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Impact of Fecal Microbiota Transplant Formulations, Storage Conditions, and Duration on Bacterial Viability, Functionality, and Clinical Outcomes in Patients with Recurrent Clostridioides difficile Infection Shaheen, Mohamed; McDougall, Chelsea; Chan, Leona; Franz, Rose; Wong, Karen; Giebelhaus, Ryland T.; Nguyen, Gwen; Nam, Seo Lin; de la Mata, A. Paulina; Yeo, Sam; Harynuk, James J.; Pakpour, Sepideh; Xu, Huiping; Kao, Dina
Abstract
Fecal microbiota transplantation (FMT) is the most effective therapy for preventing recurrent Clostridioides difficile infection (rCDI). However, the impact of FMT formulations and storage conditions on bacterial viability, community structure, functionality, and clinical efficacy remains under-investigated. We studied the effect of different storage conditions on the bacterial viability (live/dead staining and cell sorting), community structure (16S rDNA analysis), and metabolic functionality (fermentation) of frozen and lyophilized FMT formulations. The clinical success rates of rCDI patients were correlated retrospectively with FMT formulations, storage durations, and host factors using the Edmonton FMT program database. Bacterial viability remained at 10–20% across various storage conditions and formulations and was comparable to that of fresh FMT. Live and dead bacterial fractions in both frozen and lyophilized FMT preparations exhibited distinct community structures. Storage durations, but not temperatures, negatively affected bacterial diversity. More short-chain fatty acids were found in the metabolomic profiling of in vitro fermentation products using lyophilized than frozen FMT. Clinical success rates in 537 rCDI patients receiving a single dose of FMT were not significantly different among the three formulations. However, longer storage durations and advanced recipient age negatively impacted clinical efficacy. Together, our findings suggest that FMT formulations and storage durations should be considered when establishing guidelines for product shelf life for optimal treatment outcomes.
Item Metadata
| Title |
Impact of Fecal Microbiota Transplant Formulations, Storage Conditions, and Duration on Bacterial Viability, Functionality, and Clinical Outcomes in Patients with Recurrent Clostridioides difficile Infection
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| Creator | |
| Publisher |
Multidisciplinary Digital Publishing Institute
|
| Date Issued |
2025-03-04
|
| Description |
Fecal microbiota transplantation (FMT) is the most effective therapy for preventing
recurrent Clostridioides difficile infection (rCDI). However, the impact of FMT formulations
and storage conditions on bacterial viability, community structure, functionality,
and clinical efficacy remains under-investigated. We studied the effect of different storage
conditions on the bacterial viability (live/dead staining and cell sorting), community
structure (16S rDNA analysis), and metabolic functionality (fermentation) of frozen and
lyophilized FMT formulations. The clinical success rates of rCDI patients were correlated
retrospectively with FMT formulations, storage durations, and host factors using the Edmonton
FMT program database. Bacterial viability remained at 10–20% across various
storage conditions and formulations and was comparable to that of fresh FMT. Live and
dead bacterial fractions in both frozen and lyophilized FMT preparations exhibited distinct
community structures. Storage durations, but not temperatures, negatively affected bacterial
diversity. More short-chain fatty acids were found in the metabolomic profiling of
in vitro fermentation products using lyophilized than frozen FMT. Clinical success rates in
537 rCDI patients receiving a single dose of FMT were not significantly different among
the three formulations. However, longer storage durations and advanced recipient age
negatively impacted clinical efficacy. Together, our findings suggest that FMT formulations
and storage durations should be considered when establishing guidelines for product shelf
life for optimal treatment outcomes.
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| Subject | |
| Genre | |
| Type | |
| Language |
eng
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| Date Available |
2025-05-02
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| Provider |
Vancouver : University of British Columbia Library
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| Rights |
CC BY 4.0
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| DOI |
10.14288/1.0448729
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| URI | |
| Affiliation | |
| Citation |
Microorganisms 13 (3): 587 (2025)
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| Publisher DOI |
10.3390/microorganisms13030587
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| Peer Review Status |
Reviewed
|
| Scholarly Level |
Researcher
|
| Rights URI | |
| Aggregated Source Repository |
DSpace
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Rights
CC BY 4.0