Imperial College London

Disease prevention not decolonization


FMT image

A new study has found that faecal microbiota transplants (FMT) can be used to try to remove multi-drug resistant bacteria (MDRO) from the gut.

The research, published in Clinical Infectious Diseases, found that FMT use was associated with a number of important clinical benefits and may be an important novel treatment for patients who are colonised with MDROs, reducing their chances of them getting severe complications such as sepsis or bloodstream infections.

In the past, the team from the Department of Metabolism, Reproduction and Digestion, has focused on using FMT to treat C. difficile, a bacterial infection of the gut. However, this latest study - a collaboration between scientists and clinicians in multiple different Trust clinical departments (including the Departments of Gastroenterology and Hepatology, Infection, Renal Medicine and Haematology) - has looked at using FMT to help patients colonized with multidrug-resistant organisms.

The study, led by Professor Julian Marchesi and Dr Frances Davies, particularly focused on two groups of immunocompromised patients vulnerable to bloodstream infections with antibiotic-resistant bacteria - patients with haematological malignancy and renal transplant patients.

Researchers now understand that in many cases where patients develop sepsis/bacteremia with bacteria resistant to antibiotics, these bacteria have originated from the gut and passed into the bloodstream.

The results showed that though the team was only able to totally decolonise bacteria from the gut in certain patients, FMT use was associated with several important clinical benefits, compared to people equally as sick but not receiving FMT. These include reducing their length of stay in hospital, less need for carbapenems (the 'last line' antibiotics reserved to treat the most hard-to-treat bacterial infections), and lower rates of bloodstream infections overall.

Speaking about the research, first-author Dr Rohma Ghani and co-author Dr Ben Mullish said: "We are excited about the progression from our earlier work on faecal microbiota transplants and we believe this research highlights a novel approach to antimicrobial resistance - an area of huge importance."

This study was funded in part by the MRC and NIHR Imperial BRC.  


'Disease prevention not decolonization – a model for fecal microbiota transplantation in patients colonized with multidrug-resistant organisms' by Rohma Ghani, Benjamin Mullish, Julie McDonald et al. is published in Clinical Infectious Diseases. DOI: 10.1093/cid/ciaa948



Benjie Coleman

Benjie Coleman
Department of Surgery & Cancer

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