Consensus report: faecal microbiota transfer – clinical applications and procedures

König, Julia; Siebenhaar, Arno; Högenauer, Christoph; Arkkila, Perttu; Nieuwdorp, Max; Norén, Torbjörn; Ponsioen, Cyriel Y.; Rosien, Ulrich; Rossen, Noortje; Satokari, Reetta; Stallmach, Andreas; Vos, Willem M. de; Keller, Josbert J.; Brummer, Robert Jan

doi:10.1111/apt.13868

Cited by 97 publications

(107 citation statements)

References 124 publications

(291 reference statements)

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“…A total of 30 patients (85.7%) had resolution of their symptoms 6–8 weeks post‐transplant, while 5 patients (14.3%) continued to have symptoms. This is a rate of success similar to those seen in previous studies . Of note, there was no correlation found between the five patients who failed the FMT.…”

Section: Discussionsupporting

confidence: 88%

Fecal microbiota transplantation in recurrent Clostridium difficile infection: A retrospective single‐center chart review

et al. 2018

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Background and Aim Fecal microbiota transplantation (FMT) has been proposed as a treatment option for patients with recurrent Clostridium difficile ( C. difficile ) infection but remains a novel option. We examined if FMT is an effective means of treating recurrent C. difficile infection. Methods A retrospective review of 35 patients who underwent FMT was completed. Demographics and other variables, including the use of proton pump inhibitor therapy and history of inflammatory bowel disease, were collected. Results Twenty‐five patients (71.4%) belonged to a high‐risk population (working in a hospital setting, rehabilitation center, or nursing facility) and a total of 74.3% of patients ( n = 26 patients) had no history of proton pump inhibitor use. Twenty‐five patients (71.4%) had used metronidazole prior to transplantation, 35 patients (100%) had used vancomycin, and 7 patients (20%) had used fidaxomicin for prior infection. Four patients (11.4%) had used all three antibiotics during prior treatment. Of the eight patients who had a history of inflammatory bowel disease, six (75%) experienced resolution of symptoms after transplantation. A total of 30 patients (85.7%) had resolution of their symptoms 6–8 weeks’ posttransplant, while 5 patients (14.3%) continued to have symptoms. Conclusions Our retrospective chart review supports that patients benefit from FMT in the setting of recurrent C. difficile infection.

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Section: Discussionsupporting

confidence: 88%

Fecal microbiota transplantation in recurrent Clostridium difficile infection: A retrospective single‐center chart review

et al. 2018

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“…8 First, a screening program that minimizes the risk of transferring infectious and non-infectious diseases must be implemented. Detailed screening protocols have been published, 7 , 9-11 but the work required for their implementation is extensive; moreover, despite a scientific consensus for this vigorous screening, 12 , 13 the evidence supporting the screening protocols remains low. Second, as FMT gains momentum, an inherent need for recruiting enough potential feces donors evolves.…”

Section: Introductionmentioning

confidence: 99%

Recruitment of feces donors among blood donors: Results from an observational cohort study

et al. 2018

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As the use of fecal microbiota transplantation (FMT) has gained momentum, an increasing need for continuous access to healthy feces donors has developed. Blood donors constitute a healthy subset of the general population and may serve as an appropriate group for recruitment. In this study, we investigated the suitability of blood donors as feces donors. In a prospective cohort study, we recruited blood donors onsite at a public Danish blood bank. Following their consent, the blood donors underwent a stepwise screening process: First, blood donors completed an electronic pre-screening questionnaire to rule out predisposing risk factors. Second, eligible blood donors had blood and fecal samples examined. Of 155 blood donors asked to participate, 137 (88%) completed the electronic pre-screening questionnaire, 16 declined, and 2 were excluded. Of the 137 donors who completed the questionnaire, 79 (58%) were excluded mainly due to having an allergy, being overweight, or presenting gastrointestinal complaints. Among the remaining 58 (37%) donors, complete blood and feces screenings were obtained from 46 (79%). Of these 46 donors, 15 (33%) were excluded primarily due to abnormal blood results or the presence of apathogenic intestinal parasites. Overall, 31 (20%; 95% confidence interval 14–27%) of the 155 blood donors qualified as feces donors. In conclusion, blood donors constitute a suitable and motivated population for a continuous recruitment of voluntary feces donors. We found that a stepwise recruitment procedure was feasible and that 20% of the blood donors were eligible for feces donation.

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“…A careful donor screening regarding faecal microbiota composition, pathogen status and undesirable antigens and ‘phenotypes’ must be performed preventively (Petrof and Khoruts, 2014; Alang and Kelly, 2015). Despite the increasing demand for FMT, rigorous exclusion criteria for donors strongly limit the widespread availability of suitable faecal material (Konig et al ., 2017). The approach of transplanting ‘artificially’ produced microbiota, which has been extensively characterized, might alleviate these limitations.…”

Section: Introductionmentioning

confidence: 99%

Cryopreservation of artificial gut microbiota produced with in vitro fermentation technology

Bircher

Schwab

Geirnaert

et al. 2017

Microbial Biotechnology

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SummaryInterest in faecal microbiota transplantation (FMT) has increased as therapy for intestinal diseases, but safety issues limit its widespread use. Intestinal fermentation technology (IFT) can produce controlled, diverse and metabolically active ‘artificial’ colonic microbiota as potential alternative to common FMT. However, suitable processing technology to store this artificial microbiota is lacking. In this study, we evaluated the impact of the two cryoprotectives, glycerol (15% v/v) and inulin (5% w/v) alone and in combination, in preserving short‐chain fatty acid formation and recovery of major butyrate‐producing bacteria in three artificial microbiota during cryopreservation for 3 months at −80°C. After 24 h anaerobic fermentation of the preserved microbiota, butyrate and propionate production were maintained when glycerol was used as cryoprotectant, while acetate and butyrate were formed more rapidly with glycerol in combination with inulin. Glycerol supported cryopreservation of the Roseburia spp./Eubacterium rectale group, while inulin improved the recovery of Faecalibacterium prausnitzii. Eubacterium hallii growth was affected minimally by cryopreservation. Our data indicate that butyrate producers, which are key organisms for gut health, can be well preserved with glycerol and inulin during frozen storage. This is of high importance if artificially produced colonic microbiota is considered for therapeutic purposes.

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Consensus report: faecal microbiota transfer – clinical applications and procedures

Cited by 97 publications

References 124 publications

Fecal microbiota transplantation in recurrent Clostridium difficile infection: A retrospective single‐center chart review

Fecal microbiota transplantation in recurrent Clostridium difficile infection: A retrospective single‐center chart review

Recruitment of feces donors among blood donors: Results from an observational cohort study

Cryopreservation of artificial gut microbiota produced with in vitro fermentation technology

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