Department of Soil, Water, and Climate, and Microbial and Plant Genomics Institute, University of Minnesota, St Paul, MN USA ; BioTechnology Institute, 1479 Gortner Ave, 140 Gortner Labs, St. Paul, MN 55108 USA.
BioFrontiers Institute, University of Colorado, Boulder, CO USA.
Microbiome. 2015 Mar 30;3:10. doi: 10.1186/s40168-015-0070-0. eCollection 2015.
Fecal microbiota transplantation (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI) that often fails standard antibiotic therapy. Despite its widespread recent use, however, little is known about the stability of the fecal microbiota following FMT.
Here we report on short- and long-term changes and provide kinetic visualization of fecal microbiota composition in patients with multiply recurrent CDI that were refractory to antibiotic therapy and treated using FMT. Fecal samples were collected from four patients before and up to 151 days after FMT, with daily collections until 28 days and weekly collections until 84 days post-FMT. The composition of fecal bacteria was characterized using high throughput 16S rRNA gene sequence analysis, compared to microbiota across body sites in the Human Microbiome Project (HMP) database, and visualized in a movie-like, kinetic format. FMT resulted in rapid normalization of bacterial fecal sample composition from a markedly dysbiotic state to one representative of normal fecal microbiota. While the microbiome appeared most similar to the donor implant material 1 day post-FMT, the composition diverged variably at later time points. The donor microbiota composition also varied over time. However, both post-FMT and donor samples remained within the larger cloud of fecal microbiota characterized as healthy by the HMP.
Dynamic behavior is an intrinsic property of normal fecal microbiota and should be accounted for in comparing microbial communities among normal individuals and those with disease states. This also suggests that more frequent sample analyses are needed in order to properly assess success of FMT procedures.
粪便微生物群移植（FMT）是一种有效的复发性艰难梭菌感染（CDI）治疗方法，通常能克服标准抗生素治疗的失败。然而，尽管其最近广泛应用，但对于 FMT 后粪便微生物群的稳定性知之甚少。
我们在此报告了多重复发 CDI 患者在抗生素治疗无效后使用 FMT 治疗的短期和长期变化，并提供了粪便微生物群组成的动力学可视化。在 FMT 之前和之后最多 151 天收集了来自 4 名患者的粪便样本，在 28 天内每天采集，在 84 天内每周采集。使用高通量 16S rRNA 基因序列分析来描述粪便细菌的组成，将其与人类微生物组计划（HMP）数据库中跨身体部位的微生物组进行比较，并以类似电影的动态格式进行可视化。FMT 迅速使细菌粪便样本组成从明显的失调状态正常化到正常粪便微生物群的代表。虽然微生物组在 FMT 后 1 天与供体植入物最相似，但在以后的时间点上组成有不同程度的差异。供体微生物组组成也随时间而变化。然而，无论是 FMT 后还是供体样本，都仍然在 HMP 所定义的健康粪便微生物群的更大范围内。
动态行为是正常粪便微生物群的固有特性，在比较正常个体和疾病状态下的微生物群落时应予以考虑。这也表明，为了正确评估 FMT 程序的成功，需要更频繁地进行样本分析。
