Zhuang Liying, You Yanjing, Zeng Shenyuan, Yu Zongyang, Wang Huijuan, Chen Meiyan, Wen Wen
Department of Respiratory and Critical Care Medicine, Fuzong Clinical Medical College of Fujian Medical University, Dongfang Hospital of Xiamen University, The 900th Hospital of Joint Logistics Support Force, Fuzhou, China.
Front Med (Lausanne). 2024 Dec 24;11:1451751. doi: 10.3389/fmed.2024.1451751. eCollection 2024.
To evaluate the therapeutic potential of fecal microbiota transplantation (FMT) in treating severe pneumonia patients with concurrent pan-drug resistant infection.
A case report of a 95-year-old female patient with severe pneumonia, complicated by pan-resistant bacterial infections, is presented. The patient was diagnosed with severe pneumonia caused by COVID-19, along with co-infections of , , , , ESBL-producing pan-drug resistant and pan-resistant . During hospitalization, the patient underwent comprehensive treatments, including antimicrobials, mechanical ventilation, and fiberoptic bronchoscopic alveolar lavage. FMT was administered following the failure of conventional treatments to resolve recurrent diarrhea, increased sputum production, and persistent pan-drug resistant infection.
Post-FMT, the patient exhibited significant clinical improvement, including reduced sputum production, cessation of diarrhea, and the normalization of respiratory symptoms. Gut microbiota analysis revealed that FMT enhanced the abundance of beneficial microbiota and suppressed , and the patient was successfully discharged after 133 days of hospitalization.
FMT emerged as a pivotal intervention in the management of this severe pneumonia case, suggesting its efficacy in restoring gut microbiota balance and aiding recovery from multi-drug-resistant infections. This case underscores the potential of FMT as a therapeutic option in severe pulmonary infections, especially in the context of antibiotic resistance in severe pneumonia patients.
评估粪便微生物群移植（FMT）治疗合并泛耐药感染的重症肺炎患者的治疗潜力。
报告1例95岁女性重症肺炎患者，合并泛耐药细菌感染。该患者被诊断为新型冠状病毒肺炎（COVID-19）所致重症肺炎，同时合并 、 、 、 、产超广谱β-内酰胺酶（ESBL）的泛耐药 及泛耐药 感染。住院期间，患者接受了包括抗菌药物、机械通气和纤维支气管镜肺泡灌洗在内的综合治疗。在常规治疗未能解决反复腹泻、痰液增多和持续的泛耐药感染后，给予了FMT。
FMT后，患者临床症状显著改善，包括痰液分泌减少、腹泻停止和呼吸道症状恢复正常。肠道微生物群分析显示，FMT增加了有益微生物群的丰度并抑制了 ，患者住院133天后成功出院。
FMT成为该重症肺炎病例管理中的关键干预措施，表明其在恢复肠道微生物群平衡和帮助从多重耐药感染中恢复方面的有效性。该病例强调了FMT作为重症肺部感染治疗选择的潜力，尤其是在重症肺炎患者存在抗生素耐药的情况下。
