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Front. Microbiol. | doi: 10.3389/fmicb.2019.01704

GUT MICROBIOTA MODULATION FOR MULTIDRUG-RESISTANT ORGANISM DECOLONIZATION: PRESENT AND FUTURE PERSPECTIVES

  • 1Division of Immunology and Infectious Diseases, University-Hospital Pediatric Department, Bambino Gesù Children Hospital (IRCCS), Italy
  • 2Human Microbiome Unit, Bambino Gesù Children's Hospital (IRCCS), Italy
  • 3Department of Laboratories, Parasitology and Human Microbiome Units, Bambino Gesù Children Hospital (IRCCS), Italy

The emergence of antimicrobial resistance (AMR) is of great concern to global public health. Treatment of multi-drug resistant (MDR) infections is a major clinical challenge: the increase in antibiotic resistance leads to a greater risk of therapeutic failure, relapses, longer hospitalizations, and worse clinical outcomes. Currently, there are no validated treatments for many MDR or pandrug-resistant (PDR) infections, and preventing the spread of these pathogens through hospital infection control procedures and antimicrobial stewardship programs is often the only tool available to healthcare providers. Therefore, new solutions to control the colonization of MDR pathogens are urgently needed. In this narrative review, we discuss current knowledge of microbiota-mediated mechanisms of AMR and strategies for MDR colonizzation control. We focus particularly on fecal microbiota transplantation (FMT) for MDR intestinal decolonization and report updated literature on its current clinical use.

Keywords: Antimicrobial resistance (AMR), Antimicrobial stewardship (AMS), Antimicrobial stewardship program (ASP), Microbiota profiling, Fecal microbiota transplant (FMT), Multidrug resistance (MDR) bacteria, microbiota modulation strategies

Received: 01 Apr 2019; Accepted: 10 Jul 2019.

Edited by:

Peter Mullany, University College London, United Kingdom

Reviewed by:

Markus M. Heimesaat, Charité Medical University of Berlin, Germany
Srishti Saha, Mayo Clinic, United States  

Copyright: © 2019 Gargiullo, Del Chierico, D'Argenio and Putignani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Lorenza Putignani, Department of Laboratories, Parasitology and Human Microbiome Units, Bambino Gesù Children Hospital (IRCCS), Rome, Italy, lorenza.putignani@opbg.net