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Fecal microbiota transplantation to eradicate vancomycin-resistant enterococci colonization in case of an outbreak
Authors:B. Davido  R. Batista  H. Fessi  H. Michelon  L. Escaut  C. Lawrence  M. Denis  C. Perronne  J. Salomon  A. Dinh
Affiliation:1. Service de maladies infectieuses et tropicales, hôpital Raymond-Poincaré, AP–HP, 104, boulevard Raymond-Poincaré, 92380 Garches, France;2. Pharmacie hospitalière, hôpital Cochin, AP–HP, 75014 Paris, France;3. Néphrologie, hôpital Tenon, AP–HP, 75010 Paris, France;4. Pharmacie hospitalière, hôpital Raymond-Poincaré, AP–HP, 92380 Garches, France;5. Service de maladies infectieuses, hôpital Bicêtre, AP–HP, 94270 Le Kremlin-Bicêtre, France;6. Laboratoire de microbiologie, hôpital Raymond-Poincaré, AP–HP, 92380 Garches, France;7. Laboratoire de microbiologie, hôpital Tenon, AP–HP, 75010 Paris, France
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:Fecal transplantation  Multidrug-resistant bacteria  Vancomycin-resistant enterococci  Transplantation fécale  Bactérie multirésistante  Entérocoque résistant à la vancomycine
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