The intestinal microbiota and susceptibility to infection in immunocompromised patients.
The intestinal microbiota and susceptibility to infection in immunocompromised patients.
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DOI：
10.1097/qco.0b013e3283630dd3
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发表时间：
2013-08
影响因子：
3.9
通讯作者：
Pamer EG
中科院分区：
文献类型：
--
作者：
Taur Y;Pamer EG
免疫功能低下患者的许多感染起源于胃肠道。这些感染的发病机制通常始于肠道菌群的改变。了解微生物群及其如何引起或预防感染对于开发更有效的预防和治疗这些感染至关重要。这篇文章回顾和讨论了最近的工作提供洞察肠道微生物群这些高危免疫功能低下的患者。研究继续支持这样一个前提，即共生菌，主要是厌氧菌，通过微生物群落内部和与宿主的相互作用，防止与更多致病菌的过度生长或支配，从而维持微生物的稳定性和定植抗性。在因大剂量化疗或造血干细胞移植而产生免疫抑制的患者中，抗生素对微生物群的破坏以及宿主免疫的损害会引起有利于致病菌控制肠道的扰动，导致细菌易位增加和对全身性感染的易感性。了解肠道微生物群和抗生素的影响将有助于指导我们治疗这些肠道源性感染。
Many infections of immunocompromised patients originate from the gastrointestinal tract. The pathogenesis of these infections often begins with alteration of the intestinal microbiota. Understanding the microbiota and how it can either cause or prevent infection is vital for the development of more effective prevention and treatment of these infections. This article reviews and discusses recent work providing insight into the intestinal microbiota of these at-risk immunocompromised patients. Studies continue to support the premise that commensal bacteria, largely anaerobic, serve to maintain microbial stability and colonization resistance by preventing overgrowth or domination with more pathogenic bacteria, through interactions within the microbial community and with the host. In patients with immune suppression due to high-dose chemotherapy or hematopoietic stem cell transplantation, disruption of the microbiota through antibiotics as well as impairment of host immunity gives rise to perturbations favoring intestinal domination by pathogenic species, leading to increased bacterial translocation and susceptibility to systemic infection. An understanding of the intestinal microbiota and the impact of antibiotics will help to guide our treatment of these gut-originating infections.