Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection

In fecal microbiota transplantation (FMT) against recurrent Clostridioides difficile infection (CDI), clinical outcomes are usually determined after 8 weeks. We hypothesized that the intestinal microbiota changes earlier than this timepoint, and analyzed fecal samples obtained 1 week after treatment...

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Main Authors: Shaodong Wei, Martin Iain Bahl, Simon Mark Dahl Baunwall, Jens Frederik Dahlerup, Christian Lodberg Hvas, Tine Rask Licht
Format: Article
Language:English
Published: Taylor & Francis Group 2022-12-01
Series:Gut Microbes
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Online Access:https://www.tandfonline.com/doi/10.1080/19490976.2022.2084306
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author Shaodong Wei
Martin Iain Bahl
Simon Mark Dahl Baunwall
Jens Frederik Dahlerup
Christian Lodberg Hvas
Tine Rask Licht
author_facet Shaodong Wei
Martin Iain Bahl
Simon Mark Dahl Baunwall
Jens Frederik Dahlerup
Christian Lodberg Hvas
Tine Rask Licht
author_sort Shaodong Wei
collection DOAJ
description In fecal microbiota transplantation (FMT) against recurrent Clostridioides difficile infection (CDI), clinical outcomes are usually determined after 8 weeks. We hypothesized that the intestinal microbiota changes earlier than this timepoint, and analyzed fecal samples obtained 1 week after treatment from 64 patients diagnosed with recurrent CDI and included in a randomized clinical trial, where the infection was treated with either vancomycin-preceded FMT (N = 24), vancomycin (N = 16) or fidaxomicin (N = 24). In comparison with non-responders, patients with sustained resolution after FMT had increased microbial alpha diversity, enrichment of Ruminococcaceae and Lachnospiraceae, depletion of Enterobacteriaceae, more pronounced donor microbiota engraftment, and resolution of gut microbiota dysbiosis. We found that a constructed index, based on markers for the identified genera Escherichia and Blautia, successfully predicted clinical outcomes at Week 8, which exemplifies a way to utilize clinically feasible methods to predict treatment failure. Microbiota changes were restricted to patients who received FMT rather than antibiotic monotherapy, indicating that FMT confers treatment response in a different way than antibiotics. We suggest that early identification of microbial community structures after FMT is of clinical value to predict response to the treatment.
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spelling doaj-art-40395e48d60f42fd9993ae8dd1fd962f2025-08-20T02:38:10ZengTaylor & Francis GroupGut Microbes1949-09761949-09842022-12-0114110.1080/19490976.2022.2084306Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infectionShaodong Wei0Martin Iain Bahl1Simon Mark Dahl Baunwall2Jens Frederik Dahlerup3Christian Lodberg Hvas4Tine Rask Licht5National Food Institute, Technical University of Denmark, Kgs Lyngby, DenmarkNational Food Institute, Technical University of Denmark, Kgs Lyngby, DenmarkDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, DenmarkDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, DenmarkDepartment of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus N, DenmarkNational Food Institute, Technical University of Denmark, Kgs Lyngby, DenmarkIn fecal microbiota transplantation (FMT) against recurrent Clostridioides difficile infection (CDI), clinical outcomes are usually determined after 8 weeks. We hypothesized that the intestinal microbiota changes earlier than this timepoint, and analyzed fecal samples obtained 1 week after treatment from 64 patients diagnosed with recurrent CDI and included in a randomized clinical trial, where the infection was treated with either vancomycin-preceded FMT (N = 24), vancomycin (N = 16) or fidaxomicin (N = 24). In comparison with non-responders, patients with sustained resolution after FMT had increased microbial alpha diversity, enrichment of Ruminococcaceae and Lachnospiraceae, depletion of Enterobacteriaceae, more pronounced donor microbiota engraftment, and resolution of gut microbiota dysbiosis. We found that a constructed index, based on markers for the identified genera Escherichia and Blautia, successfully predicted clinical outcomes at Week 8, which exemplifies a way to utilize clinically feasible methods to predict treatment failure. Microbiota changes were restricted to patients who received FMT rather than antibiotic monotherapy, indicating that FMT confers treatment response in a different way than antibiotics. We suggest that early identification of microbial community structures after FMT is of clinical value to predict response to the treatment.https://www.tandfonline.com/doi/10.1080/19490976.2022.2084306Clostridioides difficilefecal microbiota transplantationfidaxomicingut microbiotavancomycin
spellingShingle Shaodong Wei
Martin Iain Bahl
Simon Mark Dahl Baunwall
Jens Frederik Dahlerup
Christian Lodberg Hvas
Tine Rask Licht
Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
Gut Microbes
Clostridioides difficile
fecal microbiota transplantation
fidaxomicin
gut microbiota
vancomycin
title Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
title_full Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
title_fullStr Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
title_full_unstemmed Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
title_short Gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent Clostridioides difficile infection
title_sort gut microbiota differs between treatment outcomes early after fecal microbiota transplantation against recurrent clostridioides difficile infection
topic Clostridioides difficile
fecal microbiota transplantation
fidaxomicin
gut microbiota
vancomycin
url https://www.tandfonline.com/doi/10.1080/19490976.2022.2084306
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