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**MTC01** is an investigational, defined live biotherapeutic product composed of 15 obligate anaerobic bacterial strains isolated from a single healthy fecal microbiota transplant donor. It is being developed by Icahn School of Medicine at Mount Sinai as a standardized, in-vitro-manufactured alternative to donor-derived fecal microbiota transplantation for recurrent *Clostridioides difficile* infection. The product is intended to restore protective gut microbial functions through durable strain engraftment and microbiome ecological replacement. In a randomized phase 1b study, an endoscopically delivered MTC01 dose prevented recurrent infection at 8 weeks in 7 of 9 treated participants, with no treatment-related adverse events reported. ([preview-www.nature.com](https://preview-www.nature.com/articles/s41591-026-04442-2.pdf))
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