Evaluating long-term stool preservation methods for maximizing the recovery of viable human fecal microbiota

The gut microbiome plays a fundamental role in human health, prompting efforts to catalogue and preserve its diversity across human populations. While DNA sequencing dominates microbiome research, cultivation remains essential for mechanistic studies and therapeutic development. Yet, best practices for long-term stool preservation remain limited. Here, we compared the stability of eight cryopreservation treatments for maintaining viable stool microbiota over a 1-year storage period at -80°C (freezer) or at -196°C (liquid nitrogen), using samples from infants, children, and adults. Combining cultivation on six media with 16S rRNA sequencing, we show that ultralow temperature cryopreservation has minimal impact on microbiota diversity compared to fresh cultures. Standard glycerol preservation and simple snap-freezing performed comparably to more complex and costly protocols, with all cultured samples retaining donor-specific microbiota profiles also after long-term cryopreservation. The lack of strong treatment-specific effects on microbiota composition suggest a shared microbial response to freeze-thaw stress favoring fast-growing taxa. Our findings offer practical, low-cost strategies for stool biobanking.