Evaluation of the efficacy of inactivated fecal transplants against Clostridioides difficile: an in vitro study
Year: 2026
Type: article
Abstract: Fecal microbiota transplantation (FMT) requires rigorous donor screening, limiting donor eligibility and increasing costs. Recent evidence suggests that bacterial viability may not be essential for treating recurrent Clostridioides difficile infections. This study aimed to evaluate whether inactivated fecal preparations retain anti-C. difficile (CD) activity in vitro. Stool samples from three donors underwent eight different inactivation protocols, including mechanical, thermal, and chemical treatments. Bacterial viability and anti-CD activity were assessed by culture and inhibition assays. Mechanical filtration, pasteurisation, and sterilisation eliminated bacterial growth, while tyndallisation and ethanol treatments only partially reduced viability. Inhibition of CD growth was observed exclusively in samples containing live bacteria, with no significant difference compared to native stool. Inactivated samples, despite potentially retaining other microbiota-derived components, showed no anti-CD activity. These results suggest that live bacteria are essential for in vitro antagonism of C. difficile and thus in the therapeutic effects of FMT.
Authors: Vinciane Baillieu, Johanne Delannoy, Nathalie Kapel, Frédéric Barbut, Alexis Mosca, Anne Christine Joly, Anne-Judith Waligora-Dupriet, Rachel Sintes
Institutions: Inserm, Université Paris Cité, Sorbonne Université, Assistance Publique – Hôpitaux de Paris, Hôpital Saint-Antoine, Fédération Hospitalo-Universitaire, Paris Center for Microbiome Medicine, Physiopathologie et pharmacotoxicologie placentaire humaine : Microbiote pré & post natal, Pitié-Salpêtrière Hospital, Centre de Recherche Saint-Antoine, Centre National de la Recherche Scientifique, Hôpital Robert-Debré, Centre de Recherche sur l'Inflammation
Language: English
Subfield: Infectious Diseases
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,090
OpenAlex ID: W7125913933
