterial engraftment, the best approach to achieve engraftment after FMT in IBS-D (and other disea...

Full description

Bibliographic Details
Main Authors: Singh, Prashant, Alm, Eric J, Kelley, John M, Cheng, Vivian, Smith, Mark, Kassam, Zain, Nee, Judy, Iturrino, Johanna, Lembo, Anthony
Other Authors: Massachusetts Institute of Technology. Department of Biological Engineering
Format: Article
Language:English
Published: Informa UK Limited 2023
Online Access:https://hdl.handle.net/1721.1/147723
_version_ 1826216898650439680
author Singh, Prashant
Alm, Eric J
Kelley, John M
Cheng, Vivian
Smith, Mark
Kassam, Zain
Nee, Judy
Iturrino, Johanna
Lembo, Anthony
author2 Massachusetts Institute of Technology. Department of Biological Engineering
author_facet Massachusetts Institute of Technology. Department of Biological Engineering
Singh, Prashant
Alm, Eric J
Kelley, John M
Cheng, Vivian
Smith, Mark
Kassam, Zain
Nee, Judy
Iturrino, Johanna
Lembo, Anthony
author_sort Singh, Prashant
collection MIT
description Fecal microbiota transplantation (FMT) is an attractive strategy to correct microbial dysbiosis in diarrhea-predominant irritable bowel syndrome (IBS-D). Although the mechanism of FMT is thought to be bacterial engraftment, the best approach to achieve engraftment after FMT in IBS-D (and other diseases) is not clear. We evaluated the effect of FMT (with or without pretreatment with antibiotics) on gut microbiome and symptoms in patients with IBS-D. In this randomized, placebo-controlled, single-center study, 44 patients with IBS-D with a least moderate severity (IBS severity scoring system, i.e., IBS-SSS, ≥175) were randomly assigned to one of four groups: single-dose oral FMT alone, single-dose oral FMT following a 7-day pretreatment course of Ciprofloxacin and Metronidazole (CM-FMT) or Rifaximin (R-FMT), or Placebo FMT. Primary endpoint was engraftment post-FMT and secondary endpoints were changes in IBS-SSS, and IBS-quality of life (IBS-QOL) at week 10. Median engraftment was significantly different among the three FMT groups (P = .013). Engraftment post-FMT was significantly higher in the FMT alone arm (15.5%) compared to that in R-FMT group (5%, P = .04) and CM-FMT group (2.4%, P = .002). The mean change in IBS-SSS and IBS-QOL from baseline were not significantly different among the four groups or between the three FMT groups combined vs. placebo at week 10. In summary, antibiotic pretreatment significantly reduced bacterial engraftment after FMT in patients with IBS-D.
first_indexed 2024-09-23T16:55:14Z
format Article
id mit-1721.1/147723
institution Massachusetts Institute of Technology
language English
last_indexed 2024-09-23T16:55:14Z
publishDate 2023
publisher Informa UK Limited
record_format dspace
spelling mit-1721.1/1477232023-01-27T03:01:27Z Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D Singh, Prashant Alm, Eric J Kelley, John M Cheng, Vivian Smith, Mark Kassam, Zain Nee, Judy Iturrino, Johanna Lembo, Anthony Massachusetts Institute of Technology. Department of Biological Engineering Fecal microbiota transplantation (FMT) is an attractive strategy to correct microbial dysbiosis in diarrhea-predominant irritable bowel syndrome (IBS-D). Although the mechanism of FMT is thought to be bacterial engraftment, the best approach to achieve engraftment after FMT in IBS-D (and other diseases) is not clear. We evaluated the effect of FMT (with or without pretreatment with antibiotics) on gut microbiome and symptoms in patients with IBS-D. In this randomized, placebo-controlled, single-center study, 44 patients with IBS-D with a least moderate severity (IBS severity scoring system, i.e., IBS-SSS, ≥175) were randomly assigned to one of four groups: single-dose oral FMT alone, single-dose oral FMT following a 7-day pretreatment course of Ciprofloxacin and Metronidazole (CM-FMT) or Rifaximin (R-FMT), or Placebo FMT. Primary endpoint was engraftment post-FMT and secondary endpoints were changes in IBS-SSS, and IBS-quality of life (IBS-QOL) at week 10. Median engraftment was significantly different among the three FMT groups (P = .013). Engraftment post-FMT was significantly higher in the FMT alone arm (15.5%) compared to that in R-FMT group (5%, P = .04) and CM-FMT group (2.4%, P = .002). The mean change in IBS-SSS and IBS-QOL from baseline were not significantly different among the four groups or between the three FMT groups combined vs. placebo at week 10. In summary, antibiotic pretreatment significantly reduced bacterial engraftment after FMT in patients with IBS-D. 2023-01-26T14:34:58Z 2023-01-26T14:34:58Z 2022 2023-01-26T14:23:31Z Article http://purl.org/eprint/type/JournalArticle https://hdl.handle.net/1721.1/147723 Singh, Prashant, Alm, Eric J, Kelley, John M, Cheng, Vivian, Smith, Mark et al. 2022. "Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D." Gut Microbes, 14 (1). en 10.1080/19490976.2021.2020067 Gut Microbes Creative Commons Attribution 4.0 International license https://creativecommons.org/licenses/by/4.0/ application/pdf Informa UK Limited Taylor & Francis
spellingShingle Singh, Prashant
Alm, Eric J
Kelley, John M
Cheng, Vivian
Smith, Mark
Kassam, Zain
Nee, Judy
Iturrino, Johanna
Lembo, Anthony
Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title_full Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title_fullStr Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title_full_unstemmed Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title_short Effect of antibiotic pretreatment on bacterial engraftment after Fecal Microbiota Transplant (FMT) in IBS-D
title_sort effect of antibiotic pretreatment on bacterial engraftment after fecal microbiota transplant fmt in ibs d
url https://hdl.handle.net/1721.1/147723
work_keys_str_mv AT singhprashant effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT almericj effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT kelleyjohnm effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT chengvivian effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT smithmark effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT kassamzain effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT neejudy effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT iturrinojohanna effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd
AT lemboanthony effectofantibioticpretreatmentonbacterialengraftmentafterfecalmicrobiotatransplantfmtinibsd