Clinical Efficacy and Microbiome Changes Following Fecal Microbiota Transplantation in Children With Recurrent Clostridium Difficile Infection.
Clinical Efficacy and Microbiome Changes Following Fecal Microbiota Transplantation in Children With Recurrent Clostridium Difficile Infection.
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复发性艰难梭菌感染儿童粪便微生物移植后的临床疗效和微生物组变化
DOI：
10.3389/fmicb.2018.02622
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发表时间：
2018
影响因子：
5.2
通讯作者：
Wang Y
中科院分区：
文献类型：
--
作者：
Li X;Gao X;Hu H;Xiao Y;Li D;Yu G;Yu D;Zhang T;Wang Y
粪便微生物群移植（FMT）已被证明是成人复发性艰难梭菌感染（RCDI）的有效治疗方法。本研究旨在评价FMT治疗儿童RCDI的临床疗效，并探讨FMT治疗期间粪便微生物群的变化。这项单中心前瞻性初步研究共入组了11例中位年龄为3.5岁的RCDI受试者。经鼻肠管上消化道途径（13/16，81.2%）或直肠下消化道途径（3/16，18.8%）FMT治愈11例（11/11，100%）。单次FMT治愈率为63.6%（7/11），4例（4/11，36.4%）行2 ~ 3次FMT。4名儿童（4/11，36.4%）报告了轻度不良事件，包括一过性腹泻、轻度腹痛、一过性发热和呕吐。从34名参与者（9名RCDI儿童，9名供体和16名健康对照）收集的59份粪便样本的肠道微生物群组成分析显示，FMT前儿童RCDI患者的α多样性低于健康对照和供体，FMT前样本的粪便微生物群落（β多样性）与健康对照和供体不同。供体和健康对照之间的α多样性，β多样性或系统发育距离没有显着差异。在FMT后，儿科RCDI患者的肠道微生物群的丰富性和多样性都得到了改善，细菌群落更接近供体和健康对照组。此外，FMT将儿科RCDI的肠道微生物组功能重新导向健康状态。我们的研究结果表明，使用FMT治疗小儿RCDI是安全和耐受的。FMT使RCDI儿童的肠道微生物组组成和功能向健康状态转变。
Fecal microbiota transplantation (FMT) has been shown as an effective treatment for recurrent clostridium difficile infection (RCDI) in adults. In this study, we aim to evaluate the clinical efficacy of FMT in treating children with RCDI, and explore fecal microbiota changes during FMT treatment. A total of 11 RCDI subjects with a median age of 3.5 years were enrolled in this single-center prospective pilot study. All patients were cured (11/11, 100%) by FMT either through upper gastrointestinal tract route with a nasointestinal tube (13/16, 81.2%) or lower gastrointestinal tract route with a rectal tube (3/16, 18.8%). The cure rate of single FMT was 63.6% (7/11), and 4 (4/11, 36.4%) cases were performed with 2 or 3 times of FMT. Mild adverse events were reported in 4 children (4/11, 36.4%), including transient diarrhea, mild abdominal pain, transient fever and vomit. Gut microbiota composition analysis of 59 fecal samples collected from 34 participants (9 RCDI children, 9 donors and 16 health controls) showed that the alpha diversity was lower in pediatric RCDI patients before FMT than the healthy controls and donors, and fecal microbial community of pre-FMT samples (beta diversity) was apart from that of healthy controls and donors. No significant differences in alpha diversity, beta diversity or phylogenetic distance were detected between donors and healthy controls. Both the richness and diversity of gut microbiota were improved in the pediatric RCDI patients after FMT, and the bacteria community was shifted closer to the donor and healthy control group. Furthermore, FMT re-directed gut microbiome functions of pediatric RCDI toward a health state. Our results indicate that it is safe and tolerant to use FMT in treating pediatric RCDI. FMT shifted the gut microbiome composition and function in children with RCDI toward a healthy state.
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影响因子：
12.3
作者：
Lloyd-Price J;Abu-Ali G;Huttenhower C
通讯作者：
Huttenhower C
影响因子：
11.8
作者：
McDonald, L. Clifford;Gerding, Dale N.;Wilcox, Mark H.
通讯作者：
Wilcox, Mark H.
DOI：
10.1056/nejmra0707500
发表时间：
2008-10-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Kelly, Ciaran P;LaMont, J Thomas
通讯作者：
LaMont, J Thomas
影响因子：
3.6
作者：
Gupta, Arjun;Pardi, Darrell S.;Khanna, Sahil
通讯作者：
Khanna, Sahil
影响因子：
46.9
作者：
通讯作者：
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