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阑尾切除术作为复发性和暴发性艰难梭菌感染发生的潜在诱发因素。

Appendectomy as a Potential Predisposing Factor for the Development of Recurrent and Fulminant Clostridium Difficile.

作者信息

Heindl Stacey E, Tsouklidis Nicholas

机构信息

Medicine, Avalon University School of Medicine, Willemstad, CUW.

Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.

出版信息

Cureus. 2020 Aug 28;12(8):e10091. doi: 10.7759/cureus.10091.

Abstract

This literature review assesses how the vermiform appendix has been considered a vestigial organ by many, but over the years, new research has allowed us to reconsider its potential purpose. Studies have indicated that the appendix plays an evident role in immune response and harbors a biofilm that may remain unaffected by gastrointestinal infections, such as infection with Clostridium difficile. Our research analyzes the prominent gut-associated lymphoid tissue (GALT) as a mechanism of defence in infection, as well as the robust biofilm that could aid in the reinoculation of beneficial bacteria within the colon. Furthermore, we wanted to determine if patients who have undergone a prior appendectomy, leading to decreased GALT and a lack of a bacterial reservoir, were predisposed to the development of Clostridium difficile, with particular emphasis in the recurrence and development of fulminant Clostridium difficile infections. Although research continues to be conflicting, there appears to be some connection between these variables, but prospective studies are needed in order to say for certain that there is a link.

摘要

这篇文献综述评估了多年来很多人如何将阑尾视为退化器官,但新的研究让我们重新思考其潜在功能。研究表明,阑尾在免疫反应中发挥着明显作用,并且含有一种生物膜,这种生物膜可能不受胃肠道感染(如艰难梭菌感染)的影响。我们的研究分析了突出的肠道相关淋巴组织(GALT)作为感染防御机制,以及有助于在结肠内重新接种有益细菌的强大生物膜。此外,我们想确定先前接受过阑尾切除术的患者,由于导致GALT减少和缺乏细菌库,是否易患艰难梭菌,尤其着重于暴发性艰难梭菌感染的复发和发展。尽管研究结果仍存在矛盾,但这些变量之间似乎存在某种联系,但需要进行前瞻性研究才能确定存在关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c729/7455376/971c65272ad6/cureus-0012-00000010091-i01.jpg

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