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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.

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Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Department of Zoology, University of Oxford, Oxford, UK.
Division of Infectious Diseases and Division of Gastroenterology, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Washington University in St. Louis School of Medicine, St. Louis, MO 63110, USA.
American Museum of Natural History, New York, NY 10024, USA.
Weill Cornell Medical College, New York, NY 10065, USA.
Rockefeller University, New York, NY 10065, USA.
University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.


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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