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粪便微生物群移植治疗炎症性肠病患者与非炎症性肠病患者难治性或复发性感染的疗效比较:一项回顾性队列研究

Comparative Efficacy of Fecal Microbiota Transplantation in Treating Refractory or Recurrent Infection among Patients with and without Inflammatory Bowel Disease: A Retrospective Cohort Study.

作者信息

Chen Jing-Han, Chiu Cheng-Hsun, Chen Chien-Chang, Chen Yi-Ching, Yeh Pai-Jui, Kuo Chia-Jung, Chiu Cheng-Tang, Cheng Hao-Tsai, Pan Yu-Bin, Le Puo-Hsien

机构信息

School of Medicine, Chang Gung University, Taoyuan 333, Taiwan.

Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Linkou, Taoyuan 333, Taiwan.

出版信息

Biomedicines. 2024 Jun 23;12(7):1396. doi: 10.3390/biomedicines12071396.

Abstract

infection (CDI) worsens inflammatory bowel disease (IBD) prognosis. While fecal microbiota transplantation (FMT) is effective for refractory or recurrent CDI (rrCDI), comparative success rates between IBD and non-IBD patients are scarce. This study addresses this gap. A retrospective cohort study was conducted at Chang Gung Memorial Hospital from April 2019 to October 2023. Patients receiving FMT for rrCDI were categorized into IBD and non-IBD groups. Baseline characteristics and outcomes were compared at one month and one year, with successful FMT defined as the resolution of diarrhea without CDI recurrence. The study included 88 patients: 30 with IBD and 58 without IBD. The IBD group was younger, with fewer comorbidities. Success rates at one month were similar between groups (IBD: 80.0% vs. non-IBD: 78.9%, = 0.908), as were negative toxin tests (IBD: 83.3% vs. non-IBD: 63.8%, = 0.174). One-year success rates (IBD: 70.0% vs. non-IBD: 67.6%, = 0.857) and eradication rates (IBD: 94.4% vs. non-IBD: 73.9%, = 0.112) were also similar. Poor bowel preparation predicted FMT failure at one month (OR = 0.23, = 0.019). No safety issues were reported. FMT is a safe, effective treatment for rrCDI, demonstrating similar success rates in patients with and without IBD.

摘要

艰难梭菌感染(CDI)会恶化炎症性肠病(IBD)的预后。虽然粪便微生物群移植(FMT)对难治性或复发性CDI(rrCDI)有效,但IBD患者和非IBD患者之间的比较成功率却很少见。本研究填补了这一空白。2019年4月至2023年10月在长庚纪念医院进行了一项回顾性队列研究。接受FMT治疗rrCDI的患者被分为IBD组和非IBD组。在1个月和1年时比较基线特征和结局,成功的FMT定义为腹泻缓解且无CDI复发。该研究纳入了88例患者:30例患有IBD,58例未患有IBD。IBD组患者更年轻,合并症更少。两组在1个月时的成功率相似(IBD:80.0% vs.非IBD:78.9%,P = 0.908),毒素检测阴性率也相似(IBD:83.3% vs.非IBD:63.8%,P = 0.174)。1年成功率(IBD:70.0% vs.非IBD:67.6%,P = 0.857)和根除率(IBD:94.4% vs.非IBD:73.9%,P = 0.112)也相似。肠道准备不佳预示着1个月时FMT失败(OR = 0.23,P = 0.019)。未报告安全问题。FMT是一种安全、有效的rrCDI治疗方法,在有IBD和无IBD的患者中显示出相似的成功率。

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The interplay of infection and inflammatory bowel disease.感染与炎症性肠病的相互作用。
Therap Adv Gastroenterol. 2021 May 30;14:17562848211020285. doi: 10.1177/17562848211020285. eCollection 2021.

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