Not just passengers: Phages as agents of genetic exchange in fecal microbiota transplantation
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Date
2026-04-15
Authors
Gonzalez Pastor, Belén
Shkoporov, Andrey
Hill, Colin
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Abstract
Fecal microbiota transplantation (FMT) is an effective therapy for recurrent Clostridioides difficile infection and is increasingly being explored for other microbiota-associated diseases. However, general research has largely focused on bacterial engraftment, overlooking the contribution of the gut virome. In this perspective, we highlight phage-mediated horizontal gene transfer (HGT) as a potentially influential process occurring following FMT. Donor-derived phages may potentially influence community structure, engraft in resident bacteria, and modulate microbial functions or host physiology. In addition, temperate phages are well-equipped to mobilize bacterial genes, such as metabolic functions, stress-response traits, and antibiotic resistance determinants, raising the possibility that gene flow could well contribute to FMT outcomes. We propose a conceptual model in which phages act as bidirectional mediators of adaptation, not only accompanying bacterial communities but also influencing gut ecosystems in subtle, yet potentially consequential, ways. © 2026 The Authors.
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© 2026 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords
Bacteriophage , FMT , HGT , Microbiome , Virome , [Microbiology]
Citation
Gonzalez Pastor, B, Shkoporov, A & Hill, C 2026, 'Not just passengers: Phages as agents of genetic exchange in fecal microbiota transplantation', Cell Host and Microbe, vol. 34, no. 5, pp. 780-789. https://doi.org/10.1016/j.chom.2026.03.017
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