Durable coexistence of donor and recipient strains after fecal microbiota transplantation
Persistence of fecal transplants Fecal microbiota transplantation is a successful way of treating the distressing symptoms of irritable bowel disease or Clostridium difficile infection. The procedure is done by administering a concentrate of colonic bacteria from a healthy donor. Li et al. used metagenomic data to look at single nucleotide variants after transplants in humans. Donor and recipient strains coexisted for at least 3 months. Some donor strains replaced related strains of the same species, but totally novel species from a donor were unlikely to thrive in a recipient. Rational design of personalized fecal transplant "cocktails" will therefore rely on resolution beyond the species level. Science, this issue p. 586 The mystery of the success of clinical microbial transplant therapy is beginning to be decoded. Fecal microbiota transplantation (FMT) has shown efficacy in treating recurrent Clostridium difficile infection and is increasingly being applied to other gastrointestinal disorders, yet the fate of native and introduced microbial strains remains largely unknown. To quantify the extent of donor microbiota colonization, we monitored strain populations in fecal samples from a recent FMT study on metabolic syndrome patients using single nucleotide variants in metagenomes. We found extensive coexistence of donor and recipient strains, persisting 3 months after treatment. Colonization success was greater for conspecific strains than for new species, the latter falling within fluctuation levels observed in healthy individuals over a similar time frame. Furthermore, same donor recipients displayed varying degrees of microbiota transfer, indicating individual patterns of microbiome resistance and donor recipient compatibilities.
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