The mechanism of action of stool transplantation has not been
established. However, patients with recurrent C. difficile infection
have been found to have decreased diversity in their stool microbiome
[25,26]. Ordinarily, C. difficile growth is inhibited by a normal
stool microbiome, but a depleted microbiome is thought to provide
an opportunity for C. difficile overgrowth. By repopulating the
gastrointestinal tract with a healthy microbiome, stool transplantation
appears to reestablish resistance to C. difficile growth,
often called colonization resistance [16]. To confirm the association
between stool transplantation and microbiome diversity, future
studies should examine the microbiome of patients with RCDI
before and after transplantation. Interestingly, we as well as others
[22] noted that patients who experience a relapse of CDI following
FMT have a high likelihood of responding to a standard treatment
course of vancomycin, which may be explained by a partial reestablishment
of a healthy stool microbiome diversity afforded by the
prior stool transplantation.
The mechanism of action of stool transplantation has not beenestablished. However, patients with recurrent C. difficile infectionhave been found to have decreased diversity in their stool microbiome[25,26]. Ordinarily, C. difficile growth is inhibited by a normalstool microbiome, but a depleted microbiome is thought to providean opportunity for C. difficile overgrowth. By repopulating thegastrointestinal tract with a healthy microbiome, stool transplantationappears to reestablish resistance to C. difficile growth,often called colonization resistance [16]. To confirm the associationbetween stool transplantation and microbiome diversity, futurestudies should examine the microbiome of patients with RCDIbefore and after transplantation. Interestingly, we as well as others[22] noted that patients who experience a relapse of CDI followingFMT have a high likelihood of responding to a standard treatmentcourse of vancomycin, which may be explained by a partial reestablishmentof a healthy stool microbiome diversity afforded by theprior stool transplantation.
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