Faecalibacterium prausnitzii increases following fecal microbiota transplantation in recurrent Clostridioides difficile infection

Abstract

Objective Fecal microbiota transplantation (FMT) is a highly effective treatment for Clostridioides difficile infection (CDI). However, the fecal transplant’s causal components translating into clearance of the CDI are yet to be identified. The commensal bacteria Faecalibacterium prausnitzii may be of great interest in this context, since it is one of the most common species of the healthy gut microbiota and produces metabolites with anti-inflammatory properties. Although there is mounting evidence that F. prausnitzii is an important regulator of intestinal homeostasis, data about its role in CDI and FMT are relatively scarce. Methods Stool samples from patients with recurrent CDI were collected to investigate the relative abundance of F. prausnitzii before and after FMT. Twenty-one patients provided fecal samples before the FMT procedure, at 2 weeks post-FMT, and at 2–4 months post-FMT. The relative abundance of F. prausnitzii was determined using quantitative polymerase chain reaction. Results The abundance of F. prausnitzii was elevated in samples (N = 9) from donors compared to pre-FMT samples (N = 15) from patients (adjusted P<0.001). No significant difference in the abundance of F. prausnitzii between responders (N = 11) and non-responders (N = 4) was found before FMT (P = 0.85). In patients with CDI, the abundance of F. prausnitzii significantly increased in the 2 weeks post-FMT samples (N = 14) compared to the pre-FMT samples (N = 15, adjusted P<0.001). The increase persisted 2–4 months post-FMT (N = 15) compared to pre-FMT samples (N = 15) (adjusted P<0.001). Conclusions FMT increases the relative abundance of F. prausnitzii in patients with recurrent CDI, and this microbial shift remains several months later. The baseline abundance of F. prausnitzii in donors or recipients was not associated with future treatment response, although a true predictive capacity cannot be excluded because of the limited sample size. Further studies are needed to discern whether F. prausnitzii plays an active role in the resolution of CDI.

Rational Design of Live Biotherapeutic Products for the Prevention ofClostridioides difficileInfection

“…We found clustering of the main protective species within the families Lachnospiraceae, Bacteroidaceae, and Oscillospiraceae. For example, F. prausnitzii , a beneficial human gut microbe touted as a candidate for next-generation probiotics 37 , was found to have reduced abundance in CDI patients, which was restored after FMT 38 . Interestingly, we have also identified a protective strain of the species Dorea longicatena, which is a component of a defined bacterial consortium (VE303) with encouraging Phase 2 clinical data, consisting of eight, nonpathogenic, nontoxigenic, commensal strains of Clostridia 39 .…”

Gut Microbiota Composition Associated with Clostridioides difficile Colonization and Infection

“…This bacterium is reduced in gut dysbiosis, in IBD, in obesity, in diabetes, etc. [ 96 ]. Lachnospiraceae is protective against CDI [ 20 ].…”

Ulcerative Colitis in Response to Fecal Microbiota Transplantation via Modulation of Gut Microbiota and Th17/Treg Cell Balance

“…These results suggest that stable Faecalibaterium colonization following FMT may play a crucial role in UC remission by alleviating intestinal inflammation. Of note, a recent study also found that FMT increases the relative abundance of F. prausnitzii in patients with recurrent CDI, and this microbial shift remains several months later [ 30 ]. However, the exact anti-inflammatory mechanism of Faecalibacterium remains unknown in these patients.…”