Metatranscriptome analysis of fecal microbiota transplantation in chronic antibiotic resistant pouchitis

Ileal pouch-anal anastomosis (IPAA) is the standard of care after total proctocolectomy for ulcerative colitis (UC). Around 50% of patients will experience pouchitis, an idiopathic inflammatory condition, with symptoms such as increased bowel movements, fever, bloody stool, and abdominal pain. Antibiotics are the backbone of treatment of pouchitis, however antibiotic resistant pouchitis develops in 5-10% of those patients. It has been shown that fecal microbiota transplantation (FMT) is an effective treatment for UC, but results for FMT antibiotic-resistant pouchitis are inconsistent. To find out which metabolic functions are provided to the recipients during FMT treatment we analyzed the stool metatranscriptomes of the patients and their donors. Three patients were treated by two to three FMTs and stool samples were analyzed for up to 140 days.