title: Challenges in fecal donor selection and screening for fecal microbiota transplantation: A review.
abstract: Fecal microbiota transplantation is best understood as an effective and inexpensive therapy for recurrent Clostridium difficile infection but fecal donor selection and screening should be periodically revised. Here, we review current recommendations for selection and screening of fecal donors for fecal microbiota transplantation. We recommend considering diabetes mellitus, prior cardiovascular events, and clinical healthcare exposure as fecal donor exclusion criteria until more is known about the association of these conditions with the human gut microbiome. We review the non-bacterial members of the human gut microbiome, associations of the gut microbiome with colorectal malignancies, the human gut resistome and how these may impact future donor screening recommendations. Collaboration between clinicians, clinical laboratory scientists, industry and regulatory agencies will be critically important for continued improvement in donor selection and screening.
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Emory University School of Medicine , Atlanta , GA , USA.
authors.forename: Michael H
authors.identifier: 0000-0002-6181-4599
authors.initials: MH
authors.lastname: Woodworth
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Emory University School of Medicine , Atlanta , GA , USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Carpentieri
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Emory University School of Medicine , Atlanta , GA , USA.
authors.forename: Kaitlin L
authors.identifier: 0000-0002-4098-3422
authors.initials: KL
authors.lastname: Sitchenko
authors.affiliation: a Division of Infectious Diseases, Department of Medicine , Emory University School of Medicine , Atlanta , GA , USA.|b Department of Pathology , Emory University Hospital , Atlanta , GA , USA.
authors.forename: Colleen S
authors.identifier: 0000-0003-1757-8477
authors.initials: CS
authors.lastname: Kraft
mesh_terms: D003015:Clostridium Infections / Q000628:therapy; D046148:Donor Selection; D024901:Drug Resistance, Multiple, Bacterial; D000069467:Fecal Microbiota Transplantation; D005243:Feces / Q000382:microbiology*; D000069196:Gastrointestinal Microbiome / Q000187:drug effects; D006801:Humans; D008659:Metabolic Diseases / Q000175:diagnosis / Q000382:microbiology; D009765:Obesity / Q000175:diagnosis / Q000382:microbiology; D014481:United States; D014486:United States Food and Drug Administration
keywords: Clostridium difficile; FMT; antibiotic resistance; fecal microbiota transplantation; gut microbial therapeutics; microbiome; resistome; stool donor screening