Currently, allprobioticsavailableonthemarkethavebeenobtained byselectionandcultivationofalimitednumberofmicroorganisms from arelativelysmallnumberof sources.In many cases a bacterial strain is isolated from a dairyproduct or a human stool sample, tested for safety andspecific health benefits, and administered as a therapeuticagent or functional food to many different individuals.Many of these current probiotic species constitute a lowproportion of those naturally present in the targeted eco-systems of the human body. Besides, their physiologicalimpact after a period of administration may be limited bytheir inability to colonise the human body for an extendedperiod of time. Evidence has accumulated that the geneticmakeup of the host is a crucial factor for facilitating thecolonisation of beneficial bacteria in the human body.Therefore, treatment of a patient suffering from a recur-ring infection could be more effective with one or more ofthe patient’s own species. This innovation would fit withthe current development of personalised therapeutics. Themicrobial population isolated from the infected site of thebody can be enriched for bacteria, which are associatedwith a healthy microbiome. The ex-vivo-enriched samplecan be used for therapeutic purposes and may be moreefficacious than probiotics administered according to theone-size-fits-all concept. I advocate such a method, calledTripleA, referring to the three consecutive steps involved:Acquisition of the sample, Alteration of the microbialcomposition, and Administration of the enriched sample.Human beings are colonised with microorganisms frombirth. The epithelial surfaces in the body provide specificniches, where a variety of microorganisms, known as theindigenous microbiota, feed and protect the host. A recentstudy on the stability of the intestinal microbiota hasshown that the same strains are maintained over timewithin anindividualandbetweenfamilymembers,butnotbetween unrelated individuals [1]. Thus, early colonisers,including those acquired from our parents, have the po-tential tocarryouttheirbeneficialroleformostofourlives.Some members of the intestinal microbiota have evolvedspecies-specific physical interactions with the host thatmediate stable and resilient gut colonisation [2]. The bac-terial properties, proposed to play a role in host specificity,have been based on relevant interindividual variation atthe species and strain level and include binding, substrateutilisation, and factors inducing immunological responsesin the host [3]. In addition, mucosal immune cells locatedbeneath the epithelium play a critical part in regulatingboth the mucosal barrier and the relative composition ofthe luminal microbiota [4]. Accordingly, treatments aimedat microbiota restoration could be most effective by theapplication of beneficial species isolated from the patient’sown body.A medical case where TripleA may be advantageous isthetreatmentofbacterialvaginosis(BV),anaberrantstateof the vaginal microbiota, which is characterised by anincrease in the vaginal pH, a reduction of Lactobacillusspp., and an increased diversity of vaginal anaerobic bac-teria [5]. BV is associated with adverse pregnancy out-comes, upper genital tract infections, and increased risk ofsexually transmitted diseases [6]. The common treatmentforBVisadministrationoftheantibioticsmetronidazoleorclindamycin, which are often ineffective, harmful to thebeneficialLactobacillusspp.present,andassociatedwithawide range of side effects and infection recurrences [7]. AsolutionisofferedbyTripleA,whichincludessamplingandenrichment of the BV-associated microbiota for Lactoba-cillus spp. [8]. Candidate species to enrich for includeLactobacillus crispatus, Lactobacillus gasseri, Lactobacil-lus iners, and Lactobacillus jensenii, which have beenidentified in 28%, 11%, 86%, and 18% of women withBV, respectively [9], but are clearly associated with ahealthy state when one of these species dominates thevaginal microbiota. A healthy state is defined in this caseas a condition with a relatively low susceptibility to sexu-ally transmitted diseases. It has been widely accepted thatthe activity of Lactobacillus spp. contributes to maintainthis state through the protection of the vaginal environ-ment against pathogens by the production of lactic acid,resulting in a low pH. However, intravaginal administra-tion of probiotic lactobacilli shows a variable outcome inthe cure rate of BV [10]. Host-specific Lactobacillus spp.could be more effective in a shift towards a sustainablehealthy state, because they are adapted to the host andexpected to be able to colonise the urogenital tract (Box 1).TripleA may also be advantageous in the treatment ofrecurring intestinal diseases, in particular Clostridiumdifficile infection (CDI). In this case, treatment with anti-biotics, including vancomycin or metronidazole, is associ-ated