Mrazek Katharina, Bereswill Stefan, Heimesaat Markus M
Institute of Microbiology, Infectious Diseases and Immunology, Gastrointestinal Microbiology Research Group, Charité - University Medicine Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Eur J Microbiol Immunol (Bp). 2019 Mar 4;9(1):14-22. doi: 10.1556/1886.2019.00002. eCollection 2019 Mar 18.
Intestinal carriage of multi-drug resistant (MDR) Gram-negative bacteria including (Psae) constitutes a pivotal prerequisite for subsequent fatal endogenous infections in patients at risk. We here addressed whether fecal microbiota transplantation (FMT) could effectively combat MDR-Psae carriage. Therefore, secondary abiotic mice were challenged with MDR-Psae by gavage. One week later, mice were subjected to peroral FMT from either murine or human donors on 3 consecutive days. Irrespective of murine or human origin of fecal transplant, intestinal MDR-Psae loads decreased as early as 24 h after the initial FMT. Remarkably, the murine FMT could lower intestinal MDR-Psae burdens by approximately 4 log orders of magnitude within 1 week. In another intervention study, mice harboring a human gut microbiota were perorally challenged with MDR-Psae and subjected to murine FMT on 3 consecutive days, 1 week later. Strikingly, within 5 days, murine FMT resulted in lower loads and carrier rates of MDR-Psae in mice with a human gut microbiota. In conclusion, FMT might be a promising antibiotics-independent option to combat intestinal MDR-Psae carriage and thus prevent from future endogenous infections of patients at risk.
包括肺炎克雷伯菌在内的多重耐药（MDR）革兰氏阴性菌在肠道内的定植是高危患者后续发生致命性内源性感染的关键先决条件。我们在此探讨粪便微生物群移植（FMT）是否能有效对抗多重耐药肺炎克雷伯菌的定植。因此，对无菌小鼠进行灌胃，使其感染多重耐药肺炎克雷伯菌。一周后，连续3天对小鼠进行来自小鼠或人类供体的经口FMT。无论粪便移植的来源是小鼠还是人类，在首次FMT后24小时内，肠道内多重耐药肺炎克雷伯菌的载量就开始下降。值得注意的是，小鼠FMT可在1周内将肠道内多重耐药肺炎克雷伯菌的负担降低约4个对数级。在另一项干预研究中，对具有人类肠道微生物群的小鼠经口感染多重耐药肺炎克雷伯菌，并在1周后连续3天进行小鼠FMT。令人惊讶的是，在5天内，小鼠FMT使具有人类肠道微生物群的小鼠体内多重耐药肺炎克雷伯菌的载量和携带率降低。总之，FMT可能是一种有前景的、不依赖抗生素的方法，可对抗肠道内多重耐药肺炎克雷伯菌的定植，从而预防高危患者未来的内源性感染。
