title: Microbial composition analysis of Clostridium difficile infections in an ulcerative colitis patient treated with multiple fecal microbiota transplantations.
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.
authors: Dept. Medicine, GI Diseases Research Unit, Queen's University, Kingston, ON, Canada. Electronic address: chantalle.brace@queensu.ca.
authors: Chantalle
authors: C
authors: Brace
authors: Dept. Biochemistry, University of Western Ontario, London, ON, Canada. Electronic address: ggloor@uwo.ca.
authors: Gregory B
authors: GB
authors: Gloor
authors: Dept. Medicine, GI Diseases Research Unit, Queen's University, Kingston, ON, Canada. Electronic address: ropelesm@hdh.kari.net.
authors: Mark
authors: M
authors: Ropeleski
authors: Dept. Molecular and Cellular Biology, University of Guelph, Guelph, ON, Canada. Electronic address: eav@uoguelph.ca.
authors: Emma
authors: E
authors: Allen-Vercoe
authors: Dept. Medicine, GI Diseases Research Unit, Queen's University, Kingston, ON, Canada. Electronic address: eop@queensu.ca.
authors: Elaine O
authors: EO
authors: Petrof
mesh_terms: D000369:Aged, 80 and over; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications / Q000175:diagnosis / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D006801:Humans; D008297:Male; D064307:Microbiota; D012812:Sigmoidoscopy
keywords: Clostridium difficile; Fecal bacteriotherapy; Fecal microbiota transplantation; Gut microbiome; Inflammatory bowel disease; Probiotics; Ulcerative colitis