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肠道微生物过度生长必然会导致自发突变增加,进而在危重症患者中引发多克隆性和抗生素耐药性。

Microbial gut overgrowth guarantees increased spontaneous mutation leading to polyclonality and antibiotic resistance in the critically ill.

作者信息

van Saene H K F, Taylor N, Damjanovic V, Sarginson R E

机构信息

Department of Medical Microbiology, University of Liverpool, Liverpool L69 3GA, UK.

出版信息

Curr Drug Targets. 2008 May;9(5):419-21. doi: 10.2174/138945008784221189.

DOI:10.2174/138945008784221189
PMID:18473771
Abstract

Polyclonality is defined as the occurrence of different genotypes of a bacterial species. We are of the opinion that these different clones originate within the patient. When infections and outbreaks occur, the terms of polyclonal infections and polyclonal outbreaks have been used, respectively. The origin of polyclonality has never been reported, although some authors suggest the acquisition of different clones from different animate and inanimate sources. We think that the gut of the critically ill patient with microbial overgrowth is the ideal site for the de-novo development of new clones, following increased spontaneous mutation.

摘要

多克隆性被定义为一个细菌物种中不同基因型的出现。我们认为这些不同的克隆源自患者体内。当感染和暴发发生时,分别使用了多克隆感染和多克隆暴发这两个术语。尽管一些作者提出从不同的有生命和无生命来源获取不同的克隆,但多克隆性的起源从未被报道过。我们认为,在微生物过度生长的危重病患者的肠道是自发突变增加后新克隆从头发育的理想场所。

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引用本文的文献

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Long-term use of selective digestive decontamination in an ICU highly endemic for bacterial resistance.在细菌耐药性高发的 ICU 中长期使用选择性消化道去污染。
Crit Care. 2018 May 30;22(1):141. doi: 10.1186/s13054-018-2057-2.
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Inappropriate dose of enteral antimicrobials promotes resistance.肠内抗菌药物剂量不当会促进耐药性。
J Clin Microbiol. 2013 May;51(5):1644. doi: 10.1128/JCM.00152-13.
3
Selective decontamination of the digestive tract: the mechanism of action is control of gut overgrowth.选择性消化道去污:作用机制是控制肠道过度生长。
Intensive Care Med. 2012 Nov;38(11):1738-50. doi: 10.1007/s00134-012-2690-1. Epub 2012 Sep 22.
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Long-term use of selective decontamination of the digestive tract does not increase antibiotic resistance: a 5-year prospective cohort study.长期使用选择性消化道去污染不会增加抗生素耐药性:一项为期 5 年的前瞻性队列研究。
Intensive Care Med. 2011 Sep;37(9):1458-65. doi: 10.1007/s00134-011-2307-0. Epub 2011 Jul 19.
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Gut overgrowth harms the critically ill.肠道细菌过度生长对重症患者有害。
Intensive Care Med. 2011 Sep;37(9):1560; author reply 1561-2. doi: 10.1007/s00134-011-2287-0. Epub 2011 Jun 28.