Improving Risk–Benefit in Faecal Transplantation through Microbiome Screening

FMT has demonstrated clinical efficacy for a growing number of conditions. High rates of systemic infection in transplant recipients, and recent cases of sepsis caused by antibiotic-resistant pathogens transmitted through FMT, highlight the need to improve FMT safety. Commensal gut microbes can substantially reduce sepsis risk through interactions with both pathogens and the host. In addition to screening for pathogens, assessment of donor material should consider the composition and structure of the wider faecal microbiota. Measures to protect commensal microbes during transplant preparation, and to deplete pathogen populations, could substantially improve the safety of FMT. Faecal microbiota transplantation (FMT) has been shown to be effective in the treatment of a growing number of conditions, and its clinical use continues to rise. However, recent cases of antibiotic-resistant pathogen transmission through FMT, resulting in at least one case of fatal sepsis, highlight the need to reevaluate current donor screening practices. Commensal gut microbes profoundly influence infection risk but are not routinely assessed in donor stool. Extending the assessment of donor material beyond pathogen populations to include the composition and structure of the wider faecal microbiota has the potential to reduce infectious complications in FMT recipients. Faecal microbiota transplantation (FMT) has been shown to be effective in the treatment of a growing number of conditions, and its clinical use continues to rise. However, recent cases of antibiotic-resistant pathogen transmission through FMT, resulting in at least one case of fatal sepsis, highlight the need to reevaluate current donor screening practices. Commensal gut microbes profoundly influence infection risk but are not routinely assessed in donor stool. Extending the assessment of donor material beyond pathogen populations to include the composition and structure of the wider faecal microbiota has the potential to reduce infectious complications in FMT recipients. transplantation from another person of cells with the ability to regenerate multiple types of new cells. This procedure is commonly used as part of the treatment of leukaemia and other blood cancers. the number, distribution, phylogenetic relatedness, and functional characteristics of the bacterial taxa associated with a given niche. proteinaceous compounds produced by one type of bacteria that inhibit or kill other bacteria. viruses that infect and replicate within bacteria. the ability of commensal gut microbiota to prevent the expansion of pathogen populations. organisms that occupy the same area as others without causing harm to other species. taxa that are important for community structure, integrity, and function, and whose influence is nonredundant. an organism that is commensal but has potential to become a pathogen. a disease-causing organism.