粪菌移植治疗艰难梭菌感染的研究进展

Treatment of Clostridium difficile infection with fecal microbiota transplantion: research progress

艰难梭菌感染(Clostridium difficile infection,CDI)是院内抗生素相关性腹泻的最重要因素之一,其主要临床表现包括血便、腹泻、中毒性巨结肠、伪膜性肠炎等。近年来,CDI发病率、复发率、死亡率和治疗费用均明显增加,但其各种治疗方法均有局限性,尤其是抗生素治疗复发性艰难梭菌感染已面临许多棘手问题。目前证实肠道菌群失调和CDI感染关系密切,肠道菌群紊乱后导致艰难梭菌过度繁殖并释放毒素,可导致艰难梭菌感染。粪菌移植作为重建肠道菌群的重要方式,已成为复发性、难治性艰难梭菌感染最有效的治疗方式之一,不良反应极少。本文就国内外粪菌移植治疗艰难梭菌感染的研究进展作一综述。

Clostridium difficile infection(CDI) is one of the leading causes of antibiotic associated diarrhea in hospital, and its main clinical manifestation includes blood stool, diarrhea, toxic megacolon, pseudomembranous enteritis, etc. In recent years, the incidence, recurrence rate, mortality rate and treatment cost of CDI have increased significantly, but various treatment methods have their limitations. Especially for recurrent Clostridium difficile infection(rCDI), antibiotic treatment has been facing many challenges. Previous studies have exhibited the strong relationships between intestinal microbiota dysbiosis and CDI infection: microbiota disorder would cause the excessive reproduction of Clostridium difficile and the release of toxins. As an important way to rebuild intestinal flora, fecal microbiota transplantation(FMT) is recognized as an effective therapeutic modality for recurrent or refractory CDI, with less adverse reactions reported during treatment. In conclusion, this research aims to give an overview on the progress in research on the treatment of CDI.