Accelerate Diagnostics, Inc., Scientific Affairs, Tucson, AZ, USA.
Amsterdam UMC, University of Amsterdam, Center for Experimental and Molecular Medicine, Amsterdam, The Netherlands.
J Antimicrob Chemother. 2019 Jan 1;74(Suppl 1):i6-i15. doi: 10.1093/jac/dky530.
The gut microbiome is now considered an organ unto itself and plays an important role in health maintenance and recovery from critical illness. The commensal organisms responsible for the framework of the gut microbiome are valuable in protection against disease and various physiological tasks. Critical illness and the associated interventions have a detrimental impact on the microbiome. While antimicrobials are one of the fundamental and often life-saving modalities in septic patients, they can also pave the way for subsequent harm because of the resulting damage to the gut microbiome. Contributing to many of the non-specific signs and symptoms of sepsis, the balance between the overuse of antimicrobials and the clinical need in these situations is often difficult to delineate. Given the potency of antimicrobials utilized to treat septic patients, the effects on the gut microbiome are often rapid and long-lasting, in which case full recovery may never be observed. The overgrowth of opportunistic pathogens is of significant concern as they can lead to infections that become increasingly difficult to treat. Continued research to understand the disturbances within the gut microbiome of critically ill patients and their outcomes is essential to help develop future therapies to circumvent damage to, or restore, the microbiome. In this review, we discuss the impact of the antimicrobials often used for the treatment of sepsis on the gut microbiota.
肠道微生物组现在被认为是一个独立的器官，在维持健康和从重病中恢复方面发挥着重要作用。负责肠道微生物组框架的共生生物在预防疾病和各种生理任务方面具有重要价值。严重疾病和相关干预措施对微生物组有不利影响。虽然抗生素是脓毒症患者基本且经常是救命的治疗方法之一，但由于抗生素对肠道微生物组造成的损害，它们也可能为随后的伤害铺平道路。肠道微生物组的平衡在许多非特异性症状和体征中起着重要作用，在这些情况下，抗生素的过度使用和临床需求之间的平衡往往难以确定。鉴于用于治疗脓毒症患者的抗生素的效力，抗生素对肠道微生物组的影响通常是迅速而持久的，在这种情况下，可能永远无法观察到完全恢复。机会性病原体的过度生长令人严重关切，因为它们会导致感染，使治疗变得越来越困难。继续研究以了解重症患者肠道微生物组的紊乱及其结果，对于帮助开发未来的治疗方法以避免或恢复微生物组至关重要。在这篇综述中，我们讨论了常用于治疗脓毒症的抗生素对肠道微生物群的影响。
