PMID- 33910622 OWN - NLM STAT- MEDLINE DCOM- 20211122 LR - 20211122 IS - 2047-783X (Electronic) IS - 0949-2321 (Print) IS - 0949-2321 (Linking) VI - 26 IP - 1 DP - 2021 Apr 28 TI - Tandem fecal microbiota transplantation cycles in an allogeneic hematopoietic stem cell transplant recipient targeting carbapenem-resistant Enterobacteriaceae colonization: a case report and literature review. PG - 37 LID - 10.1186/s40001-021-00508-8 [doi] LID - 37 AB - BACKGROUND: Due to limited antibiotic options, carbapenem-resistant Enterobacteriaceae (CRE) infections are associated with high non-relapse mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Also, intestinal CRE colonization is a risk factor for subsequent CRE infection. Several clinical studies have reported successful fecal microbiota transplantation (FMT) for the gut decontamination of a variety of multidrug-resistant bacteria (MDRB), even in immunosuppressed patients. Similarly, other studies have also indicated that multiple FMTs may increase or lead to successful therapeutic outcomes. CASE PRESENTATION: We report CRE colonization in an allo-HSCT patient with recurrent CRE infections, and its successful eradication using tandem FMT cycles at 488 days after allo-HSCT. We also performed a comprehensive microbiota analysis. No acute or delayed adverse events (AEs) were observed. The patient remained clinically stable with CRE-negative stool culture at 26-month follow-up. Our analyses also showed some gut microbiota reconstruction. We also reviewed the current literature on decolonization strategies for CRE. CONCLUSIONS: CRE colonization led to a high no-relapse mortality after allo-HSCT; however, well-established decolonization strategies are currently lacking. The successful decolonization of this patient suggests that multiple FMT cycles may be potential options for CRE decolonization. FAU - Su, Fengqin AU - Su F AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Luo, Yi AU - Luo Y AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Yu, Jian AU - Yu J AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Shi, Jimin AU - Shi J AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Zhao, Yanmin AU - Zhao Y AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Yan, Mengni AU - Yan M AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Huang, He AU - Huang H AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. AD - Institute of Hematology, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. FAU - Tan, Yamin AU - Tan Y AUID- ORCID: 0000-0002-6742-3636 AD - Bone Marrow Transplantation Center, The First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou, 310003, China. yamin0001@126.com. AD - Hematology Department, The Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, 1 Banshan East Road, Hangzhou, 310022, Zhejiang, China. yamin0001@126.com. LA - eng GR - 81670169/National Natural Science Foundation of China/ GR - 2010KYA075/the Medical Science and Technology Project of Zhejiang Province/ PT - Case Reports PT - Journal Article DEP - 20210428 PL - England TA - Eur J Med Res JT - European journal of medical research JID - 9517857 RN - 0 (Anti-Bacterial Agents) SB - IM MH - Anti-Bacterial Agents/pharmacology MH - Carbapenem-Resistant Enterobacteriaceae/*isolation & purification MH - *Drug Resistance, Multiple, Bacterial MH - Enterobacteriaceae Infections/microbiology/*therapy MH - Fecal Microbiota Transplantation/*methods MH - *Gastrointestinal Microbiome MH - Hematopoietic Stem Cell Transplantation/*adverse effects MH - Humans MH - Leukemia, Myeloid, Acute/microbiology/pathology/*therapy MH - Male MH - Middle Aged MH - Transplantation, Homologous PMC - PMC8080403 OTO - NOTNLM OT - Carbapenem-resistant Enterobacteriaceae colonization OT - Fecal microbiota transplantation OT - Gut microbiota OT - Hematopoietic stem cell transplantation OT - Multidrug-resistant bacteria COIS- The authors declare that they have no competing interests. EDAT- 2021/04/30 06:00 MHDA- 2021/11/23 06:00 PMCR- 2021/04/28 CRDT- 2021/04/29 05:37 PHST- 2020/12/16 00:00 [received] PHST- 2021/04/13 00:00 [accepted] PHST- 2021/04/29 05:37 [entrez] PHST- 2021/04/30 06:00 [pubmed] PHST- 2021/11/23 06:00 [medline] PHST- 2021/04/28 00:00 [pmc-release] AID - 10.1186/s40001-021-00508-8 [pii] AID - 508 [pii] AID - 10.1186/s40001-021-00508-8 [doi] PST - epublish SO - Eur J Med Res. 2021 Apr 28;26(1):37. doi: 10.1186/s40001-021-00508-8.