上消化道感染中粪便微生物群移植的经验。
Experiences with fecal microbiota transplantation in infections via upper gastrointestinal tract.
作者信息
Vigvári Szabolcs, Vincze Áron, Solt Jenő, Sipos Dávid, Feiszt Zsófia, Kovács Beáta, Kappéter Ágnes, Péterfi Zoltán
机构信息
1 Department of Infectology, 1st Department of Internal Medicine, University of Pécs , Pécs, Hungary.
2 Department of Gastroenterology, 1st Department of Internal Medicine, University of Pécs , Pécs, Hungary.
出版信息
Acta Microbiol Immunol Hung. 2019 Jun 1;66(2):179-188. doi: 10.1556/030.65.2018.051. Epub 2018 Dec 26.
Dramatic changes in the epidemiology of infections have been reported from the western world in the past decade. The proportion of severe cases is significantly elevating and clinicians now have to contend with the problem of additional and more frequent episodes of recurrences including an upward trend in the mortality rate. This situation led us to investigate the possibility of the fecal microbiota transplantation (FMT). An amount of 100 ml of fecal microbiota solution was instilled into a nasojejunal (NJ) tube in 16 cases and into a nasogastric (NG) tube in 44 cases. In all of the cases, where the solution was instilled via nasojejunal tubes, the symptoms resolved within 24 h. We did not note any recurrences in this group. When the material was flushed in through nasogastric tubes, the symptoms resolved in 39 (88.64%) cases within 24 h. In this group, we have experienced a recurrent episode of infection in five (11.36%) cases. Three of them were cured with a second transplantation. We have found that in our practice the upper gastrointestinal tract methods had the primary cure rate of 91.67%, whereas the secondary cure rate is 96.67%. When we compared the NJ and NG methods, we have found that the differences in the outcomes are not significant statistically ( = 0.3113 using Fisher's exact probability test). In conclusion, FMT proved to be very effective, particularly in recurrent infections and in cases where conventional treatment had failed.
在过去十年中,西方世界报告了感染流行病学的巨大变化。重症病例的比例显著上升,临床医生现在不得不应对复发次数增加且更频繁的问题,包括死亡率呈上升趋势。这种情况促使我们研究粪便微生物群移植(FMT)的可能性。16例患者通过鼻空肠(NJ)管注入100毫升粪便微生物群溶液,44例患者通过鼻胃(NG)管注入。在所有通过鼻空肠管注入溶液的病例中,症状在24小时内得到缓解。我们在该组中未发现任何复发情况。当通过鼻胃管冲洗材料时,39例(88.64%)患者的症状在24小时内得到缓解。在该组中,我们有5例(11.36%)患者经历了感染复发。其中3例通过第二次移植治愈。我们发现在我们的实践中,上消化道方法的初次治愈率为91.67%,二次治愈率为96.67%。当我们比较NJ和NG方法时,我们发现结果差异在统计学上不显著(使用Fisher精确概率检验,P = 0.3113)。总之,FMT被证明非常有效,特别是在复发性感染和传统治疗失败的病例中。