Cheng Yao-Wen, Fischer Monika
Department of Gastroenterology, University of California San Francisco, San Francisco, California.
Division of Gastroenterology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
Clin Colon Rectal Surg. 2020 Mar;33(2):92-97. doi: 10.1055/s-0040-1701233. Epub 2020 Feb 25.
Fecal microbiota transplantation (FMT) is the process of transplanting stool from a healthy donor into the gut of a diseased individual for therapeutic purposes. It has a clearly defined role in the treatment of recurrent (reclassified as " ") infection (CDI), with cure rates over 90% and decreased rates of subsequent recurrence compared with anti-CDI antibiotics. There is emerging evidence that FMT is also effective in the treatment of severe and fulminant CDI, with associated decreases in mortality and colectomy rates compared with standard antibiotic therapy. FMT shows promise as salvage therapy for critically-ill CDI patients refractory to maximum medical therapy and not deemed to be surgical candidates. FMT should be considered early in the course of severe CDI and should be delivered immediately in patients with signs of refractory CDI. Expansion of FMT's use along the spectrum of CDI severity has potential to decrease associated rates of mortality and colectomy.
粪便微生物群移植（FMT）是将健康供体的粪便移植到患病个体肠道中以达到治疗目的的过程。它在复发性（重新分类为“ ”）感染（CDI）的治疗中具有明确的作用，治愈率超过90%，与抗CDI抗生素相比，后续复发率降低。越来越多的证据表明，FMT在治疗严重和暴发性CDI方面也有效，与标准抗生素治疗相比，死亡率和结肠切除术发生率有所降低。对于接受最大程度药物治疗仍难治且不被视为手术候选者的重症CDI患者，FMT有望作为挽救疗法。在严重CDI病程早期就应考虑FMT，对于出现难治性CDI迹象的患者应立即进行FMT。随着CDI严重程度范围扩大FMT的应用，有可能降低相关的死亡率和结肠切除术发生率。
