GUT MICROBIOTA

Balancing the risks and rewards of live biotherapeutics

Live biotherapeutics have been used clinically both as defined probiotics and as undefined faecal microbiota transplants. Two new studies illustrate the risks of administering live microorganisms to highly compromised patients. These risks should be considered in the context of the potential therapeutic value of these treatments.

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References

  1. 1.

    DeFilipp, Z. et al. Drug-resistant E. coli bacteremia transmitted by fecal microbiota transplant. N. Engl. J. Med. 381, 2043–2050 (2019).

  2. 2.

    Yelin, I. et al. Genomic and epidemiological evidence of bacterial transmission from probiotic capsule to blood in ICU patients. Nat. Med. 25, 1728–1732 (2019).

  3. 3.

    Hill, C. Virulence or niche factors: what’s in a name? J. Bacteriol. 194, 5725–5727 (2012).

  4. 4.

    U.S. Food & Drug Administration. Important safety alert regarding use of fecal microbiota for transplantation and risk of serious adverse reactions due to transmission of multi-drug resistant organisms. fda.gov https://www.fda.gov/vaccines-blood-biologics/safety-availability-biologics/important-safety-alert-regarding-use-fecal-microbiota-transplantation-and-risk-serious-adverse (2019).

  5. 5.

    Lai, C. Y. et al. Systematic review with meta-analysis: review of donor features, procedures and outcomes in 168 clinical studies of faecal microbiota transplantation. Aliment. Pharmacol. Ther. 49, 354–363 (2019).

  6. 6.

    Ott, S. J. et al. Efficacy of sterile fecal filtrate transfer for treating patients with Clostridium difficile infection. Gut 152, 799–811 (2017).

  7. 7.

    Dominguez-Bello, M. G. et al. Partial restoration of the microbiota of cesarean-born infants via vaginal microbial transfer. Nat. Med. 22, 250–253 (2016).

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Author information

Correspondence to Colin Hill.

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Competing interests

C.H. is a board member of the International Scientific Association of Probiotics and Prebiotics (ISAPP).

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Hill, C. Balancing the risks and rewards of live biotherapeutics. Nat Rev Gastroenterol Hepatol (2019). https://doi.org/10.1038/s41575-019-0254-3

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