FMT restoration of gut fungi linked to efficacy for C. diff infection

WASHINGTON — In addition to restoring gut bacteria, fecal microbiota transplantation also appears to restore the gut fungi, known as the “mycobiome” or “fungome,” and this correlates with treatment response in patients with Clostridium difficile infection, according to research presented at Digestive Disease Week.

Tao Zuo, MD, of the Chinese University of Hong Kong, and colleagues conducted their trial to further explore how FMT impacts the gut mycobiome in the treatment of CDI.

“Our previous findings on FMT are based on the bacteria of the microbiota,” Zuo said in his presentation. “How about the other microbiota component, gut fungi? We know less about it compared with the gut bacteria.”

Zuo and colleagues conducted both fungal and bacterial sequencing on stool samples of 31 patients with CDI and 23 healthy controls. The patients with CDI were split into two groups. One group received FMT treatment (n = 16) and the second group received vancomycin (n = 8). The researchers tracked changes in the mycobiome and bacterial microbiome for both groups.

They found that CDI was associated with a decrease in fungal diversity, richness and evenness, as well as an overabundance of the genus Candida and species Candida albicans compared with the healthy control group (P < .05).

Following the treatment, Zuo and colleagues found that FMT was linked to a significant decrease in C. albicans. The mycobiota of patients treated with FMT were more likely to resemble that of the stool donor. Their gut fungal diversity included a prevalence of Saccharomyces and Aspergillus, whereas the mycobiota of patients treated with just vancomycin were still dominated by Candida.

Zuo concluded that their findings show that restoring the fungal, as well as bacterial microbiota, is critical to the efficacy of FMT for the treatment of CDI. – by Alex Young

Reference:

Zuo T, et al. Abstract 83. Presented at: Digestive Disease Week; June 2-5, 2018; Washington, D.C.

Disclosures: Zuo reports no relevant financial disclosures. Please see the DDW faculty disclosure index for a list of all other authors’ relevant financial disclosures.