title: Fecal microbiota transplantation to fightClostridium difficileinfections and other intestinal diseases.
abstract: We have analyzed fecal bacterial and viral communities of a patient with recurrentC. difficileinfection (rCDI) who was cured by fecal microbiota transplantation (FMT). The "Zürich Patient" experienced immediate cure and has remained free of symptoms for now over 5 y. Donor-similar bacterial compositions after 4.5 y post-FMT demonstrated sustainable engraftment of donor microbiota predominated byBacteroidetesandFirmicutesbacteria. Appearance of beneficial speciesFaecalibacterium prausnitziiandAkkermansia municiphilawas detected while disease-relatedProteobacteriadecreased. Stabilization of the microbiota took longer than expected from the rapidly improving clinical symptoms, suggesting the need for longer-lasting patient observation. The virome was mainly composed ofCaudoviralesbacteriophages but surprisingly also contained sequences related to aChlorellagiant virus that normally infects green algae not known to inhabitate the human intestine. FMT is highly effective against rCDI and is presently broadening its application to other conditions including inflammatory bowel disease (IBD). Here, we discuss the prospects and challenges of FMT against rCDI and other indications including a focus on bacteriophages.
authors.affiliation: Max Planck Institute for Molecular Genetics, Berlin, Germany; Institute for Medical Microbiology, Unversity of Zürich, Zürich, Switzerland.
authors.forename: Karin
authors.initials: K
authors.lastname: Moelling
authors.affiliation: Max Planck Institute for Molecular Genetics, Berlin, Germany; Institute for Medical Microbiology, Unversity of Zürich, Zürich, Switzerland; Max Planck Institute of Colloids and Interfaces, Potsdam, Germany; Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: Felix
authors.initials: F
authors.lastname: Broecker
keywords: Chlorella giant virus; Clostridium difficile; clinical trial; fecal microbiota transplantation; microbiota; phage therapy; virome