Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 2012 Mar 1;54(5):707-13. doi: 10.1093/cid/cir899. Epub 2011 Dec 12.
Increasing understanding of the normal commensal microorganisms in humans suggests that restoring and maintaining the microbiome may provide a key to preventing colonization and infection with multidrug-resistant organisms (MDROs). Intact communities of commensals can prevent colonization with MDROs through both competition for space and resources and the complex immunologic and biochemical interactions that have developed between commensal and host over millennia. Current antimicrobials, however, exert tremendous collateral damage to the human microbiome through overuse and broadening spectrum, which has likely been the driving force behind the introduction and proliferation of MDROs. The future direction of infection control and anti-infective therapy will likely capitalize on an expanding understanding of the protective role of the microbiome by (1) developing and using more microbiome-sparing antimicrobial therapy, (2) developing techniques to maintain and restore indigenous microbiota, and (3) discovering and exploiting host protective mechanisms normally afforded by an intact microbiome.
越来越多的人开始了解人类体内正常的共生微生物，这表明恢复和维持微生物组可能是预防多药耐药菌（MDRO）定植和感染的关键。完整的共生微生物群落可以通过争夺空间和资源，以及共生体与宿主在数千年的进化过程中形成的复杂免疫和生化相互作用，来防止 MDRO 的定植。然而，目前的抗菌药物由于过度使用和广谱性，对人体微生物组造成了巨大的附带损害，这可能是 MDRO 引入和传播的驱动力。感染控制和抗感染治疗的未来方向可能会通过以下方式利用对微生物组保护作用的深入了解：（1）开发和使用更能保护微生物组的抗菌治疗方法；（2）开发维持和恢复本土微生物群的技术；（3）发现和利用完整微生物组提供的宿主保护机制。
