Sultana Shamima, Sarker Shafiqul A, Brüssow Harald
Clinical Sciences Department, International Center for Diarrhoeal Disease Research, Dhaka, Bangladesh.
Department of Gut Ecology, Host-Microbe Interaction Group, Nestlé Research Center, Lausanne, Switzerland.
Environ Microbiol. 2017 Aug;19(8):2926-2934. doi: 10.1111/1462-2920.13787. Epub 2017 May 29.
In 1890, Robert Koch has formulated postulates describing what criteria a parasite has to fulfil to qualify as an aetiological agent for an infectious disease. Since then Koch's postulates have experienced reformulations by nearly every generation of microbiologists reflecting new discoveries changing the understanding of infectious diseases pathogenesis. The latest addition to this discussion is the role of the host commensal microbiota in turning infections into disease. After an overview of the historical developments of the postulates, data on diarrhoea aetiology from Bangladesh with respect to Koch's postulates were analysed. In countries with a low environmental hygiene standard, some recognized bacterial enteropathogens appear as a necessary, but not sufficient condition for diarrhoea. The possibility emerges that the loss of a physiological commensal gut microbiota equilibrium ('dysbiosis') is an important co-factor for some bacterial pathogens to induce diarrhoea. Koch's hypothesis '1 pathogen + 1 host = 1 disease' is therefore better formulated as 'X (pathogen/s) + Y (local milieu) + Z (individual host susceptibility) = disease'.
1890年，罗伯特·科赫提出了一些准则，描述了寄生虫要成为传染病的病原体必须满足哪些标准。从那时起，几乎每一代微生物学家都对科赫法则进行了重新阐述，以反映新的发现，这些发现改变了人们对传染病发病机制的理解。这场讨论的最新内容是宿主共生微生物群在将感染转变为疾病过程中的作用。在概述了这些准则的历史发展之后，分析了来自孟加拉国的腹泻病因学数据与科赫法则的关系。在环境卫生标准较低的国家，一些公认的细菌性肠道病原体似乎是腹泻的必要但不充分条件。由此出现了一种可能性，即生理性共生肠道微生物群平衡的丧失（“生态失调”）是一些细菌性病原体诱发腹泻的重要辅助因素。因此，科赫假说“1种病原体 + 1个宿主 = 1种疾病”可以更好地表述为“X（病原体/多种病原体）+ Y（局部环境）+ Z（个体宿主易感性）= 疾病”。
