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微生物群管理在感染治疗中的应用:从粪便微生物群移植到益生菌再到保留微生物群的抗菌剂。

Application of Microbiome Management in Therapy for Infections: From Fecal Microbiota Transplantation to Probiotics to Microbiota-Preserving Antimicrobial Agents.

作者信息

Chiu Chun-Wei, Tsai Pei-Jane, Lee Ching-Chi, Ko Wen-Chien, Hung Yuan-Pin

机构信息

Department of Internal Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan 700, Taiwan.

Department of Medical Laboratory Science and Biotechnology, National Cheng Kung University, Medical College, Tainan 704, Taiwan.

出版信息

Pathogens. 2021 May 24;10(6):649. doi: 10.3390/pathogens10060649.

Abstract

Oral vancomycin and metronidazole, though they are the therapeutic choice for infections (CDIs), also markedly disturb microbiota, leading to a prolonged loss of colonization resistance to after therapy; as a result, their use is associated with a high treatment failure rate and high recurrent rate. An alternative for CDIs therapy contains the delivery of beneficial (probiotic) microorganisms into the intestinal tract to restore the microbial balance. Recently, mixture regimens containing species, , or have been extensively studied for the prophylaxis of CDIs. Fecal microbiota transplantation (FMT), the transfer of (processed) fecal material from healthy donors to patients for treating CDIs, combined with vancomycin was recommended as the primary therapy for multiple recurrent CDIs (rCDIs). Either probiotics or FMT have been utilized extensively in preventing or treating CDIs, aiming at less disturbance in the microbiota to prevent rCDIs after therapy cessation. Otherwise, many newly developed therapeutic agents have been developed and aim to preserve microbiota during CDI treatment to prevent disease recurrence and might be useful in clinical patients with rCDIs in the future.

摘要

口服万古霉素和甲硝唑虽然是艰难梭菌感染(CDIs)的治疗选择,但也会显著扰乱微生物群,导致治疗后对[具体病原体]的定植抗性长期丧失;因此,它们的使用与高治疗失败率和高复发率相关。CDIs治疗的一种替代方法是将有益(益生菌)微生物输送到肠道以恢复微生物平衡。最近,含有[具体菌种1]、[具体菌种2]或[具体菌种3]的联合方案已被广泛研究用于预防CDIs。粪便微生物群移植(FMT),即将(处理过的)粪便物质从健康供体转移到患者体内以治疗CDIs,与万古霉素联合使用被推荐作为多次复发性CDIs(rCDIs)的主要治疗方法。益生菌或FMT已被广泛用于预防或治疗CDIs,目的是减少对微生物群的干扰,以防止治疗停止后rCDIs的发生。此外,许多新开发的治疗药物已经问世,旨在在CDI治疗期间保护微生物群以防止疾病复发,未来可能对rCDIs临床患者有用。

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