Le Puo-Hsien, Yeh Yuan-Ming, Chen Yi-Ching, Chen Chyi-Liang, Tsou Yung-Kuan, Chen Chien-Chang, Chiu Cheng-Tang, Chiu Cheng-Hsun
Chang Gung Microbiota Therapy Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Chang Gung Inflammatory Bowel Disease Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Taiwan Association for the Study of Intestinal Diseases (TASID), Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Chang Gung Microbiota Therapy Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Health Industry Technology, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
J Microbiol Immunol Infect. 2025 Oct;58(5):585-592. doi: 10.1016/j.jmii.2025.03.004. Epub 2025 Mar 4.
Clostridium innocuum is a vancomycin-resistant pathobiome associated with poor clinical outcomes in inflammatory bowel disease (IBD). In ulcerative colitis (UC), it correlates with reduced remission rates, while in Crohn's disease (CD), it is linked to creeping fat formation and intestinal strictures. Notably, some patients experience refractory or recurrent C. innocuemailum infections despite metronidazole treatment. This study evaluates the safety and efficacy of single-dose fecal microbiota transplantation (FMT) in IBD patients with refractory or recurrent C. innocuum infections.
We conducted a feasibility pilot study involving seven IBD patients (3 CD, 4 UC) with refractory (n = 5) or recurrent (n = 2) C. innocuum infections following metronidazole treatment. Patients underwent single-dose FMT and were monitored for six months.
No adverse events were recorded. All participants demonstrated improved disease activity post-FMT, as assessed by the Crohn's Disease Activity Index and Mayo Score. However, a mild increase in symptom severity was noted at six months. Follow-up cultures showed persistent C. innocuum infection in one patient and asymptomatic recurrence in another at three months. Alpha diversity of the gut microbiome increased post-FMT, and Bray-Curtis dissimilarity analysis revealed a microbiota composition more similar to that of the donor.
Single-dose FMT appears to be a safe and feasible therapeutic approach for refractory or recurrent C. innocuum infections in IBD patients, with potential benefits in disease activity and microbiome restoration. Further studies are warranted to optimize long-term outcomes.
无害梭菌是一种耐万古霉素的病理微生物群，与炎症性肠病（IBD）的不良临床结局相关。在溃疡性结肠炎（UC）中，它与缓解率降低相关，而在克罗恩病（CD）中，它与匐行脂肪形成和肠道狭窄有关。值得注意的是，尽管接受了甲硝唑治疗，一些患者仍会出现难治性或复发性无害梭菌感染。本研究评估单剂量粪便微生物群移植（FMT）对难治性或复发性无害梭菌感染的IBD患者的安全性和有效性。
我们进行了一项可行性初步研究，纳入了7例IBD患者（3例CD，4例UC），这些患者在接受甲硝唑治疗后出现难治性（n = 5）或复发性（n = 2）无害梭菌感染。患者接受单剂量FMT，并进行为期6个月的监测。
未记录到不良事件。通过克罗恩病活动指数和梅奥评分评估，所有参与者在FMT后疾病活动均有所改善。然而，在6个月时症状严重程度略有增加。随访培养显示，1例患者在3个月时仍存在持续性无害梭菌感染，另1例患者出现无症状复发。FMT后肠道微生物群的α多样性增加，Bray-Curtis差异分析显示微生物群组成与供体更相似。
单剂量FMT似乎是IBD患者难治性或复发性无害梭菌感染的一种安全可行的治疗方法，对疾病活动和微生物群恢复可能有益。有必要进一步研究以优化长期结局。
