Cheng Yao-Wen, Fischer Monika
Department of Gastroenterology, Kaiser Permanente Santa Clara Medical Center, Santa Clara, California.
Division of Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana.
Clin Colon Rectal Surg. 2023 Jan 25;36(2):151-156. doi: 10.1055/s-0043-1760865. eCollection 2023 Mar.
Fecal microbiota transplantation (FMT) is the process of transplanting stool from a healthy donor into the gut of a patient for therapeutic purposes. Current guidelines recommend FMT for the prevention of multiply recurrent infection (CDI) after two recurrences, with cure rates approaching 90%. Emerging evidence also supports the use of FMT in the management of severe and fulminant CDI, resulting in decreased mortality and colectomy rates compared with standard of care approach. FMT shows promise as salvage therapy for critically-ill, refractory CDI patients who are poor surgical candidates. FMT should be considered early in the clinical course of severe CDI, preferably within 48 hours of failing to respond to antibiotic therapy and volume resuscitation. Besides CDI, ulcerative colitis was more recently identified as a potential treatment target for FMT. Several live biotherapeutics for microbiome restoration are on the horizon.
粪便微生物群移植（FMT）是将健康供体的粪便移植到患者肠道以达到治疗目的的过程。当前指南推荐在艰难梭菌感染（CDI）复发两次后进行FMT以预防多次复发感染，治愈率接近90%。新出现的证据也支持FMT用于治疗严重和暴发性CDI，与标准治疗方法相比，可降低死亡率和结肠切除术发生率。对于手术风险高的危重症、难治性CDI患者，FMT有望成为挽救治疗方法。在严重CDI的临床过程中应尽早考虑FMT，最好在对抗生素治疗和容量复苏无反应后的48小时内进行。除CDI外，溃疡性结肠炎最近也被确定为FMT的潜在治疗靶点。几种用于恢复微生物群的活体生物疗法即将出现。
