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  • Conference paper
    Martinez-Gili L, Mullish BH, Correia G, Chekmeneva E, Homeffer-Van Der Sluis V, McClure EL, Marchesi J, Gerber G, Bry L, Allegretti JRet al., 2021,

    A distinctive signature of fecal bile acids and other novel metabolites accompanying recurrence after primary clostridioides difficile infection

    , Society for Surgery of the Alimentary Tract Annual Meeting at Digestive Disease Week (DDW), Publisher: Elsevier, Pages: S368-S368, ISSN: 0016-5085
  • Conference paper
    Allegretti JR, Mullish BH, Marchesi J, Kennedy K, Gerber G, Bry Let al., 2021,

    ASSOCIATION BETWEEN NOVEL METABOLOMIC BIOMARKERS AND C.DIFFICILE RECURRENCE

    , Society-for-Surgery-of-the-Alimentary-Tract Annual Meeting at Digestive Disease Week (DDW), Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S369-S369, ISSN: 0016-5085
  • Conference paper
    Mullish BH, Innes AJ, Ghani R, Szydlo R, Williams HR, Thursz MR, Marchesi J, Davies F, Pavlu Jet al., 2021,

    FECAL MICROBIOTA TRANSPLANT PRIOR TO ALLOGENEIC HEMATOPOIETIC CELL TRANSPLANT IN PATIENTS COLONIZED WITH MULTI-DRUG RESISTANT ORGANISMS IS ASSOCIATED WITH IMPROVED SURVIVAL

    , Society-for-Surgery-of-the-Alimentary-Tract Annual Meeting at Digestive Disease Week (DDW), Publisher: W B SAUNDERS CO-ELSEVIER INC, Pages: S168-S169, ISSN: 0016-5085
  • Journal article
    Ghani R, Mullish BH, McDonald JAK, Ghazy A, Williams HRT, Brannigan ET, Mookerjee S, Satta G, Gilchrist M, Duncan N, Corbett R, Innes AJ, Pavlu J, Thursz MR, Davies F, Marchesi JRet al., 2021,

    Disease prevention not decolonization – a model for fecal microbiota transplantation in patients colonized with multidrug-resistant organisms

    , Clinical Infectious Diseases, Vol: 72, Pages: 1444-1447, ISSN: 1058-4838

    Fecal microbiota transplantation (FMT) yields variable intestinal decolonization results for multidrug-resistant organisms (MDROs). This study showed significant reductions in antibiotic duration, bacteremia and length of stay in 20 patients colonized/ infected with MDRO receiving FMT (compared to pre-FMT history, and a matched group not receiving FMT), despite modest decolonization rates.

  • Journal article
    Mullish BH, Alexander JL, Segal JP, 2021,

    Microbiota and faecal microbiota transplant

    , Microbiota in Health and Disease, Vol: 3, ISSN: 2704-8845

    As the range of disease states associated with the gut microbiome expands - and the mechanistic links between the gut microbiome and host physiology further deepens – so interest also grows in microbiome manipulation as medical therapy. In particular, bolstered by its established role in recurrent C. difficile infection (and promising results in other conditions), faecal microbiota transplant (FMT) has remained of growing global focus. This article reviews the key FMT-based studies published between April 2020 - March 2021. While the COVID-19 pandemic was the dominant challenge of the year, important FMT trials of interest were published for patients with a range of different conditions. The emergence of ‘next generation’ microbiome therapeutics offers an additional perspective and new opportunities within the field.

  • Journal article
    Gupta S, Mullish BH, Allegretti JR, 2021,

    Fecal microbiota transplantation: the evolving risk landscape

    , American Journal of Gastroenterology, Vol: 116, Pages: 647-656, ISSN: 0002-9270

    Fecal microbiota transplantation (FMT) has been recommended in clinical guidelines for the treatment for recurrent Clostridioides difficile infection (CDI). However, it is considered investigational by most regulatory agencies. As the adoption of FMT increased from a small group of CDI experts alone to more widespread use, there has been a corresponding increase in concern regarding potential risk. FMT is largely considered a safe procedure, though risks described range from mild gastrointestinal symptoms to serious infection. Currently, there is variability in how ‘FMT’ is characterized specifically with regards to testing approach, which, in turn, impacts the risk profile. This has been highlighted by the rare cases of multidrug-resistant organisms, Shiga toxin-producing E. coli and enteropathogenic E. coli recently reported, where these organisms were not screened. These cases have prompted additional screening mandates from the FDA, which has maintained its policy of enforcement discretion for the use of FMT for CDI not responding to standard therapy. Here, we examine the evolving risk landscape of FMT.

