Efficacy of Combined Jejunal and Colonic Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection
Efficacy of Combined Jejunal and Colonic Fecal Microbiota Transplantation for Recurrent Clostridium difficile Infection
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DOI：
10.1016/j.cgh.2013.12.032
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发表时间：
2014-09-01
影响因子：
12.6
通讯作者：
Fricke, W. Florian
中科院分区：
文献类型：
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作者：
Dutta, Sudhir K.;Girotra, Mohit;Fricke, W. Florian
复发性艰难梭菌感染 (RCDI) 的患病率正在增加；粪便微生物群移植（FMT）是一种有效的疗法。然而，尚无关于单次肠内和结肠 FMT 联合治疗的功效或捐赠者和接受者之间微生物群变化特征的研究。我们对 27 名 RCDI 患者进行了一项研究，这些患者通过小肠镜检查和结肠镜检查一次性接受了固定体积的处理过的粪便滤液。对患者进行密切监测，并从 2 对患者-捐赠者中收集粪便样本进行 16S rRNA 分析。所有患者的排便次数、腹痛、白细胞计数和粪便艰难梭菌毒素均减少（P < .05）。 FMT 增加了微生物多样性，增加了毛螺菌科（厚壁菌门）的比例，并减少了肠杆菌科的比例。 FMT 与 2 名 RCDI 患者粪便微生物群组成的显着变化相关。
The prevalence of recurrent Clostridium difficile infection (RCDI) is increasing; fecal microbiota transplantation (FMT) is an effective therapy. However, there have been no studies of the efficacy of a single session of combined enteral and colonic FMT or characterizations of changes in the microbiota between donors and recipients. We performed a study of 27 patients with RCDI who were given a fixed volume of processed fecal filtrate via enteroscopy and colonoscopy in a single session. Patients were closely monitored, and fecal samples were collected from 2 patient-donor pairs for 16S rRNA analysis. All patients had reduced stool frequency, abdominal pain, white blood cell counts, and elimination of fecal C difficile toxin (P < .05). FMT increased microbial diversity, increasing proportions of Lachnospiraceae (phylum Firmicutes) and reducing proportions of Enterobacteriaceae. FMT was associated with marked changes in the composition of fecal microbiota in 2 patients with RCDI.