Department of Gastroenterology, Nepean Hospital, Penrith, New South Wales, Australia.
J Clin Gastroenterol. 2010 Sep;44(8):551-61. doi: 10.1097/MCG.0b013e3181e5d06b.
To determine whether fecal bacteriotherapy results in a durable beneficial change in the colonic microbiota of patients with flora-related disorders.
Earlier studies have implicated the colonic microbiota in a number of conditions. Administration of a fecal suspension from a healthy individual to an ill individual (fecal bacteriotherapy) can cure Clostridium difficile infection and potentially other diseases. Oral probiotics do not work in this condition, yet there has been no study to determine whether fecal bacteriotherapy results in prolonged implantation.
Fecal samples were collected from 10 patients undergoing fecal bacteriotherapy. Patients completed an antibiotic schedule and bowel lavage before the infusion of healthy donor feces. Using a molecular approach, the bacterial populations in patient fecal samples were followed from pretreatment to 24 weeks post-initial infusion and compared with the initial infused donor fecal suspension.
At intervals of 4, 8, and 24 weeks after the procedure, the bacterial populations in the patients' fecal samples consisted predominantly of bacteria derived from the healthy donor samples. Comparisons of similarity at 4, 8, and 24 week samples to the donor-infused sample were made and each recipient's baseline sample was statistically significant with Friedman test.
This study demonstrates a durable beneficial change in the patients' bacterial populations of the colon to represent those of the healthy donor's microbiota. Manipulation of the colonic microbiota to improve its protective and beneficial role represents a promising field of new therapeutic strategies for the treatment of gastrointestinal conditions.
确定粪便细菌治疗是否会导致与菌群相关疾病患者的结肠菌群发生持久的有益变化。
早期的研究表明，结肠菌群与许多疾病有关。将健康个体的粪便悬液施用于患病个体（粪便细菌治疗）可以治愈艰难梭菌感染，并可能治愈其他疾病。口服益生菌在这种情况下无效，但尚未有研究确定粪便细菌治疗是否会导致长期定植。
从 10 名接受粪便细菌治疗的患者中收集粪便样本。患者在输注健康供体粪便前完成抗生素方案和肠道灌洗。使用分子方法，从预处理到初始输注后 24 周，跟踪患者粪便样本中的细菌种群，并将其与初始输注的供体粪便混悬液进行比较。
在治疗后 4、8 和 24 周的间隔时间内，患者粪便样本中的细菌种群主要由来自健康供体样本的细菌组成。对 4、8 和 24 周样本与供体输注样本的相似性进行了比较，每个受者的基线样本与弗里德曼检验均具有统计学意义。
本研究表明，患者结肠细菌种群发生了持久的有益变化，代表了健康供体微生物组的变化。操纵结肠菌群以改善其保护和有益作用代表了治疗胃肠道疾病的新治疗策略的一个有前途的领域。