  • Conference paper
    Edwards L, Woodhouse C, Mullish BH, Tranah T, Miguens Blanco J, Kronsten VT, Zamalloa A, Patel VC, Marchesi J, Goldenberg S, Shawcross DLet al., 2021,

    Faecal microbiota transplantation improves intestinal barrier function and modulates mucosal IL-17 immunity in patients with advanced cirrhosis

    , ILC 2021, Publisher: Elsevier, Pages: S220-S221, ISSN: 0168-8278
  • Journal article
    Mullish BH, Marchesi JR, McDonald JAK, Pass DA, Masetti G, Michael DR, Plummer S, Jack AA, Davies TS, Hughes TR, Wang Det al., 2021,

    Probiotics reduce self-reported symptoms of upper respiratory tract infection in overweight and obese adults: should we be considering probiotics during viral pandemics?

    , Gut Microbes, Vol: 13, Pages: 1-9, ISSN: 1949-0976

    Gut microbiome manipulation to alter the gut-lung axis may potentially protect humans against respiratory infections, and clinical trials of probiotics show promise in this regard in healthy adults and children. However, comparable studies are lacking in overweight/obese people, who have increased risks in particular of viral upper respiratory tract infections (URTI). This Addendum further analyses our recent placebo-controlled trial of probiotics in overweight/obese people (focused initially on weight loss) to investigate the impact of probiotics upon the occurrence of URTI symptoms. As well as undergoing loss of weight and improvement in certain metabolic parameters, study participants taking probiotics experienced a 27% reduction in URTI symptoms versus control, with those ≥45 years or BMI ≥30 kg/m2 experiencing greater reductions. This symptom reduction is apparent within 2 weeks of probiotic use. Gut microbiome diversity remained stable throughout the study in probiotic-treated participants. Our data provide support for further trials to assess the potential role of probiotics in preventing viral URTI (and possibly also COVID-19), particularly in overweight/obese people.

  • Journal article
    Gilca-Blanariu GE, Stefanescu G, Girleanu I, Iqbal T, Segal J, Mullish B, Quraishi MN, Keller J, Molnar T, Megraud F, Dumitrascu D, Manuc M, Iancu LS, Marica C, Gheorghe C, Manzoor S, Trifan Aet al., 2021,

    Romanian National Guideline on Translating Fecal Microbiota Transplantation Applications related to Clostridioides difficile Infections into the Local Clinical Practice

    , Journal of Gastrointestinal and Liver Diseases, Vol: 30, Pages: 147-163, ISSN: 1841-8724

    <jats:p>Fecal microbiota transplantation involves the infusion of intestinal microorganisms via the transfer of a stool from a healthy individual into a diseased individual, with the intent of restoring normal intestinal flora. Fecal transplant is proposed for the treatment of refractory Clostridioides difficile infection. At present, recurrent Clostridioides difficile infection is the only indication supported by solid scientific evidence. Regulations by healthcare authorities vary among different countries. Considering that Romania does not have an available national guideline to offer standardization, this paper aimed to create a national fecal microbiota transplantation guideline concerning indications, techniques and donor screening, developed by international and local scientific working groups.</jats:p>

  • Journal article
    Jervis P, Pintanel P, Hopkins K, Wierzbicki C, Shelton J, Skelly E, Rosa G, Almeida-Reinoso D, Eugenia-Ordonez M, Ron S, Harrison X, Fisher Met al., 2021,

    Post‐epizootic microbiome associations across communities of neotropical amphibians

    , Molecular Ecology, Vol: 30, Pages: 1322-1335, ISSN: 0962-1083

    Microbiome–pathogen interactions are increasingly recognized as an important element of host immunity. While these host‐level interactions will have consequences for community disease dynamics, the factors which influence host microbiomes at larger scales are poorly understood. We here describe landscape‐scale pathogen–microbiome associations within the context of post‐epizootic amphibian chytridiomycosis, a disease caused by the panzootic chytrid fungus Batrachochytrium dendrobatidis. We undertook a survey of Neotropical amphibians across altitudinal gradients in Ecuador ~30 years following the observed amphibian declines and collected skin swab‐samples which were metabarcoded using both fungal (ITS‐2) and bacterial (r16S) amplicons. The data revealed marked variation in patterns of both B. dendrobatidis infection and microbiome structure that are associated with host life history. Stream breeding amphibians were most likely to be infected with B. dendrobatidis. This increased probability of infection was further associated with increased abundance and diversity of non‐Batrachochytrium chytrid fungi in the skin and environmental microbiome. We also show that increased alpha diversity and the relative abundance of fungi are lower in the skin microbiome of adult stream amphibians compared to adult pond‐breeding amphibians, an association not seen for bacteria. Finally, stream tadpoles exhibit lower proportions of predicted protective microbial taxa than pond tadpoles, suggesting reduced biotic resistance. Our analyses show that host breeding ecology strongly shapes pathogen–microbiome associations at a landscape scale, a trait that may influence resilience in the face of emerging infectious diseases.

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