“Bacterial Consortium”: A Potential Evolution of Fecal Microbiota Transplantation for the Treatment of Clostridioides difficile Infection

Abstract

Fecal microbiota transplantation (FMT) consists of infusion of feces from a donor to a recipient patient in order to restore the resident microbial population. FMT has shown to be a valid clinical option for Clostridioides difficile infections (CDI). However, this approach shows several criticalities, such as the recruiting and screening of voluntary donors. Our aim was to evaluate the therapeutic efficacy of a synthetic bacterial suspension defined “Bacterial Consortium” (BC) infused in the colon of CDI patients. The suspension was composed by 13 microbial species isolated by culturomics protocols from healthy donors’ feces. The efficacy of the treatment was assessed both clinically and by metagenomics typing. Fecal samples of the recipient patients were collected before and after infusion. DNA samples obtained from feces at different time points (preinfusion, 7, 15, 30, and 90 days after infusion) were analyzed by next-generation sequencing. Before infusion, patient 1 showed an intestinal microbiota dominated by the phylum Bacteroidetes. Seven days after the infusion, Bacteroidetes decreased, followed by an implementation of Firmicutes and Verrucomicrobia. Patient 2, before infusion, showed a strong abundance of Proteobacteria and a significant deficiency of Bacteroidetes and Verrucomicrobia. Seven days after infusion, Proteobacteria strongly decreased, while Bacteroidetes and Verrucomicrobia increased. Metagenomics data revealed an “awakening” by microbial species absent or low concentrated at time T0 and present after the infusion. In conclusion, the infusion of selected bacteria would act as a trigger factor for “bacterial repopulation” representing an innovative treatment in patients with Clostridioides difficile infections.

Modulation of the Gut Microbiota to Control Antimicrobial Resistance (AMR)—A Narrative Review with a Focus on Faecal Microbiota Transplantation (FMT)

“…This risk must be balanced against any evidence of superiority. Synthetically produced products containing a range of bacterial strains are in development and will support greater uniformity between batches [ 63 ].…”

The Impact of Microbiota–Immunity–Hormone Interactions on Autoimmune Diseases and Infection

“…Some probiotic strains, including those of Lactobacilli , Bifidobacteria , Propionibacterium , E. coli , Saccharomyces , and Bacillus , can positively regulate TLR activation through the decrease in MAPK activation and NF-κB pathways, thus limiting the production of pro-inflammatory cytokines [ 243 ]. Moreover, several small molecules have demonstrated efficacy in inhibiting the bacterial β-glucuronidase enzyme, a pivotal player in metabolizing glucuronide drug conjugates produced by host metabolism [ 244 , 245 ].…”

“…A synthetic bacterial preparation of microorganisms called "Bacterial Consortium" is under development with the aim to provide the administration of specific beneficial bacterial strains to support the growth of a new community, with the goal of achieving beneficial outcomes [241,242]. Some probiotic strains, including those of Lactobacilli, Bifidobacteria, Propionibacterium, E. coli, Saccharomyces, and Bacillus, can positively regulate TLR activation through the decrease in MAPK activation and NF-κB pathways, thus limiting the production of pro-inflammatory cytokines [243]. Moreover, several small molecules have demonstrated efficacy in inhibiting the bacterial β-glucuronidase enzyme, a pivotal player in metabolizing glucuronide drug conjugates produced by host metabolism [244,245].…”

Microbiota Transplant and Gynecological Disorders: The Bridge between Present and Future Treatments

“…Furthermore, it is essential to know in detail the bacterial composition of the suspension to be infused into the recipient, in order to increase FMT efficacy and especially safety. For these reasons, the therapeutic efficacy of a synthetic bacterial preparation called "Bacterial Consortium" is now under development [123,124]. This approach involves the isolation from healthy donors' stool samples of several bacterial species normally present in the human intestinal microbiota, and thus the use of this "Bacterial Consortium", composed by 13 microbial species, as a safe and valid alternative to donor stools [123].In conclusion, understanding the mechanisms by which the human microbiota can influence the progression of diseases, including gynecological disorders, can lead to the development of personalized approaches to shape the microbiota composition (and so its function), improving the symptoms and patients' prognosis.…”