Abstract：
OBJECTIVE: We evaluated the effect of fecal microbiota transplantation (FMT) on the clearance of carbapenemase-producing Enterobacterales (CPE) carriage.
METHODS: We performed a prospective, multi-center study, conducted among patients who received a single dose of FMT from one of four healthy donors. The primary endpoint was complete clearance of CPE carriage two weeks after FMT with a secondary endpoint at three months. Shotgun metagenomic sequencing was performed to assess gut microbiota composition of donors and recipients before and after FMT.
RESULTS: Twenty CPE-colonized patients were included in the study, where post-FMT 20% (n = 4/20) of patients met the primary endpoint and 40% (n = 8/20) of patients met the secondary endpoint. Kaplan-Meier curves between patients with FMT intervention and the control group (n = 82) revealed a similar rate of decolonization between groups. Microbiota composition analyses revealed that response to FMT was not donor-dependent. Responders had a significantly lower relative abundance of CPE species pre-FMT than non-responders, and 14 days post-FMT responders had significantly higher bacterial species richness and alpha diversity compared to non-responders (p < 0.05). Responder fecal samples were also enriched in specific species, with significantly higher relative abundances of Faecalibacterium prausnitzii, Parabacteroides distasonis, Collinsella aerofaciens, Alistipes finegoldii and Blautia_A sp900066335 (q<0.01) compared to non-responders.
CONCLUSIONS: FMT administration using the proposed regimen did not achieve statistical significance for complete CPE decolonization but was correlated with the relative abundance of specific bacterial taxa, including CPE species.
METHODS: We performed a prospective, multi-center study, conducted among patients who received a single dose of FMT from one of four healthy donors. The primary endpoint was complete clearance of CPE carriage two weeks after FMT with a secondary endpoint at three months. Shotgun metagenomic sequencing was performed to assess gut microbiota composition of donors and recipients before and after FMT.
RESULTS: Twenty CPE-colonized patients were included in the study, where post-FMT 20% (n = 4/20) of patients met the primary endpoint and 40% (n = 8/20) of patients met the secondary endpoint. Kaplan-Meier curves between patients with FMT intervention and the control group (n = 82) revealed a similar rate of decolonization between groups. Microbiota composition analyses revealed that response to FMT was not donor-dependent. Responders had a significantly lower relative abundance of CPE species pre-FMT than non-responders, and 14 days post-FMT responders had significantly higher bacterial species richness and alpha diversity compared to non-responders (p < 0.05). Responder fecal samples were also enriched in specific species, with significantly higher relative abundances of Faecalibacterium prausnitzii, Parabacteroides distasonis, Collinsella aerofaciens, Alistipes finegoldii and Blautia_A sp900066335 (q<0.01) compared to non-responders.
CONCLUSIONS: FMT administration using the proposed regimen did not achieve statistical significance for complete CPE decolonization but was correlated with the relative abundance of specific bacterial taxa, including CPE species.
摘要：
目的：我们评估了粪便菌群移植（FMT）对产生碳青霉烯酶的肠杆菌（CPE）转移的清除作用。
方法：我们进行了前瞻性，多中心研究，在接受来自四个健康供体之一的单剂量FMT的患者中进行。主要终点是FMT后两周CPE携带的完全清除，次要终点是三个月。进行鸟枪宏基因组测序以评估FMT之前和之后的供体和受体的肠道微生物群组成。
结果：20名CPE定植患者被纳入研究，其中FMT后20%(n=4/20)的患者达到主要终点,40%(n=8/20)的患者达到次要终点.接受FMT干预的患者与对照组（n=82）之间的Kaplan-Meier曲线显示两组之间的脱色率相似。微生物组成分析表明，对FMT的反应不是供体依赖性的。应答者FMT前的CPE物种相对丰度明显低于非应答者，FMT后14天，与非反应者相比，FMT反应者具有显着更高的细菌物种丰富度和α多样性（p<0.05）。响应者的粪便样本也富含特定物种，普氏粪杆菌的相对丰度明显较高，双分支杆菌,科林塞拉气溶胶，与无反应者相比，费利氏和Blautia_Asp900066335（q<0.01）。
结论：使用拟议方案的FMT给药对于完全的CPE脱色没有达到统计学意义，但与特定细菌分类群的相对丰度相关，包括CPE物种。
方法：我们进行了前瞻性，多中心研究，在接受来自四个健康供体之一的单剂量FMT的患者中进行。主要终点是FMT后两周CPE携带的完全清除，次要终点是三个月。进行鸟枪宏基因组测序以评估FMT之前和之后的供体和受体的肠道微生物群组成。
结果：20名CPE定植患者被纳入研究，其中FMT后20%(n=4/20)的患者达到主要终点,40%(n=8/20)的患者达到次要终点.接受FMT干预的患者与对照组（n=82）之间的Kaplan-Meier曲线显示两组之间的脱色率相似。微生物组成分析表明，对FMT的反应不是供体依赖性的。应答者FMT前的CPE物种相对丰度明显低于非应答者，FMT后14天，与非反应者相比，FMT反应者具有显着更高的细菌物种丰富度和α多样性（p<0.05）。响应者的粪便样本也富含特定物种，普氏粪杆菌的相对丰度明显较高，双分支杆菌,科林塞拉气溶胶，与无反应者相比，费利氏和Blautia_Asp900066335（q<0.01）。
结论：使用拟议方案的FMT给药对于完全的CPE脱色没有达到统计学意义，但与特定细菌分类群的相对丰度相关，包括CPE物种。
