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The Faculty of Medicine at The Chinese University of Hong Kong (CU Medicine) has been working to combat Clostridioides Difficile Infection (CDI) through extensive research on Faecal Microbiota Transplantation (FMT) since 2013. With CDI recurrence and mortality rates reaching 35% and 40%, respectively, worldwide, FMT has emerged as a valuable strategy, involving the transfer of healthy microbiota from screened donors to recipients’ colons. Despite some European and U.S. hospitals offering FMT, the procedure’s limited adoption and varying success rates of 40% to 80% highlight the need for standardised protocols in donor screening, stool storage, and safety profiles.
In response to these challenges, CU Medicine’s Microbiota I-Center (MagIC) developed MOZAICTM (Multi-kingdom OptimiZAtIon for microbiota Consortia) in 2020. This innovative technology, funded by the Hong Kong government’s InnoHK initiative, significantly enhances FMT outcomes, achieving a success rate exceeding 90% in patients with recurrent CDI. Moreover, patients’ median survival doubled from 2.1 to 4.7 years, marking a substantial leap forward in treating this persistent infection.
MOZAICTM, a patented technology, uses a novel analytical platform driven by machine learning analysis. Drawing on over 800 FMT datasets and more than 2000 metagenomic sequenced samples, it dissects the intricate network of multi-kingdom microbiota, their genes, and functions. This comprehensive understanding facilitates personalised donor selection and donor-recipient matching, leading to superior FMT outcomes and improved long-term safety.
CU Medicine’s microbiota stool bank aligns with the standards set by the UK Birmingham FMT Centre, the first Medicines and Healthcare Products Regulatory Agency (MHRA) licensed facility in the UK. This alignment ensures that CU Medicine’s FMT service adheres to rigorous quality and safety measures, contributing to its success in treating patients.
Despite the success of FMT and MOZAICTM, the incidence of CDI in Hong Kong has surged over three times, from approximately 15 cases per 100,000 adults in 2006 to 54 cases in 2019. In 2022, around 3,600 patients in Hong Kong suffered from CDI. Those at high risk include the elderly, individuals with chronic diseases or inflammatory bowel disease and frequent antibiotic users.
The Chairperson of the Department of Microbiology at CU Medicine stressed the urgent need for effective management, as not all CDI patients respond to antibiotics, and recurrence is common. The rise in CDI cases poses not only immediate risks but also the potential for larger-scale infection.
MOZAICTM has played a pivotal role in addressing these challenges. The Croucher Professor of Medical Sciences and Director of MagIC likened the human gut to a forest ecosystem, damaged by pathogenic bacteria like Clostridioides Difficile. Since 2020, MOZAICTM has achieved a cure rate of over 90%, outperforming conventional antibiotics. The technology has demonstrated associations with improved survival, reduced hospital stay, and lower medical costs.
The success of MOZAICTM has prompted a collaboration between CU Medicine and the Hong Kong Hospital Authority (HA) to provide a territory-wide FMT service in public hospitals. HA’s FMT Service Coordinator and Associate Consultant in the Department of Medicine and Therapeutics at the Prince of Wales Hospital anticipates substantial benefits for the public healthcare system, allowing for more efficient resource utilisation in the face of the growing CDI cases in Hong Kong.
This partnership exemplifies the successful translation of innovation into clinical application, highlighting the potential of gut microbiota in curing diseases and saving lives. The Dean and Co-Director of MagIC envisions establishing Hong Kong as a leading microbiome innovation and technology hub in the Asia Pacific region. The collaboration with industry partners aims to extend the application of MOZAICTM to the Greater Bay Area, benefiting over 80 million residents in the region.
The Chairman of the Hospital Authority lauded the breakthrough application of FMT technology in treating CDI patients, expressing optimism about the positive impact on future treatments. The Secretary for Innovation, Technology, and Industry in the Hong Kong government emphasised the InnoHK initiative’s role in elevating Hong Kong into a global innovation powerhouse. The collaboration between CU Medicine and HA reflects the commitment to delivering high-quality research and practical applications for the betterment of humanity and society.
