Project 466388

Antimicrobial resistant organism are a growing global threat to health. As the number and abundance of antimicrobial resistant organisms increases, both common infections (such as urinary tract infections) and the most complex medical procedures (such as organ and bone marrow transplantation) become more risky and complicated. The human microbiome, the trillions of organisms that live on and in human hosts, normally provide protection from disease causing organisms and antimicrobial resistance. In some scenarios - such as after infection with Clostridioides difficile (a diarrhea-causing bacteria) or after antibiotic treatment, the normal microbiome is disrupted, allowing antimicrobial resistant organisms to flourish. The transfer of complex communities of healthy microbes can be accomplished through transplants of healthy donor stool ("Fecal Microbiota Transplants, or FMT), and this has been used to successfully treat recurrent Clostridioides difficile infection (rCDI). FMT is also a potential way to 'decolonize' or get rid of antimicrobial resistant organisms, and also to prevent infections. However, FMT has significant safety limitations and also is difficult to do at a large scale. Recently, alternatives to FMT that can be grown in a lab have been used to treat rCDI, including a 'microbial consortium' or mixture of live cultured bacterial called Microbial Ecosystem Therapeutic-2 (MET-2). Notably, recipients of MET-2 had very large decreases in the number of pathogenic bacteria and antimicrobial resistance genes in their stool microbiomes. In this trial, we will treat people with recent bacteremia that have received antibiotics, to see if we can safely and feasibly recruit people into a trial of MET-2 to see if we can decolonize them of antimicrobial resistant organisms, improve their microbiomes and prevent infection, with the ultimate goal of pursuing a definitive trial.