Fecal Microbial Transplants Reduce Antibiotic-resistant Genes in Patients With RecurrentClostridium difficileInfection
Top Cited Papers
Open Access
- 29 March 2016
- journal article
- clinical trial
- Published by Oxford University Press (OUP) in Clinical Infectious Diseases
- Vol. 62 (12), 1479-1486
- https://doi.org/10.1093/cid/ciw185
Abstract
Background. Recurrent Clostridium difficile infection (RCDI) is associated with repeated antibiotic treatment and the enhanced growth of antibiotic-resistant microbes. This study tested the hypothesis that patients with RCDI would harbor large numbers of antibiotic-resistant microbes and that fecal microbiota transplantation (FMT) would reduce the number of antibiotic-resistant genes. Methods. In a single center study, patients with RCDI (n = 20) received FMT from universal donors via colonoscopy. Stool samples were collected from donors (n = 3) and patients prior to and following FMT. DNA was extracted and shotgun metagenomics performed. Results as well as assembled libraries from a healthy cohort (n = 87) obtained from the Human Microbiome Project were aligned against the NCBI bacterial taxonomy database and the Comprehensive Antibiotic Resistance Database. Results were corroborated through a DNA microarray containing 354 antibiotic resistance (ABR) genes. Results. RCDI patients had a greater number and diversity of ABR genes compared with donors and healthy controls. Beta-lactam, multidrug efflux pumps, fluoroquinolone, and antibiotic inactivation ABR genes were increased in RCDI patients, although donors primarily had tetracycline resistance. RCDI patients were dominated by Proteobacteria with Escherichia coli and Klebsiella most prevalent. FMT resulted in a resolution of symptoms that correlated directly with a decreased number and diversity of ABR genes and increased Bacteroidetes and Firmicutes with reduced Proteobacteria. ABR gene profiles were maintained in recipients for up to a year following FMT. Conclusions. RCDI patients have increased numbers of antibiotic-resistant organisms. FMT is effective in the eradication of pathogenic antibiotic-resistant organisms and elimination of ABR genes.Keywords
Funding Information
- Alberta Health Services
- Canadian Institutes of Health Research (93675)
This publication has 32 references indexed in Scilit:
- How much metagenomic sequencing is enough to achieve a given goal?Scientific Reports, 2013
- Fast gapped-read alignment with Bowtie 2Nature Methods, 2012
- Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humansJCI Insight, 2010
- Call of the wild: antibiotic resistance genes in natural environmentsNature Reviews Microbiology, 2010
- Decontamination of the Digestive Tract and Oropharynx in ICU PatientsThe New England Journal of Medicine, 2009
- ARDB--Antibiotic Resistance Genes DatabaseNucleic Acids Research, 2008
- Distribution and Physiology of ABC-Type Transporters Contributing to Multidrug Resistance in BacteriaMicrobiology and Molecular Biology Reviews, 2007
- Co-selection of antibiotic and metal resistanceTrends in Microbiology, 2006
- Linkage of a novel mercury resistance operon with streptomycin resistance on a conjugative plasmid in Enterococcus faeciumPlasmid, 2005
- Acquisition of Clostridium difficile by Hospitalized Patients: Evidence for Colonized New Admissions as a Source of InfectionThe Journal of Infectious Diseases, 1992