IDDF2019-ABS-0157 Fecal microbiota transplantations reconstitute gut fungal and viral microbiota in graft-versus-host disease

摘要: Background Fecal microbiota transplant (FMT) has emerged as a potential treatment for severe colitis associated with graft-versus-host disease (GvHD) following hematopoietic stem cell transplant. Bacteria engraftment been reported, however, the fate of fungi and viruses their relationship response after FMT remains unclear. Here we report first time longitudinal dynamics gut mycobiome virome in teenager GvHD successfully treated multiple FMTs. Methods A 14-year-old boy life-threatening grade-4 aGVHD, refractory to corticosteroids biologic therapies, were total four FMTs conducted by duodenojejunal infusion from two different donors. samples collected at baseline up 120 days FMT. Combined DNA extraction fecal bacteria was performed, followed ultra-deep metagenomics sequencing profiling bacteriome fungome. virus-like particles enriched feces on VLP well virome. Clinical phenotype outcome assessed correlated microbial profiles. Results altered bacterial, fungal viral communities simultaneously patient, resulted recovery patient. Bacterial diversity gradually restored each FMT, donor-derived occurred instantly single persisted 4 months, whilst improved but composition varied substantially over time. Moreover, reduced an overrepresented fungus Fusarium oxysporum (61.4% day 0 vs 0.5% 120) virus Torque teno (98.8% patient parallel substantial increase abundance Caudovirales bacteriophages. In addition, Serial enhanced ecological network bacteria-fungi interactions recipient significant these inter-kingdom correlations Conclusions We show that respond differently addition bacteria, future practice should account significance reconstituting viruses.