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粪便微生物群移植治疗溃疡性结肠炎患者的复发性感染

Fecal microbiota transplantation for recurrent infection in a patient with ulcerative colitis.

作者信息

Nanki Kosaku, Mizuno Shinta, Matsuoka Katsuyoshi, Ono Keiko, Sugimoto Shinya, Kiyohara Hiroki, Arai Mari, Nakashima Moeko, Takeshita Kozue, Saigusa Keiichiro, Senoh Mitsutoshi, Fukuda Tadashi, Naganuma Makoto, Kato Haru, Suda Wataru, Hattori Masahira, Kanai Takanori

机构信息

Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.

Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University, Tokyo, Japan.

出版信息

Intest Res. 2018 Jan;16(1):142-146. doi: 10.5217/ir.2018.16.1.142. Epub 2018 Jan 18.

Abstract

Fecal microbiota transplantation (FMT) has been reported as a safe and effective therapy in patients with refractory and recurrent infection (CDI). FMT has also been reported as a promising therapy in patients with ulcerative colitis (UC). Both, CDI and UC, are believed to be caused by dysbiosis, such as altered compositions or decreased diversity of the intestinal microbiota. This report describes a patient with UC in remission with a second recurrent episode of CDI, who was treated with FMT. A single FMT performed via colonoscopy completely resolved the patient's diarrhea and eradicated bacteriologically without any severe complications. Molecular biological analysis of the patient's fecal microbiota showed that FMT could dramatically change the altered composition of intestinal microbiota and restore its diversity. Despite the restoration of the intestinal microbiota, FMT could not prevent a relapse of UC in this patient. However, it improved the intestinal symptoms of CDI and could prevent further recurrences of CDI.

摘要

粪菌移植(FMT)已被报道为治疗难治性和复发性感染(CDI)患者的一种安全有效的疗法。FMT也被报道为治疗溃疡性结肠炎(UC)患者的一种有前景的疗法。CDI和UC都被认为是由肠道微生物群失调引起的,比如肠道微生物群的组成改变或多样性降低。本报告描述了一名处于缓解期的UC患者出现第二次CDI复发,该患者接受了FMT治疗。通过结肠镜检查进行的单次FMT完全缓解了患者的腹泻,并在细菌学上根除了感染,且未出现任何严重并发症。对该患者粪便微生物群的分子生物学分析表明,FMT可显著改变肠道微生物群的改变组成并恢复其多样性。尽管肠道微生物群得以恢复,但FMT未能预防该患者的UC复发。然而,它改善了CDI的肠道症状,并可预防CDI的进一步复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c877/5797261/d6c6e7b92e96/ir-16-142-g001.jpg

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