Ann & Robert H. Lurie Children's Hospital, Chicago, IL, United States.
Ann & Robert H. Lurie Children's Hospital, Chicago, IL, United States; Stanley Manne Children's Research Institute, Chicago, IL, United States; Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Clin Ther. 2020 Sep;42(9):1637-1648. doi: 10.1016/j.clinthera.2020.06.011. Epub 2020 Aug 12.
The prevalence of multidrug-resistant organisms is increasing worldwide, posing a unique challenge to global health care systems. Novel approaches are needed to combat the spread of infection with these organisms. The enteric microbiome, and in particular the resistome, offers a unique target in both the prevention of infection with these organisms and the acquisition and spread within the community. We highlight a novel approach to combat multidrug-resistant organisms: the use of prebiotics, probiotics, and synbiotics to manipulate the microbiome and resistome. This review summarizes the published literature and clinical trials related to these products to date, with a focus on efficacious trials. It highlights the probable mechanism of action for each product, as well as its safety profile in selective populations. Ultimately, although further research is needed before a definitive statement can be made on the efficacy of any of these 3 interventions, the literature to date offers new hope and a new tool in the arsenal in the fight against bacterial drug resistance.
多药耐药菌在全球范围内的流行率正在上升,这对全球医疗保健系统构成了独特的挑战。需要新的方法来对抗这些耐药菌的传播。肠道微生物组,特别是耐药组,为预防这些耐药菌的感染以及在社区内的获得和传播提供了一个独特的靶点。我们强调了一种对抗多药耐药菌的新方法:使用益生元、益生菌和合生素来操纵微生物组和耐药组。这篇综述总结了迄今为止与这些产品相关的已发表文献和临床试验,重点是有效试验。它强调了每种产品的可能作用机制,以及在特定人群中的安全性概况。最终,尽管在对任何这 3 种干预措施的疗效做出明确声明之前还需要进一步研究,但迄今为止的文献为对抗细菌耐药性提供了新的希望和新的工具。
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