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Fecal Microbiota Transplantation for multidrug-resistant organism: Efficacy and Response prediction

Authors
 Hye Seong  ;  Sang Kil Lee  ;  Jae Hee Cheon  ;  Dong Eun Yong  ;  Hong Koh  ;  Yun Koo Kang  ;  Woo Young Jeong  ;  Woon Ji Lee  ;  Yujin Sohn  ;  Yunsuk Cho  ;  Jong Hoon Hyun  ;  Yae Jee Baek  ;  Moo Hyun Kim  ;  Jung Ho Kim  ;  Jin Young Ahn  ;  Nam Su Ku  ;  Su Jin Jeong  ;  Joon Sup Yeom  ;  Min Seok Cho  ;  Je Hee Lee  ;  Byung-Yong Kim  ;  Jun Yong Choi 
Citation
 JOURNAL OF INFECTION, Vol.81(5) : 719-725, 2020-11 
Journal Title
 JOURNAL OF INFECTION 
ISSN
 0163-4453 
Issue Date
2020-11
Keywords
carbapenemase-producing enterobacteriaceae ; disease eradication ; fecal microbiota transplantation ; gut microbiome ; vancomycin-resistant enterococci
Abstract
Objectives: The increasing prevalence of multidrug-resistant microorganisms (MDRO) is increasing the frequency of poor clinical outcomes, prolonging hospitalizations, and raising healthcare costs. This study evaluated the eradication efficacy of fecal microbiota transplantation (FMT) and identified microbial and functional biomarkers of MDRO decolonization. Methods: Fecal solution obtained from healthy unrelated donors was infused in the participants' guts which had been colonized with carbapenemase-producing enterobacteriacea (CPE), vancomycin-resistant enterococci (VRE), or both CPE and VRE. Fecal samples from recipients were collected and microbiome changes before and after FMT were assessed. Results: Twenty-four (68.6%) out of 35 patients were decolonized within one year of receiving FMT. Multivariate analysis showed that FMT (FMT: hazard ratio (HR) = 5.343, 95% confidence interval (CI) = 1.877-15.212, p = 0.002) and MDRO types (CPE: HR = 11.146, 95% CI = 2.420-51.340, p = 0.002; CPE/VRE: HR = 2.948, 95% CI = 1.200-7.246, p = 0.018; VRE served as the reference) were significant independent factors associated with time to decolonization. Microbiota analysis showed higher richness and biodiversity before FMT resulted in VRE decolonization. The species Clostridium ramosum and the genuses Anaerostipes and Eisenbergiella could serve as taxonomic biomarkers and K02017 could serve as a functional biomarker for VRE clearance. Conclusion: FMT is an effective way to decolonize MDRO and its effectiveness may be predicted by microbiome analysis.
Full Text
https://www.sciencedirect.com/science/article/pii/S0163445320305971
DOI
10.1016/j.jinf.2020.09.003
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Laboratory Medicine (진단검사의학교실) > 1. Journal Papers
Yonsei Authors
Kang, Yunkoo(강윤구) ORCID logo https://orcid.org/0000-0003-1712-2138
Koh, Hong(고홍) ORCID logo https://orcid.org/0000-0002-3660-7483
Ku, Nam Su(구남수) ORCID logo https://orcid.org/0000-0002-9717-4327
Kim, Moo Hyun(김무현)
Kim, Jung Ho(김정호) ORCID logo https://orcid.org/0000-0002-5033-3482
Baek, Yae Jee(백예지)
Seong, Hye(성혜) ORCID logo https://orcid.org/0000-0002-5633-7214
Sohn, Yujin(손유진)
Ahn, Jin Young(안진영) ORCID logo https://orcid.org/0000-0002-3740-2826
Yeom, Joon Sup(염준섭) ORCID logo https://orcid.org/0000-0001-8940-7170
Yong, Dong Eun(용동은) ORCID logo https://orcid.org/0000-0002-1225-8477
Lee, Sang Kil(이상길) ORCID logo https://orcid.org/0000-0002-0721-0364
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Jeong, Wooyong(정우용)
Cho, Yunsuk(조윤숙)
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
Choi, Jun Yong(최준용) ORCID logo https://orcid.org/0000-0002-2775-3315
Hyun, Jong Hoon(현종훈)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180540
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