AP&T: 细菌混合物要比单纯粪便菌群移植在治疗难治性梭状芽胞杆菌感染中效果更佳

2021-04-21 MedSci原创 MedSci原创

粪菌移植在治疗难治性梭状芽胞杆菌感染的效果已经得到很多的证实,但是存在很多的副作用,比如肠道外感染情况的发生。

      粪菌移植在治疗难治性梭状芽胞杆菌感染的效果已经得到很多的证实,但是存在很多的副作用,比如肠道外感染情况的发生。因此,一些成分更加明确的细菌混合物可能是粪便微生物菌群移植(FMT)的更安全替代方案。本项研究旨在比较由12种菌株构成的细菌混合疗法联合FMT或万古霉素治疗难治性梭状芽胞杆菌感染(CDI)的效果。

 

      研究人员筛选了经实验室确认的复发性CDI感染的患者,在进行FMT和细菌混合物治疗之前,先用万古霉素预处理了7-14天。连续三天进行直肠灌肠疗法,灌肠一次再进行FMT一次,在14天内重复这样的治疗2到3次。万古霉素组单独治疗14天。主要观察结局是90天内临床治愈率。次要结果是180天全因死亡率。

 

      研究结果显示与接受FMT治疗方法相比,细菌混合物灌肠治疗和万古霉素治疗的临床治愈率更高:45%VS 76%VS 76%(OR 3.9,95%CI(1.4-11.4),P <0.01),治愈的频率更高。直肠细菌灌肠疗法和万古霉素的疗效相似(P = 0.61)。FMT组死亡率为6%,细菌灌肠疗法组为13%,万古霉素组为23%。与万古霉素相比,FMT有降低死亡率的趋势,(OR0.2(0.04-1.12),P = 0.07)。

 

      本项研究证实直肠细菌灌肠疗法似乎与万古霉素一样有效,但每周灌肠1-3次的FMT治疗方法在治疗复发性艰难梭菌感染方面优于万古霉素,并可能降低死亡率。

 

 

 

原始出处:

Anne Abildtrup Rode. Et al. Randomised clinical trial: a 12‐strain bacterial mixture versus faecal microbiota transplantation versus vancomycin for recurrent Clostridioides difficile infections. Alimentary Pharmacology & Therapeutics.2021.

 

