Fecal Microbial Transplantation; Challenges In Health And Diseases: A Review

Fecal microbial transplantation (FMT) has gained mainstream attention with its remarkable efficacy in treating recurrent Clostridium difficile infection (RCDI). This includes other gastrointestinal diseases (inflammatory bowel disease [IBD], irritable bowel syndrome [IBS], and chronic constipation), neurological disorders (multiple sclerosis, Parkinson’s disease), and hematologic disease (idiopathic thrombocytopenic purpura). The first application of FMT in western medicine was published in 1958 by Ben Eisema and colleagues. Challenges such as donor selection, sample handling, predicting recipient compatibility to a given donor microbiome, and standardization of therapeutic FMT protocol still require total commitment and focused strategies to overcome. Another challenge of exposure to multidrug-resistant organisms (MDROs) as a result of FMT emerges just recently, which leads to the death of a 73-year-old man in June 2019. As such Food and Drug Agency (FDA) recommends donor screening questions specifically "address risk factors for colonization with MDROs, exclusion of individuals at higher risk of settlement with MDROs and MDRO testing of donor stool before transplant.