Science

Ying Taur, Katharine Coyte, Jonas Schluter, Elizabeth Robilotti, Cesar Figueroa, Mergim Gjonbalaj, Eric R. Littmann, Lilan Ling, Liza Miller, Yangtsho Gyaltshen, Emily Fontana, Sejal Morjaria, Boglarka Gyurkocza, Miguel-Angel Perales,
Hugo Castro-Malaspina, Roni Tamari, Doris Ponce, Guenther Koehne, Juliet Barker, Ann Jakubowski, Esperanza Papadopoulos, Parastoo Dahi, Craig Sauter, Brian Shaffer, James W. Young, Jonathan Peled, Richard C. Meagher, Robert R. Jenq, Marcel R. M. van den Brink, Sergio A. Giralt, Eric G. Pamer, Joao B. Xavier

Antibiotic treatment can deplete the commensal bacteria of a patient’s gut microbiota and, paradoxically, in- crease their risk of subsequent infections. In allogeneic hematopoietic stem cell transplantation (allo-HSCT), antibiotic administration is essential for optimal clinical outcomes but significantly disrupts intestinal micro- biota diversity, leading to loss of many beneficial microbes. Although gut microbiota diversity loss during allo-HSCT is associated with increased mortality, approaches to reestablish depleted commensal bacteria have yet to be developed. We have initiated a randomized, controlled clinical trial of autologous fecal microbiota transplantation (auto-FMT) versus no intervention and have analyzed the intestinal microbiota profiles of 25 allo-HSCT patients (14 who received auto-FMT treatment and 11 control patients who did not). Changes in gut microbiota diversity and composition revealed that the auto-FMT intervention boosted microbial diversity and reestablished the intestinal microbiota composition that the patient had before antibiotic treatment and allo-HSCT. These results demonstrate the potential for fecal sample banking and posttreatment remediation of a patient’s gut microbiota after microbiota-depleting antibiotic treatment during allo-HSCT.