van Furth R, Guiot H F
Department of Infectious Diseases, University Hospital, Leiden, The Netherlands.
Eur J Clin Microbiol Infect Dis. 1989 Jan;8(1):1-7. doi: 10.1007/BF01964112.
Modulation of the bacterial flora of patients with a high risk of acquiring an infection can be achieved in several ways. The approach used in the Leiden University Hospital is based on selective elimination of the aerobic bacteria in the oropharyngeal cavity and intestinal tract, leaving the anaerobic flora intact. This kind of selective modulation of the host flora has an advantage in that it does not affect the colonization resistance provided by bacterial antagonism, which prevents colonization by resistant but potentially pathogenic bacteria or fungi. The elimination of aerobic bacteria combined with nursing in protective isolation and consumption of food with few bacteria has led to a significant reduction of the incidence of major and fatal infections in patients during episodes of severe granulocytopenia. From these results it may be concluded that the objective of selective antibiotic modulation, namely, the prevention of infections, can be achieved with this approach.
可通过多种方式实现对有感染高风险患者的细菌菌群进行调节。莱顿大学医院采用的方法是基于选择性清除口咽腔和肠道中的需氧菌，而使厌氧菌菌群保持完整。这种对宿主菌群的选择性调节具有一个优势，即它不会影响由细菌拮抗作用提供的定植抗性，这种拮抗作用可防止耐药但可能致病的细菌或真菌定植。清除需氧菌并结合保护性隔离护理以及食用含菌量少的食物，已使严重粒细胞减少症患者在发病期间的主要和致命感染发生率显著降低。从这些结果可以得出结论，通过这种方法可以实现选择性抗生素调节的目标，即预防感染。
