Fecal microbiota transplantation reduces resistant bacteria colonization in kidney transplant recipients
Bacterial infections are a greater threat as they are most common causes of morbidity and mortality worldwide. Multi-drug resistant organisms (MDROs) represent an ever-increasing share of causative agents of infection, and their prevalence is now just as high. Multidrug-resistant organism (MDRO) colonization is a fundamental challenge in antimicrobial resistance.
Very few studies report about efficacy of fecal microbiota transplantation (FMT), and reduction in MDRO colonization, where not much is known about its mechanisms. A new trial published in Science Translational Medicine reports that FMT may provide a path to exploit strain competition to reduce MDRO colonization. It is known kidney transplant patients are at high risk for MDRO colonization and infection, as they receive prophylactic antibiotics after transplant, which can select for MDROs. They are thus a priority for decolonization, because many of the antibiotics used to treat MDRO infections are nephrotoxic.
The researchers conducted a randomized, controlled trial of FMT for MDRO decolonization in renal transplant recipients called PREMIX (NCT02922816). A total of 11 participants were enrolled and randomized 1:1 to FMT or an observation period followed by delayed FMT if stool cultures were MDRO positive at day 36. Participants who were MDRO positive after one FMT were treated with a second FMT. At last visit, eight of nine patients who completed all treatments were MDRO culture negative. FMT-treated participants had longer time to recurrent MDRO infection versus PREMIX-eligible controls who were not treated with FMT.
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