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Journal of Crohn's and Colitis: 9 (5)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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Microbial composition analysis of Clostridium difficile infections in an ulcerative colitis patient treated with multiple fecal microbiota transplantations

Chantalle Brace , Gregory B. Gloor , Mark Ropeleski , Emma Allen-Vercoe , Elaine O. Petrof
DOI: http://dx.doi.org/10.1016/j.crohns.2014.01.020 1133-1137 First published online: 1 September 2014

Abstract

Fecal microbiota transplantation (FMT) is a promising therapy for Clostridium difficile infection (CDI). However, questions remain regarding efficacy and safety in inflammatory bowel disease (IBD) patients, as well as longitudinal stability of donor stool composition. This report describes an IBD patient with two CDIs 18 months apart, each successfully treated with FMT with no IBD flares or complications. Microbiome composition analysis of patient samples during each infection revealed low-diversity microbiota patterns similar to those previously described in non-IBD patients with CDI and active IBD alone. Samples taken after each transplant demonstrated quick remodeling towards the donor's sample composition coinciding with symptom resolution. Of note, samples taken from the same donor 18 months apart reflected marked differences in microbiota abundances, suggesting that the use of single donors in FMT programs offers little benefit in ensuring predictability of donor stool composition over time. This report describes similar microbial composition patterns during CDI in IBD patients to those described previously in non-IBD patients, and supports FMT as safe and effective treatment for recurring CDI in this patient population.

Keywords
  • Clostridium difficile
  • Fecal bacteriotherapy
  • Fecal microbiota transplantation
  • Inflammatory bowel disease
  • Ulcerative colitis
  • Probiotics
  • Gut microbiome
  • Abbreviations
    CDI
    Clostridium difficile infection
    FMT
    fecal microbiota transplantation
    IBD
    inflammatory bowel disease
    OTU
    operational taxonomic unit
    UC
    ulcerative colitis
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