Transmission of antibiotic-susceptible Escherichia coli causing urinary tract infections in a fecal microbiota transplantation recipient: consequences for donor screening?

Vendrik, K.E.W.; Meij, T.G.J. de; Bokenkamp, A.; Ooijevaar, R.E.; Groenewegen, B.; Hendrickx, A.P.A.; ... ; Prehn, J. van (2022)

Article / Letter to editor

Fecal microbiota transplantation (FMT) has been reported to decrease the incidence of recurrent urinary tract infections (UTIs), presumably by restoring microbiome diversity and/or uropathogen competition. We report a 16-year-old female with recurrent UTIs caused by multidrug-resistant Klebsiella pneumoniae, for which frequent intravenous broad-spectrum antibiotic treatment was necessary. The patient was treated with FMT from a well-screened healthy donor without multidrug-resistant bacteria in the feces. After FMT, she developed several UTIs with an antibiotic-susceptible Escherichia coli that could be treated orally. The uropathogenic E. coli could be cultured from donor feces, and whole genome sequencing confirmed donor-to-recipient transmission. Our observation should stimulate discussion on long-term follow-up of all infections after FMT and donor fecal screening for antibiotic-susceptible Enterobacterales.

• fecal microbiota transplantation
• FMT
• MDRO
• ESBL
• uropathogen
• urinary tract infection.

• All authors: Vendrik, K.E.W.; Meij, T.G.J. de; Bokenkamp, A.; Ooijevaar, R.E.; Groenewegen, B.; Hendrickx, A.P.A.; Terveer, E.M.; Kuijper, E.J.; Prehn, J. van
• Date: 2022-07-01
• Journal: Open Forum Infectious Diseases
• Volume: 9
• Issue: 7
• DOI: doi:10.1093/ofid/ofac324
• Link: https://academic.oup.com/ofid/article/9/7/ofac324/6619633