Fecal microbiota transplantation to eradicate vancomycin-resistant enterococci colonization in case of an outbreak

Med Mal Infect. 2019 May;49(3):214-218. doi: 10.1016/j.medmal.2018.11.002. Epub 2018 Nov 27.

Abstract

Objective: A rapid and worrying emergence of vancomycin-resistant enterococci (VRE) gut colonization is occurring worldwide and may be responsible for outbreaks, especially in healthcare facilities. While no efficient decolonization strategies are recommended, we assessed fecal microbiota transplantation (FMT) to eradicate VRE colonization.

Patients and method: Our main objective was to measure the impact of FMT on decolonization of VRE carriers, confirmed by at least two consecutive negative rectal swabs at one-week interval during a 3-month follow-up period. Patients received no antibiotic prior to the FMT.

Results: After a month only three patients remained colonized with VRE. Decolonization was associated with 87.5% (n=7) of success after three months as only one patient remained colonized.

Conclusion: Our first results confirm that the FMT seems to be safe, with an impact on VRE colonization over time that may help control outbreaks.

Keywords: Bactérie multirésistante; Entérocoque résistant à la vancomycine; Fecal transplantation; Multidrug-resistant bacteria; Transplantation fécale; Vancomycin-resistant enterococci.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antibiosis / physiology
  • Clostridium Infections / epidemiology
  • Clostridium Infections / prevention & control
  • Disease Eradication / methods*
  • Disease Outbreaks
  • Dysbiosis / epidemiology
  • Dysbiosis / microbiology
  • Dysbiosis / therapy
  • Fecal Microbiota Transplantation* / statistics & numerical data
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Gram-Positive Bacterial Infections / epidemiology*
  • Gram-Positive Bacterial Infections / microbiology
  • Gram-Positive Bacterial Infections / prevention & control
  • Gram-Positive Bacterial Infections / therapy*
  • Humans
  • Intestines / microbiology
  • Male
  • Middle Aged
  • Pilot Projects
  • Risk Factors
  • Vancomycin / therapeutic use
  • Vancomycin-Resistant Enterococci* / isolation & purification
  • Vancomycin-Resistant Enterococci* / physiology

Substances

  • Vancomycin