Methods: A multicenter retrospective analysis was performed using stool samples from rCDI patients treated with FMT (n=31) or autologous FMT as a control (n=18). Material was accessed from 6 academic hospitals under existing research protocols. VRE was assessed using a PCR-based assay targeting VanA (Acuitas® MDRO Gene Test). Colonization was defined as positive result at any dilution. VRE decolonization was defined as absence of VRE colonization post-FMT among a patient colonized with VRE pre-FMT.
Results: Among the cohort, 9/31 (29%) of patients in the FMT group and 7/18 (39%) of patients in the control group were colonized with VRE at baseline. At the first time point measured post-FMT, 9/9 (100%) of colonized patients in the FMT group tested VRE-negative compared to 3/7 (43%) in the control group (p=0.02, Fisher's Exact Test). On subgroup analysis, samples collected at ≤6 weeks, 5/5 (100%) patients in the FMT group and 3/7 (43%) controls were decolonized; for samples collected at >6 weeks, 4/4 (100%) in the FMT group and 6/7 (86%) in the control group were decolonized. These results from subgroup analyses were not statistically significant given the high rate of spontaneous VRE decolonization.
Conclusion: FMT may be able to eliminate gastrointestinal colonization with VRE. However, a well-powered RCT with short follow-up time points is necessary to prospectively examine colonization dynamics and clinical outcomes. These results from a heterogeneous retrospective cohort study suggest that FMT or related microbial therapies may be effective to prevent infection and transmission of VRE in high-risk settings.
O. Aroniadis, OpenBiome: Collaborator , Research support
L. Brandt, OpenBiome: Collaborator , Research support
Crestovo: Scientific Advisor , Compensation
D. Donovan, OpGen: Employee , Salary
M. Fischer, Openbiome: Collaborator , Research support
Rebiotix: Consultant , Compensation
A. Grinspan, Seres Therapeutics: Investigator , Compensation
Z. Kassam, OpenBiome: Employee , Salary
Finch Therapeutics: Consultant and Shareholder , Equity and Research support
C. R. Kelly, None
C. Kim, OpenBiome: Employee , Salary
C. Morrow, None
M. Osman, OpenBiome: Employee , Salary
J. Quan, OpGen: Employee , Salary
M. Rodriguez, None
T. Walker, OpGen: Employee , Salary
M. Smith, OpenBiome: Employee , Salary
Finch: Board Member , Employee and Shareholder , Equity and Salary