Origins of bloodstream infections following fecal microbiota transplantation: A strain-level analysis

Adi Eshel; Itai Sharon; Arnon Nagler; David Bomze; Ivetta Danylesko; Joshua A. Fein; Mika Geva; Israel Henig; Avichai Shimoni; Tsila Zuckerman; Ilan Youngster; Omry Koren; Roni Shouval

doi:10.1182/bloodadvances.2021005110

Origins of bloodstream infections following fecal microbiota transplantation: A strain-level analysis

Adi Eshel, Itai Sharon, Arnon Nagler, David Bomze, Ivetta Danylesko, Joshua A. Fein, Mika Geva, Israel Henig, Avichai Shimoni, Tsila Zuckerman, Ilan Youngster, Omry Koren, Roni Shouval

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14 Scopus citations

Abstract

We observed high rates of bloodstream infections (BSIs) following fecal microbiota transplantation (FMT) for graft-versus-host-disease (33 events in 22 patients). To trace the BSIs' origin, we applied a metagenomic bioinformatic pipeline screening donor and recipient stool samples for bacteremia-causing strains in 13 cases. Offending strains were not detected in FMT donations. Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii could be detected in stool samples before emerging in the blood. In this largest report of BSIs post-FMT, we present an approach that may be applicable for evaluating BSI origin following microbiota-based interventions. Our findings support FMT safety in immunocompromised patients but do not rule out FMT as an inducer of bacterial translocation.

Original language	English
Pages (from-to)	568-573
Number of pages	6
Journal	Blood advances
Volume	6
Issue number	2
DOIs	https://doi.org/10.1182/bloodadvances.2021005110
State	Published - 25 Jan 2022

Bibliographical note

Publisher Copyright:
© 2022 American Society of Hematology. All rights reserved.

Funding

This work was supported by the Dahlia Greidinger Anti Cancer Fund, the Gasner Fund for Medical Research, and an institutional grant from the Chaim Sheba Medical Center. The authors thank Elvire Thouvenot-Nitzan for figure design and illustration. R.S. is supported by the American Society of Hematology Fellow Scholar Award.

Funders	Funder number
Chaim Sheba Medical Center
Gasner Fund for Medical Research
National Cancer Institute	P30CA008748
American Society of Hematology
Dahlia Greidinger Anti-Cancer Fund

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abstract = "We observed high rates of bloodstream infections (BSIs) following fecal microbiota transplantation (FMT) for graft-versus-host-disease (33 events in 22 patients). To trace the BSIs' origin, we applied a metagenomic bioinformatic pipeline screening donor and recipient stool samples for bacteremia-causing strains in 13 cases. Offending strains were not detected in FMT donations. Enterococcus faecium, Escherichia coli, Pseudomonas aeruginosa, and Acinetobacter baumannii could be detected in stool samples before emerging in the blood. In this largest report of BSIs post-FMT, we present an approach that may be applicable for evaluating BSI origin following microbiota-based interventions. Our findings support FMT safety in immunocompromised patients but do not rule out FMT as an inducer of bacterial translocation.",

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AU - Danylesko, Ivetta

AU - Fein, Joshua A.

AU - Geva, Mika

AU - Henig, Israel

AU - Shimoni, Avichai

AU - Zuckerman, Tsila

AU - Youngster, Ilan

AU - Koren, Omry

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Origins of bloodstream infections following fecal microbiota transplantation: A strain-level analysis

Abstract

Bibliographical note

Funding

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