Assessing healthcare workers as potential stool donors for faecal microbiota transplantation: a cross-sectional study of antimicrobial-resistant gut bacteria and enteropathogenic microorganisms.

Background: Faecal Microbiota Transplantation (FMT) is a procedure designed to modulate the gut microbiome, but identifying reliable stool donors remains challenging. We conducted a study at Bellvitge University Hospital to assess the prevalence of enteropathogenic microorganisms (EPs) and antimicrobial-resistant (AMR) gut bacteria among healthcare workers (HCWs) and evaluate their potential as stool donors.

Methods: From November 2022 to April 2023, 106 HCWs were enrolled. Stool samples were tested for a range of EPs using real-time PCR and conventional methods, while AMR gut bacteria were screened using selective culture media. 16SrRNA sequencing was performed, and alpha-diversity was assessed using the Shannon index.

Findings: EPs were found in 48.1% of samples (51/106), with protozoa being the most prevalent (37.7%, 40/106), followed by bacteria (10.4%, 11/106) and viruses (4.7%, 5/106). Blastocystis hominis (33%, 35/106) and Dientamoeba fragilis (18.8%, 20/106) were the most common protozoa, while Enteropathogenic Escherichia coli was the most frequent bacterial pathogen (3.8%, 4/106). Extended spectrum β-lactamase-producing E. coli was found in 2.8% of samples (3/106). Carbapenemase-producing bacteria, vancomycin-resistant enterococci, methicillin-resistant Staphylococcus aureus or Clostridioides difficile were not present in any sample. HCWs with B. hominis had significantly higher Shannon alpha-diversity than those without (p < 0.01).

Conclusion: The prevalence of EPs and AMR gut bacteria among HCWs supports the inclusion of HCWs as potential stool donors for FMT, provided they meet health and screening criteria. This approach could help address the shortage of suitable stool donors for FMT programs.