Updates and Challenges in Fecal Microbiota Transplantation for Clostridioides difficile Infection in Children.
Updates and Challenges in Fecal Microbiota Transplantation for Clostridioides difficile Infection in Children.
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DOI：
10.1097/mpg.0000000000003229
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发表时间：
2021-10-01
影响因子：
2.9
通讯作者：
Kellermayer R
中科院分区：
文献类型：
--
作者：
Hourigan SK;Nicholson MR;Kahn SA;Kellermayer R
粪便微生物群移植（FMT）是目前治疗儿科复发性艰难梭菌感染（rCDI）最有效但监管不严的疗法。在过去的两年中，在为儿科患者提供FMT的能力方面存在越来越大的挑战。首先，FDA在2019年的安全警报报告了一种多重耐药微生物从FMT供体传播到受体，导致一名患者死亡。其次，COVID-19疫情引发了进一步的安全和监管挑战。生物治疗是rCDI的有前景且更容易监管的治疗选择，在监管机构批准后，其可能在不久的将来取代FMT用于成人。然而，对于儿童而言，此类批准预计将大大延迟，这引起了人们对rCDI儿童获得有效治疗的机会有限的担忧。在这篇评论中，我们讨论了最近的挑战和未来的方向FMT和微生物治疗儿童rCDI。
Fecal microbiota transplantation (FMT) is currently the most effective, but loosely regulated therapy, for recurrent Clostridioides difficile infection (rCDI) in pediatrics. Over the last two years, there have been mounting challenges in the ability to provide FMT to pediatric patients. Firstly, an FDA safety alert in 2019 reported transmission of a multi-drug resistant organism from FMT donor to recipient resulting in the death of one patient. Secondly, the COVID-19 pandemic induced further safety and regulatory challenges. Biotherapeutics are promising and more readily regulated treatment options for rCDI, which may replace FMT in the near future for adults upon regulatory agency approvals. Such approvals, however, are expected to be significantly delayed for children, raising concerns for limited access to effective treatment for children with rCDI. In this commentary, we discuss the recent challenges and future directions of FMT and microbial therapeutics in children with rCDI.