Fecal microbiota transplantation (FMT) has promising applications in reducing multidrug-resistant organism (MDRO) colonization and antibiotic resistance (AR) gene abundance. However, data on clinical microbiology results after FMT are limited. We examined the changes in antimicrobial susceptibility profiles in patients with Gram-negative infections in the year before and the year after treatment with FMT for recurrent Clostridioides difficile infection (RCDI). We also examined whether a history of FMT changed health care provider behavior with respect to culture ordering and antibiotic prescription. Medical records for RCDI patients who underwent FMT at Emory University between July 2012 and March 2017 were reviewed retrospectively. FMT-treated patients with Gram-negative culture data in the 1-year period preceding and the 1-year period following FMT were included. Demographic and clinical data were abstracted, including CDI history, frequency of Gram-negative cultures, microbiological results, and antibiotic prescription in response to positive cultures in the period following FMT. Twelve patients were included in this case series. We pooled data from infections at all body sites and found a decrease in the number of total and Gram-negative cultures post-FMT. We compared susceptibility profiles across taxa given the potential for horizontal transmission of AR elements and observed increased susceptibility to nitrofurantoin, trimethoprim-sulfamethoxazole, and the aminoglycosides. FMT did not drastically influence health care provider ordering of bacterial cultures or antibiotic prescribing practices. We observed a reduction in Gram-negative cultures and a trend toward increased antimicrobial susceptibility. This study supports further investigation of FMT as a means of improving antimicrobial susceptibility.

中文翻译：

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粪便微生物群移植治疗复发性艰难梭菌感染后的革兰氏阴性菌群和抗菌药物敏感性

粪便微生物群移植（FMT）在减少多重耐药微生物（MDRO）定植和抗生素耐药（AR）基因丰度方面具有广阔的应用前景。然而，FMT 后临床微生物学结果的数据有限。我们检查了革兰氏阴性菌感染患者在使用 FMT 治疗复发性艰难梭菌感染 (RCDI) 的前一年和后一年抗菌药物敏感性的变化。我们还研究了 FMT 的历史是否改变了医疗保健提供者在培养物订购和抗生素处方方面的行为。对 2012 年 7 月至 2017 年 3 月期间在埃默里大学接受 FMT 的 RCDI 患者的医疗记录进行了回顾性审查。纳入 FMT 治疗前 1 年和 FMT 后 1 年革兰氏阴性培养数据的患者。提取了人口统计和临床数据，包括 CDI 病史、革兰氏阴性培养的频率、微生物学结果以及 FMT 后针对阳性培养的抗生素处方。该病例系列包括 12 名患者。我们汇总了所有身体部位感染的数据，发现 FMT 后总培养物和革兰氏阴性培养物的数量有所减少。考虑到 AR 元件水平传播的潜力，我们比较了各个分类单元的敏感性概况，并观察到对呋喃妥因、甲氧苄氨嘧啶-磺胺甲恶唑和氨基糖苷类药物的敏感性增加。FMT 并没有极大地影响医疗保健提供者细菌培养的订购或抗生素处方实践。我们观察到革兰氏阴性培养物减少以及抗菌药物敏感性增加的趋势。这项研究支持进一步研究 FMT 作为提高抗菌药物敏感性的一种手段。