# Temporal dynamics of MDRO eradication after FMT

> **NIH NIH K23** · EMORY UNIVERSITY · 2020 · $191,484

## Abstract

PROJECT SUMMARY
The World Health Organization and U.S. Centers for Disease Control and Prevention have designated
antimicrobial resistance a major threat to Global Health with over 23,000 annual deaths related to antimicrobial
resistant infections in the U.S. alone. However, the drug pipeline to develop new antibiotics is dry. Small
studies support the safety and efficacy of fecal microbiota transplantation (FMT) to eliminate intestinal
colonization with antibacterial resistant organisms but its mechanisms are not well understood. We will
leverage patient-linked samples from a clinical trial PREMIX (NCT02922816) to test our overarching
hypothesis that anaerobic bacteria, viruses, and their gene-predicted functions are causally associated with
decreased MDRO colonization after FMT. The Specific Aims of this proposal include: Aim 1: Use the clinical
gold standard of bacterial culture to estimate efficacy of FMT in MDRO eradication. Aim 2A: Establish a novel
metagenomic analytic pipeline (MAP) to quantify abundance of bacterial and viral taxa, AR, virulence, and
colonization resistance genes. Aim 2B: Use 16S rRNA sequencing to estimate temporal dynamics of difficult to
culture bacterial taxa in FMT vs controls. Aim 2C: Use metagenomic whole-genome sequencing and the MAP
to estimate temporal dynamics of AR, virulence, and colonization resistance genes in FMT vs controls. Aim 3:
Use environmental virome NGS techniques to test the association of viral (including bacteriophage) taxa with
abundance of MDRO after FMT. We expect that completion of these aims and related training will lead to
clinically applicable preliminary data and next steps in translational microbial therapeutic development for
MDRO colonization. My long-term career goal is to become a collaborative leader in ID microbiome data
science focusing on: 1) mechanisms of microbial therapeutics such as FMT in reducing colonization with multi-
drug resistant organisms (MDRO), and 2) translating these findings into clinical and public health interventions
to reduce MDRO colonization and infection. Emory and Georgia Tech are ideal and highly-collaborative
research environments, which are both national leaders in biomedical research. Both institutions provide rich
resources to complete the described aims and progress in career development to become an independent
translational ID microbiome data scientist. In addition, Emory is an active site of microbial therapeutic
investigation with 7 clinical trials of microbial therapeutics and a clinical FMT program that has completed over
300 treatments for refractory Clostridioides difficile.

## Key facts

- **NIH application ID:** 9856415
- **Project number:** 5K23AI144036-02
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Michael Holmes Woodworth
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $191,484
- **Award type:** 5
- **Project period:** 2019-04-01 → 2024-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9856415

## Citation

> US National Institutes of Health, RePORTER application 9856415, Temporal dynamics of MDRO eradication after FMT (5K23AI144036-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/9856415. Licensed CC0.

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