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免疫功能正常的成年人胃肠道非伤寒沙门氏菌感染抗生素治疗的警示:一例病例报告及文献综述

A Warning Against Antibiotic Treatment for Gastrointestinal Non-Typhoidal Salmonella Infections in Immunocompetent Adults: A Case Report and Review of the Literature.

作者信息

Keil Elizabeth

机构信息

Pharmacy, Providence Queen of the Valley Medical Center, Napa, USA.

出版信息

Cureus. 2024 Dec 18;16(12):e75953. doi: 10.7759/cureus.75953. eCollection 2024 Dec.

Abstract

is a common pathogen that causes foodborne illness worldwide. There is limited evidence describing the treatment of gastrointestinal non-typhoidal (NTS). Clinicians are inclined to treat these infections with antibiotics, but the use of antibiotics may paradoxically worsen gastrointestinal symptoms and prolong bacterial stool shedding. This is a case of gastrointestinal NTS in 30-year-old immunocompetent female patient. She experienced prolonged diarrhea for six weeks following food poisoning with Serovar Enteritidis and received antibiotics as a treatment for her symptoms. The antibiotics worsened her symptoms, and she continued to have positive stool tests. At week 11 following the initial infection, she was advised by her infectious diseases physician to avoid further antibiotic use and take probiotics including and kefir probiotics. These improved her gastrointestinal symptoms; however, she continued to have bacterial stool shedding for a total of 25 weeks. Antibiotics should be avoided for the treatment of gastrointestinal NTS in immunocompetent adults due to their lack of benefit and their potential for worsening and/or prolonging symptoms. Treatment should instead focus on recovering the gut microbiome.

摘要

是一种在全球范围内引起食源性疾病的常见病原体。描述胃肠道非伤寒性(NTS)治疗方法的证据有限。临床医生倾向于用抗生素治疗这些感染,但使用抗生素可能会适得其反,加重胃肠道症状并延长细菌粪便排泄时间。这是一例30岁免疫功能正常女性患者的胃肠道NTS病例。她在感染肠炎血清型食物中毒后持续腹泻六周,并接受了抗生素治疗其症状。抗生素使她的症状恶化,她的粪便检测仍呈阳性。在初次感染后的第11周,她的传染病医生建议她避免进一步使用抗生素,并服用包括开菲尔益生菌在内的益生菌。这些改善了她的胃肠道症状;然而,她的粪便细菌排泄总共持续了25周。由于缺乏益处且有可能加重和/或延长症状,免疫功能正常的成年人治疗胃肠道NTS时应避免使用抗生素。相反,治疗应侧重于恢复肠道微生物群。

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Kefir and Its Biological Activities.开菲尔及其生物活性。
Foods. 2021 May 27;10(6):1210. doi: 10.3390/foods10061210.
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Common Gastrointestinal Infections.常见的胃肠道感染
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