Abstract
Fecal microbiota transplantation (FMT) is a very effective treatment for recurrent
Clostridium difficile infection (CDI) in adults. However, there is a paucity of data on FMT in children
and associated microbiome changes in this particular group. We describe a child with
Down's syndrome and intracranial malignancy, who received FMT for recurrent CDI. Detailed
microbiota analysis before and after FMT, and pre- and post-recurrence, linked to
microbial communities in the donor feces showed that the patient developed a unique
microbiota profile after FMT which was very stable over time despite CDI recurrence
and subsequent fidaxomicin therapy. Bacteroidetes were stably acquired from donor feces, while Firmicutes, Actinobacteria, Fusobacteria, Verrucomicrobia, and Proteobacteria were unique to the patient. The diversity of microbiota of the patient increased
from a Shannon diversity index of 2.08 pre-FMT to 3.12 post-FMT. Our findings underscore
that patients with Down's syndrome may well tolerate and benefit from FMT even in
a severely immunocompromised state.
Keywords
fecal microbiota transplantation -
Clostridium difficile infection - Down's syndrome - microbiota analysis - child
