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粪便微生物群移植治疗儿童难治性艰难梭菌感染:最新进展

Fecal microbiota transplantation in the treatment of refractory Clostridium difficile infection in children: an update.

作者信息

Walia Ritu, Kunde Sachin, Mahajan Lori

机构信息

aDepartment of Pediatric Gastroenterology, West Virginia University, Charleston, West Virginia bDepartment of Pediatric Gastroenterology, Helen DeVos Children's Hospital, Grand Rapids, Michigan cDepartment of Pediatric Gastroenterology, Cleveland Clinic Children's Hospital, Cleveland, Ohio, USA.

出版信息

Curr Opin Pediatr. 2014 Oct;26(5):573-8. doi: 10.1097/MOP.0000000000000127.

Abstract

PURPOSE OF REVIEW

The use of transplanted fecal material for the treatment of diarrheal illness dates back to the fourth-century China. While fecal microbiota transplant has gained increasing popularity over the past 50 years for the treatment of refractory Clostridium difficile infections (RCDIs) in adults, it has only been recently utilized in children. The purpose of this article is to review the use of fecal microbiota transplant (FMT) in the treatment of pediatric RCDIs.

RECENT FINDINGS

Minimal pediatric data, including few case reports and series, document the successful use of FMT for treatment of RCDI in the past 2 years. Patients in these reports included otherwise healthy children, those with inflammatory bowel disease as well as significantly immunocompromised children. Donor fecal infusion via nasogastric tube, gastroscope or colonoscope in children aged 16 months and older demonstrated a high rate of symptom resolution and organism eradication. No complications to date have been reported in children who have undergone FMT.

SUMMARY

FMT is emerging as a well-tolerated and effective treatment for RCDI in not only adults but also children.

摘要

综述目的

将移植粪便物质用于治疗腹泻性疾病可追溯到公元4世纪的中国。虽然粪便微生物群移植在过去50年里越来越多地用于治疗成人难治性艰难梭菌感染(RCDIs),但直到最近才用于儿童。本文旨在综述粪便微生物群移植(FMT)在治疗儿童RCDIs中的应用。

最新发现

包括少数病例报告和系列研究在内的儿科数据极少,记录了过去两年中FMT成功用于治疗RCDI的情况。这些报告中的患者包括其他方面健康的儿童、患有炎症性肠病的儿童以及免疫功能严重受损的儿童。对16个月及以上儿童通过鼻胃管、胃镜或结肠镜进行供体粪便输注显示症状缓解率和病原体根除率很高。迄今为止,接受FMT的儿童尚未报告有并发症。

总结

FMT正在成为一种不仅对成人而且对儿童的RCDI耐受性良好且有效的治疗方法。

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