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P699. Temporal bacterial community dynamics vary among ulcerative colitis patients after faecal microbiota transplantation

S. Angelberger1, W. Reinisch1, A. Makristathis2, C. Lichtenberger1, C. Dejaco1, P. Papay1, G. Novacek1, M. Trauner1, A. Loy3, D. Berry3, 1Medical University of Vienna, Internal Medicine III, Vienna, Austria, 2Medical University of Vienna, Clinical Microbiology, Vienna, Austria, 3University of Vienna, Faculty of Life Science, Microbial Ecology, Vienna, Austria

Background

Faecal microbiota transplantation (FMT) from healthy donors, which is an effective alternative for treatment of Clostridium difficile-associated disease, is being considered for several disorders such as inflammatory bowel disease, irritable bowel syndrome and metabolic syndrome. Disease remission upon FMT is thought to be facilitated by an efficient colonization of healthy donor microbiota, but knowledge of the composition and temporal stability of patient microbiota after FMT is lacking.

Methods

Five patients with moderately to severely active ulcerative colitis (Mayo score ≥6) and refractory to standard therapy received FMT via nasojejunal tube and enema. In addition to clinical activity and adverse events, the patients' faecal bacterial communities were monitored at multiple time points for up to 12 weeks using 16S rRNA gene-targeted pyrosequencing.

Results

FMT elicited fever and a temporary increase of C-reactive protein. Abundant bacteria from donors established in recipients but the efficiency and stability of donor microbiota colonization varied greatly. A positive clinical response was observed after 12 weeks in one patient whose microbiota had been effectively augmented by FMT. This augmentation was marked by successive colonization of donor-derived phylotypes including the anti-inflammatory and/or short-chain fatty acids-producing Faecalibacterium prausnitzii, Rosebura faecis, and Bacteroides ovatus. Disease severity (as measured by Mayo Score) was associated with an over-representation of Enterobacteriaceae and an under-representation of Lachnospiraceae.

Conclusion

This study highlights the value of characterizing temporally resolved microbiota dynamics for a better understanding of FMT efficacy and provides potentially-useful diagnostic indicators for monitoring FMT success in the treatment of ulcerative colitis.