Impact of Fecal Microbiota Transplantation for Decolonization of Multidrug-Resistant Organisms May Vary According to Donor Microbiota

To the Editor—We have read with great interest the report published by Leung et al. The authors should be congratulated for their findings regarding the impact of fecal microbiota transplantation (FMT) on antimicrobial resistance gene carriage after Clostridium difficile infection (CDI) [1]. Nevertheless, we should be careful about data presented in only 8 patients with CDI, because they harbor a dysbiotic microbiome that may respond differently than that of other patients to FMT. Leung et al showed that 95 antimicrobial resistance genes have been removed from FMT recipients, which encourages human research in the area of FMT to ensure decolonization of gut colonized with multidrug-resistant organisms (MDROs) when all antibiotics are compromised [2, 3]. This is particularly interesting considering that previous data showed discrepancies depending on the microorganism involved in colonization, especially in cases of vancomycin-resistant enterococci (VRE) vs multidrug-resistant Enterobacteriaceae, including carbapenem-resistant Enterobacteriaceae (CRE) [4].