Laboratory handling practice for faecal microbiota transplantation

• Published in: Journal of applied microbiology Vol. 128; no. 3; pp. 893 - 898
• Main Authors: Quaranta, G., Fancello, G., Ianiro, G., Graffeo, R., Gasbarrini, A., Cammarota, G., Sanguinetti, M., Masucci, L.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.03.2020
• Subjects: Anaerobes; Anaerobic microorganisms; assay comparison; Bacterial Load; Biological Specimen Banks - standards; Clostridium difficile infection; Defrosting; Donors; Emulsions; faecal microbiota transplantation; Fecal Microbiota Transplantation; feces; Feces - microbiology; Gastrointestinal Microbiome; Gastrointestinal system; Gastrointestinal tract; guidelines; gut flora; Humans; Intestinal microflora; intestinal microorganisms; Laboratories; Laboratories - standards; laboratory work‐flow; magnetic materials; microbial load; Microbiota; Microorganisms; plate count; Specimen Handling - methods; Thawing; Transplantation; Workflow; faecal microbiota transplantation; laboratory work-flow; assay comparison; Clostridium difficile infection; gut flora
• ISSN: 1364-5072; 1365-2672; 1365-2672
• DOI: 10.1111/jam.14522

Aims Faecal microbiota transplantation (FMT) consists of the infusion of faeces from a healthy donor to the gastrointestinal tract of a recipient patient to treat disease associated with alterations in gut microbiota. The objective of this article was to describe laboratory workflow of an FMT laboratory to provide tips for preparing the faecal suspensions to be infused. Methods and Results Twenty‐stool solutions obtained from ten donors were prepared using two different protocols: magnet plate emulsion (MPE) and Seward StomacherTM Emulsion (SSE). We evaluated parameters such as preparation time, handiness, and aerobic and anaerobic microbial count. For three donors, we monitored bacterial counts after defrosting at different time‐points. MPE requires more time than SSE. In terms of microbial load, both methods showed similar values, with small and statistically differences (P ≤ 0·05) regarding anaerobes in favour of SSE. Frozen aliquots showed the same bacterial load values after defrosting. Conclusion Although both methods allow an easy and available preparation of a stool suspension, SSE seems more suitable, particularly for stool banking. Aerobic and anaerobic species are preserved with both protocols; and safety for laboratory operators is guaranteed. Significance and Impact of the Study In recent years, FMT has become a fascinating and interesting subject. Nevertheless, there are no real guidelines describing laboratory facilities and procedures. This paper aims to be a useful and simple guide to increase the number FMT centres as much possible.