the first safety alert, issued in june 2019, described the transmission of a multidrug resistant organism from a donor stool that resulted in the death of one person. the second safety alert, issued in march 2020, was regarding fmt produced from improperly tested donor stools from a stool bank which resulted in several people hospitalizations and two deaths. a safety alert in late march 2020, was due to concerns of transmission of covid-19 in donor stool. in november 2022, the fda approved a specific c. difficile fecal microbiota treatment under the brand name rebyota, administered rectally. in april 2023, the agency approved a live spore capsule that can be taken by mouth, under the brand name vowst. stool banks in 2012, a team of researchers from the massachusetts institute of technology founded openbiome, the first public stool bank in the united states across europe, numerous stool banks have emerged to serve the increasing demand. while consensus rapports exists, standard operation procedures still differ. institutions in the netherlands have published their protocols for managing fmt, and in denmark institutions manages fmt according to the european tissue and cell directive. research cultured intestinal bacteria are being studied as an alternative to fecal microbiota transplant. one example is the rectal bacteriotherapy (rbt), developed by tvede and helms, containing 12 individually cultured strains of anaerobic and aerobic bacteria originating from healthy human faeces. research has also been done to identify the most relevant microbes within fecal transplants, which could then be isolated and manufactured via industrial fermentation; such standardized products would be more scalable, would reduce the risk of infections from unwanted microbes, and would improve the scientific study of the approach, since the same substance would be administered each time. veterinary use elephants, hippos, koalas, and pandas are born with sterile intestines, and to digest vegetation need bacteria which they obtain by eating their mothers' feces, a practice termed coprophagia. other animals eat dung. in veterinary medicine fecal microbiota transplant has been known as "transfaunation" and is used to treat ruminating animals, like cows and sheep, by feeding rumen contents of a healthy animal to another individual of the same species in order to colonize its gastrointestinal tract with normal bacteria. terminology previous terms for the procedure include fecal bacteriotherapy, fecal transfusion, fecal transplant, stool transplant, fecal enema, and human probiotic infusion (hpi). because the procedure involves the complete restoration of the entire fecal microbiota, not just a single agent or combination of agents, these terms have now been replaced by the new term fecal microbiota transplantation.