Impact of Fecal Microbiota Transplant Formulations, Storage Conditions, and Duration on Bacterial Viability, Functionality, and Clinical Outcomes in Patients with Recurrent <em>Clostridioides difficile </em>Infection

• DOI: 10.20944/preprints202502.0515.v1
• Publication Date: 2025-02-10T01:41:41Z
• Authors: Mohamed Shaheen; Chelsea McDougall; Leona Chan; Rose Franz; Karen Wong; Ryland T. Gielbel...; Gwen Nguyen; Seo Lin Nam; A. Paulina de la ...; Sam Yeo; James J Harynuk; Sepideh Pakpour; Huiping Xu; Dina Kao
• Keywords: Clostridioides

Fecal microbiota transplantation (FMT) is the most effective therapy for preventing recurrent Clostridioides difficile infection (rCDI). However, impact of FMT formulations and storage conditions on bacterial viability, community structure, functionality, clinical efficacy remains under-investigated. We studied effect different viability (live/dead staining cell sorting), structure (16S rDNA analysis), metabolic functionality (fermentation) frozen lyophilized formulations. Clinical success rates rCDI patients were correlated retrospectively with formulations, durations, host factors using Edmonton program database. Bacterial remained at 10%–20% across various was comparable to that fresh FMT. Live dead fractions in both preparations exhibited distinct structures. Storage but not temperatures, negatively affected diversity. More short chain fatty acids found metabolomic profiling vitro fermentation products than 537 receiving a single dose significantly among three longer durations advanced recipient age impacted efficacy. Together, our findings suggest should be considered when establishing guidelines product shelf life optimal treatment outcomes.