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Sci Transl Med. 2018 Sep 26;10(460). pii: eaap9489. doi: 10.1126/scitranslmed.aap9489.

Reconstitution of the gut microbiota of antibiotic-treated patients by autologous fecal microbiota transplant.

Author information

1
Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
2
Department of Zoology, University of Oxford, Oxford, UK.
3
Division of Infectious Diseases and Division of Gastroenterology, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
4
Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
5
American Museum of Natural History, New York, NY 10024, USA.
6
Weill Cornell Medical College, New York, NY 10065, USA.
7
Rockefeller University, New York, NY 10065, USA.
8
University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
9
Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA. pamere@mskcc.org xavierj@mskcc.org.

Abstract

Antibiotic treatment can deplete the commensal bacteria of a patient's gut microbiota and, paradoxically, increase their risk of subsequent infections. In allogeneic hematopoietic stem cell transplantation (allo-HSCT), antibiotic administration is essential for optimal clinical outcomes but significantly disrupts intestinal microbiota diversity, leading to loss of many beneficial microbes. Although gut microbiota diversity loss during allo-HSCT is associated with increased mortality, approaches to reestablish depleted commensal bacteria have yet to be developed. We have initiated a randomized, controlled clinical trial of autologous fecal microbiota transplantation (auto-FMT) versus no intervention and have analyzed the intestinal microbiota profiles of 25 allo-HSCT patients (14 who received auto-FMT treatment and 11 control patients who did not). Changes in gut microbiota diversity and composition revealed that the auto-FMT intervention boosted microbial diversity and reestablished the intestinal microbiota composition that the patient had before antibiotic treatment and allo-HSCT. These results demonstrate the potential for fecal sample banking and posttreatment remediation of a patient's gut microbiota after microbiota-depleting antibiotic treatment during allo-HSCT.

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