Effects of fecal microbiota transplantation on clinical outcomes and fecal microbiota of foals with diarrhea.

Abstract

BACKGROUND: Diarrhea in foals can be associated with disruption of the intestinal microbiota (dysbiosis). Effective management of intestinal dysbiosis in foals has not been demonstrated. HYPOTHESIS/OBJECTIVES: Fecal microbiota transplantation (FMT) in foals with diarrhea influences the intestinal microbiota and improves clinical and clinicopathological outcomes. ANIMALS: Twenty-five foals <6&#x2009;months of age with diarrhea and systemic inflammatory response syndrome at 3 veterinary hospitals. METHODS: A prospective randomized placebo-controlled cohort study. Foals in the FMT group (n&#x2009;=&#x2009;19) or control group (n&#x2009;=&#x2009;9) received FMT or electrolyte solution once daily for 3&#x2009;days. Fecal samples were obtained on Day 0 (D0), D1, D2, D3, and D7. Within group and between group data analyses were performed for clinical, clinicopathological, and microbiota variables. RESULTS: Treatment had no effect on survival (FMT 79%; control 100%, P&#x2009;=&#x2009;.3) or resolution of diarrhea (FMT 68%; control 55%, P&#x2009;=&#x2009;.4). On D3, the white blood cell count of the FMT group was lower than the control group (D3 FMT group median 6.4&#x2009;g/L [5-8.3&#x2009;g/L]; D3 control group median 14.3&#x2009;g/L [6.7-18.9&#x2009;g/L] P&#x2009;=&#x2009;.04). Heart rate reduced over time in the FMT group (D0 median 80&#x2009;bpm [60-150&#x2009;bpm]; D2 median 70&#x2009;bpm [52-110&#x2009;bpm] [P&#x2009;=&#x2009;.005]; and D3 median 64, [54-102&#x2009;bpm] [P&#x2009;<&#x2009;.001]). Phylum Verrucomicrobiota, genus Akkermansia, and family Prevotellaceae were enriched in the FMT group on D1 (linear discriminate analysis&#x2009;>&#x2009;4). CONCLUSIONS AND CLINICAL IMPORTANCE: In foals with diarrhea, FMT appears safe and can be associated with some clinical and microbiota changes suggestive of beneficial effect.