Department of Biomedical Sciences and Pathobiology, Virginia-Maryland College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
Department of Comparative Pathobiology, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.
Crit Rev Microbiol. 2023 May;49(3):414-434. doi: 10.1080/1040841X.2022.2072705. Epub 2022 May 15.
infection (CDI) is a life-threatening disease caused by the Gram-positive, opportunistic intestinal pathogen . Despite the availability of antimicrobial drugs to treat CDI, such as vancomycin, metronidazole, and fidaxomicin, recurrence of infection remains a significant clinical challenge. The use of live commensal microorganisms, or probiotics, is one of the most investigated non-antibiotic therapeutic options to balance gastrointestinal (GI) microbiota and subsequently tackle dysbiosis. In this review, we will discuss major commensal probiotic strains that have the potential to prevent and/or treat CDI and its recurrence, reassess the efficacy of probiotics supplementation as a CDI intervention, delve into lessons learned from probiotic modulation of the immune system, explore avenues like genome-scale metabolic network reconstructions, genome sequencing, and multi-omics to identify novel strains and understand their functionality, and discuss the current regulatory framework, challenges, and future directions.
艰难梭菌感染（CDI）是一种由革兰阳性、机会性肠道病原体引起的危及生命的疾病。尽管有多种抗菌药物可用于治疗 CDI，如万古霉素、甲硝唑和非达霉素，但感染的复发仍然是一个重大的临床挑战。使用共生微生物或益生菌是最受关注的非抗生素治疗选择之一，以平衡胃肠道（GI）微生物群，从而解决肠道菌群失调。在这篇综述中，我们将讨论具有预防和/或治疗 CDI 及其复发潜力的主要共生益生菌菌株，重新评估益生菌补充作为 CDI 干预的疗效，深入研究益生菌对免疫系统调节的经验教训，探索基因组规模代谢网络重建、基因组测序和多组学等途径，以鉴定新型菌株并了解其功能，并讨论当前的监管框架、挑战和未来方向。