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1466965, encodeId=0c601466965d8, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468142, encodeId=ab481468142c3, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5be6890024, createdName=hmwwww, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528745, encodeId=555e1528e4547, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047328, encodeId=3cd3104e328f9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Apr 21 15:52:03 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959029, encodeId=fbb295902917, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/240d3ae7a8e8452d9f49793c3923ad60/78defa70ab2947c28066b378f1117648.jpg, createdBy=fa315475285, createdName=梅斯小助手, createdTime=Wed Apr 21 13:44:16 CST 2021, time=2021-04-21, status=1, ipAttribution=)]
    2021-04-23 Homburg
  2. [GetPortalCommentsPageByObjectIdResponse(id=1466965, encodeId=0c601466965d8, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468142, encodeId=ab481468142c3, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5be6890024, createdName=hmwwww, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528745, encodeId=555e1528e4547, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047328, encodeId=3cd3104e328f9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Apr 21 15:52:03 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959029, encodeId=fbb295902917, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/240d3ae7a8e8452d9f49793c3923ad60/78defa70ab2947c28066b378f1117648.jpg, createdBy=fa315475285, createdName=梅斯小助手, createdTime=Wed Apr 21 13:44:16 CST 2021, time=2021-04-21, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1466965, encodeId=0c601466965d8, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468142, encodeId=ab481468142c3, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5be6890024, createdName=hmwwww, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528745, encodeId=555e1528e4547, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047328, encodeId=3cd3104e328f9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Apr 21 15:52:03 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959029, encodeId=fbb295902917, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/240d3ae7a8e8452d9f49793c3923ad60/78defa70ab2947c28066b378f1117648.jpg, createdBy=fa315475285, createdName=梅斯小助手, createdTime=Wed Apr 21 13:44:16 CST 2021, time=2021-04-21, status=1, ipAttribution=)]
    2021-04-23 freve
  4. [GetPortalCommentsPageByObjectIdResponse(id=1466965, encodeId=0c601466965d8, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468142, encodeId=ab481468142c3, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5be6890024, createdName=hmwwww, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528745, encodeId=555e1528e4547, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047328, encodeId=3cd3104e328f9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Apr 21 15:52:03 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959029, encodeId=fbb295902917, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/240d3ae7a8e8452d9f49793c3923ad60/78defa70ab2947c28066b378f1117648.jpg, createdBy=fa315475285, createdName=梅斯小助手, createdTime=Wed Apr 21 13:44:16 CST 2021, time=2021-04-21, status=1, ipAttribution=)]
    2021-04-21 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1466965, encodeId=0c601466965d8, content=<a href='/topic/show?id=edd5e630426' target=_blank style='color:#2F92EE;'>#粪便#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76304, encryptionId=edd5e630426, topicName=粪便)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=03cc6863823, createdName=Homburg, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1468142, encodeId=ab481468142c3, content=<a href='/topic/show?id=ab52e63254e' target=_blank style='color:#2F92EE;'>#粪便菌群移植#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76325, encryptionId=ab52e63254e, topicName=粪便菌群移植)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c5be6890024, createdName=hmwwww, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1528745, encodeId=555e1528e4547, content=<a href='/topic/show?id=74b798601a1' target=_blank style='color:#2F92EE;'>#难治性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=98601, encryptionId=74b798601a1, topicName=难治性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a1ef11916292, createdName=freve, createdTime=Fri Apr 23 03:52:03 CST 2021, time=2021-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047328, encodeId=3cd3104e328f9, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=52, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Wed Apr 21 15:52:03 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=959029, encodeId=fbb295902917, content=三人行,必有我师。 <a href='/topic/show?id=d55f104233bd' target=_blank style='color:#2F92EE;'>#梅斯医学科研互助群#</a> 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=104233, encryptionId=d55f104233bd, topicName=梅斯医学科研互助群)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210413/240d3ae7a8e8452d9f49793c3923ad60/78defa70ab2947c28066b378f1117648.jpg, createdBy=fa315475285, createdName=梅斯小助手, createdTime=Wed Apr 21 13:44:16 CST 2021, time=2021-04-21, status=1, ipAttribution=)]
    2021-04-21 梅斯小助手

    三人行,必有我师。 #梅斯医学科研互助群# 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!

    0

相关资讯

Dig Dis Sci:结肠镜下粪便菌群移植(FMT)优于灌肠和鼻胃管的方式治疗艰难梭菌难治性感染

粪便微生物群移植(FMT)是使用健康供体的粪便输入至目标人群中,目的是改变患者肠道微生物组的多样性。

Clin Gastroenterology H:粪便微生物菌群移植术可以降低难治性重度艰难梭菌感染患者的死亡率

粪菌移植是将健康捐赠者粪便中的功能菌群通过一定方式移植到患者肠道内,重建肠道微生物稳态,调节肠道菌群的失调,从而发挥治疗肠道菌群失调疾病的作用。

IBD :患有艰难梭菌感染的炎症性肠病患者接受粪便微生物群移植后临床结局分析

炎性肠病(IBD)患者患有艰难梭菌反复感染(CDI)是一项很严峻的临床治疗挑战。粪便菌群移植(FMT)已经作为一种复发性的CDI疗法出现。但人们对于FMT治疗会对IBD疾病活动性的恶化存在担忧。

Lancet Infect Dis:II价艰难梭菌疫苗III期临床研究失败

类毒素A和B二价艰难梭菌疫苗不能降低高风险人群的艰难梭菌感染风险

Dig Dis Sci:高危感染艰难梭菌老年人应该进行粪便微生物菌群移植减少疾病复发

粪便菌群移植(FMT)对复发性艰难梭菌(Clostridioides difficile)感染(CDI)的治疗非常有效的办法。

IBD:患有艰难梭菌感染的炎性肠病患者出院后 90天内再入院的危险因素分析

艰难梭菌感染(CDI)被认为是一种公共卫生问题,它会导致患者住院时间,费用,死亡率和结肠切除率增加,特别是对于炎症性肠病患者来说,这样的影响更为明显。