Multidrug-Resistant Gram-Negative Bacteria Decolonization in Immunocompromised Patients: A Focus on Fecal Microbiota Transplantation

Int J Mol Sci. 2020 Aug 5;21(16):5619. doi: 10.3390/ijms21165619.

Abstract

Antimicrobial resistance is an important issue for global health; in immunocompromised patients, such as solid organ and hematological transplant recipients, it poses an even bigger threat. Colonization by multidrug-resistant (MDR) bacteria was acknowledged as a strong risk factor to subsequent infections, especially in individuals with a compromised immune system. A growing pile of studies has linked the imbalance caused by the dominance of certain taxa populating the gut, also known as intestinal microbiota dysbiosis, to an increased risk of MDR bacteria colonization. Several attempts were proposed to modulate the gut microbiota. Particularly, fecal microbiota transplantation (FMT) was successfully applied to treat conditions like Clostridioides difficile infection and other diseases linked to gut microbiota dysbiosis. In this review we aimed to provide a look at the data gathered so far on FMT, focusing on its possible role in treating MDR colonization in the setting of immunocompromised patients and analyzing its efficacy and safety.

Keywords: antimicrobial resistance; decolonization; dysbiosis; fecal microbiota transplantation; gut colonization; gut microbiota; immunocompromised; multidrug-resistant.

Publication types

  • Review

MeSH terms

  • Clostridium Infections / microbiology
  • Clostridium Infections / therapy
  • Drug Resistance, Multiple / genetics*
  • Drug Resistance, Multiple, Bacterial / genetics
  • Dysbiosis / microbiology
  • Dysbiosis / therapy*
  • Fecal Microbiota Transplantation / methods*
  • Gastrointestinal Microbiome / genetics*
  • Gram-Negative Bacteria / genetics
  • Humans
  • Immunocompromised Host / genetics
  • Immunocompromised Host / immunology