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Guidelines for feces donor screening differ in their advice to screen for <jats:italic>Blastocystis<\/jats:italic> spp., but when tested, its presence is a common reason for exclusion. <jats:italic>Blastocystis<\/jats:italic> spp. are correlated to increased bacterial alpha-diversity and distinct bacterial groups and therefore its presence may indicate favorable efficacy of fecal microbiota transplantation (FMT). The latest European consensus report no longer advices rejecting feces donors testing positive for <jats:italic>Blastocystis<\/jats:italic> spp. Only one paper has been published on human transmission of <jats:italic>Blastocysti<\/jats:italic>s spp. via frozen FMT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>To investigate the transmission and long-term effects of <jats:italic>Blastocystis<\/jats:italic>-positive FMT, prepared with fresh (i.e., unfrozen) feces.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>In a trial (NCT03074227) on FMT for refractory Irritable Bowel Syndrome (IBS), adolescents (age 16\u201320 years) received two administrations - at baseline and after 6 weeks - of fresh allogeneic FMT from a <jats:italic>Blastocystis<\/jats:italic>-positive donor via nasoduodenal tube. The follow-up was 48 weeks. <jats:italic>Blastocystis<\/jats:italic> spp. presence, viability and subtyping were determined using microscopy, culture, PCR and sequencing.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Three recipients received FMT from one donor colonized with <jats:italic>Blastocystis<\/jats:italic> subtype 3 (ST3). At baseline, two recipients were negative for <jats:italic>Blastocysti<\/jats:italic>s spp. and one recipient carried ST2. Culturing revealed viable <jats:italic>Blastocystis<\/jats:italic> spp. in fresh donor feces but not in frozen samples. After FMT with fresh feces, the two prior-negative recipients tested positive for the donor\u2019s ST3 at 12 weeks, but had lost this subtype by week 24 and 48. The recipient initially colonized with ST2 remained colonized with ST2 and did not acquire ST3. Transient adverse events occurred, but did not differ from patients treated with <jats:italic>Blastocystis<\/jats:italic>-negative FMT. No FMT-related serious adverse events emerged.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>We present the first long-term data on viable <jats:italic>Blastocystis<\/jats:italic> spp. transmission via fresh FMT in three cases. Transient colonization with <jats:italic>Blastocystis<\/jats:italic> spp. was observed, without serious FMT-related adverse events.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s10096-025-05124-6","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T08:31:01Z","timestamp":1745224261000},"page":"1621-1627","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Transient colonization with Blastocystis spp. after transmission via fecal microbiota transplantation"],"prefix":"10.1007","volume":"44","author":[{"given":"M. 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