Are Microbial Politics Local?
Authors: Elizabeth L. Hohmann
Journal: Annals of Internal Medicine (2016)

Editorials1 November 2016Are Microbial Politics Local?Elizabeth L. Hohmann, MDElizabeth L. Hohmann, MDFrom Massachusetts General Hospital, Boston, Massachusetts.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-1784 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Former Speaker of the House Tip O'Neill's claim that all politics are local came to mind after reading Kelly and colleagues' report (1) of a study of fecal microbiota transplantation (FMT) for recurrent Clostridium difficile infection (CDI). The site differences observed in this study make one wonder whether even microbial politics might be local.The American College of Gastroenterology suggests considering FMT for a third episode of CDI (2). Kelly and colleagues randomly assigned patients with 3 or more recurrences of CDI to receive, via colonoscopy, either their own demonstrably dysbiotic stool or stool from a healthy donor. Although the ...References1. Kelly CR, Khoruts A, Staley C, Sadowsky MJ, Abd M, Alani M, et al. Effect of fecal microbiota transplantation on recurrence in multiply recurrent Clostridium difficile infection. A randomized trial. Ann Intern Med. 2016;165:609-16. doi:10.7326/M16-0271 LinkGoogle Scholar2. Surawicz CM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108:478-98. [PMID: 23439232] doi:10.1038/ajg.2013.4 CrossrefMedlineGoogle Scholar3. Cammarota G, Ianiro G, Gasbarrini A. Fecal microbiota transplantation for the treatment of Clostridium difficile infection: a systematic review. J Clin Gastroenterol. 2014;48:693-702. [PMID: 24440934] doi:10.1097/MCG.0000000000000046 CrossrefMedlineGoogle Scholar4. O'Brien CL, Allison GE, Grimpen F, Pavli P. Impact of colonoscopy bowel preparation on intestinal microbiota. PLoS One. 2013;8:e62815. [PMID: 23650530] doi:10.1371/journal.pone.0062815 CrossrefMedlineGoogle Scholar5. Donskey CJ, Kundrapu S, Deshpande A. Colonization versus carriage of Clostridium difficile. Infect Dis Clin North Am. 2015;29:13-28. [PMID: 25595843] doi:10.1016/j.idc.2014.11.001 CrossrefMedlineGoogle Scholar6. Alang N, Kelly CR. Weight gain after fecal microbiota transplantation. Open Forum Infect Dis. 2015;2:ofv004. [PMID: 26034755] doi:10.1093/ofid/ofv004 CrossrefMedlineGoogle Scholar7. Li SS, Zhu A, Benes V, Costea PI, Hercog R, Hildebrand F, et al. Durable coexistence of donor and recipient strains after fecal microbiota transplantation. Science. 2016;352:586-9. [PMID: 27126044] doi:10.1126/science.aad8852 CrossrefMedlineGoogle Scholar8. Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, et al. Gut microbiota from twins discordant for obesity modulate metabolism in mice. Science. 2013;341:1241214. [PMID: 24009397] doi:10.1126/science.1241214 CrossrefMedlineGoogle Scholar9. Youngster I, Russell GH, Pindar C, Ziv-Baran T, Sauk J, Hohmann EL. Oral, capsulized, frozen fecal microbiota transplantation for relapsing Clostridium difficile infection. JAMA. 2014;312:1772-8. [PMID: 25322359] doi:10.1001/jama.2014.13875 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Massachusetts General Hospital, Boston, Massachusetts.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1784.Corresponding Author: Elizabeth L. Hohmann, MD, Infectious Disease Division, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02115; e-mail, [email protected]org.This article was published at www.annals.org on 23 August 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCorrection: Are Microbial Politics Local?Effect of Fecal Microbiota Transplantation on Recurrence in Multiply Recurrent Clostridium difficile Infection Colleen R. Kelly , Alexander Khoruts , Christopher Staley , Michael J. Sadowsky , Mortadha Abd , Mustafa Alani , Brianna Bakow , Patrizia Curran , Joyce McKenney , Allison Tisch , Steven E. Reinert , Jason T. Machan , and Lawrence J. Brandt Metrics Cited byAssessment of Quality of Life Among Patients With Recurrent Clostridioides difficile Infection Treated with Investigational Oral Microbiome Therapeutic SER-109SER-109, an Investigational Microbiome Drug to Reduce Recurrence After Clostridioides difficile Infection: Lessons Learned From a Phase 2 TrialFecal microbiota transplantation (FMT) for C. difficile infection, just say ‘No’Correction: Are Microbial Politics Local? 1 November 2016Volume 165, Issue 9Page: 667-668KeywordsAntibioticsClostridium infectionsDisclosureFecal microbiota transplantIrritable bowel syndromeMicrobiomePolymerase chain reactionToxinsTransplantationVancomycin ePublished: 23 August 2016 Issue Published: 1 November 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...