1728. A Comparison of the Microbiota of Stool Transplant Donor-Recipient Pairs Pre- and Post-transplant for Recurrent Clostridium difficile Associate Disease
Session: Poster Abstract Session: Studies of the Interface of Host-Microbial Interaction
Saturday, October 5, 2013
Room: The Moscone Center: Poster Hall C
  • FMT poster.pdf (643.1 kB)
  • Background: Stool transplant has arisen as a promising treatment for recurrent C difficileassociated disease (CDAD) and its clinical use is supported by a recently published randomized clinical trial. The presumed mechanism of action is re-establishing the normal gut microbiome. Data on microbiome analysis of donor-recipient pairs is limited in the published literature.

    Methods: Samples from donors (pre-) and recipients (pre- and 14 days post-transplant) are collected for microbiome analysis. DNA is prepared from stool samples and 16S rRNA gene sequencing is performed on the Illumina GAIIx platform. Bioinformatics analysis provides sequencing depth to the genus level.

    Results: The first set of samples from our institution had similar changes in the proportions of Proteobacteria (contraction post-transplant) and Firmicutes (expansion post-transplant) as those previously reported, but little change in Bacteroidetes. There was a significant increase in diversity 14 days after transplant although not to the level of the donor sample. The recipient had significant expansion of a population of the genus Akkermansiawhich has been reported to be associated with antibiotic treatment with no associated gastrointestinal disturbance. The recipient had alleviation of symptoms within two weeks post-transplant. Repeat sampling of the recipient at 6 months is planned.

    Conclusion: Our results from a single patient with clinical cure with stool transplant show increase in diversity and in proportion of Firmicutes after stool transplant though not to the level of the donor sample. There was considerable expansion of a non-donor derived genus, Akkermansia, in the recipient, which is a finding not related in prior reports on stool transplant for CDAD. We are continuing to collect samples from donor-recipient pairs undergoing stool transplant for recurrent CDAD. Finally, we have archived the microbiota from the donor-recipient pairs for transplant into gnotobiotic mice to further derive a mechanistic understanding of this therapeutic approach.

    James Grubbs, MD, Internal Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, Casey Morrow, PhD, Cell, Developmental and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, Martin Rodriguez, MD, University of Alabama at Birmingham, Birmingham, AL and Ranjit Kumar, PhD, Center for Clinical and Translational Science, University of Alabama at Birmingham, Birmingham, AL


    J. Grubbs, None

    C. Morrow, None

    M. Rodriguez, None

    R. Kumar, None

    Findings in the abstracts are embargoed until 12:01 a.m. PST, Oct. 2nd with the exception of research findings presented at the IDWeek press conferences.