The Use of Microbiome Restoration Therapeutics to Eliminate Intestinal Colonization With Multidrug-Resistant Organisms

Am J Med Sci. 2018 Nov;356(5):433-440. doi: 10.1016/j.amjms.2018.08.015. Epub 2018 Aug 29.

Abstract

Antibiotic resistance (AR) has been described by the World Health Organization as an increasingly serious threat to global public health. Many mechanisms of AR have become widespread due to global selective pressures such as widespread antibiotic use. The intestinal tract is an important reservoir for many multidrug-resistant organisms (MDROs), and next-generation sequencing has expanded understanding of the resistome, defined as the comprehensive sum of genetic determinants of AR. Intestinal decolonization has been explored as a strategy to eradicate MDROs with selective digestive tract decontamination and probiotics being notable examples with mixed results. This review focuses on fecal microbiota transplantation and the early evidence supporting its efficacy in decolonizing MDROs and potential mechanisms of action to reduce AR genes. Current evidence suggests that fecal microbiota transplantation may have promise in restoring healthy microbial diversity and reducing AR, and clinical trials are underway to better characterize its safety and efficacy.

Keywords: Fecal microbiota transplantation; Intestinal microbiota; Multidrug-resistant organisms; Sequencing.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Bacterial Infections / prevention & control*
  • Drug Resistance, Multiple, Bacterial / physiology*
  • Fecal Microbiota Transplantation / methods*
  • Gastrointestinal Microbiome / physiology*
  • Humans
  • Intestines / microbiology*