Fecal microbiota transplantation for the management of Clostridium difficile infection.
Fecal microbiota transplantation for the management of Clostridium difficile infection.
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DOI：
10.1016/j.idc.2014.11.009
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发表时间：
2015-03
影响因子：
4.4
通讯作者：
Young VB
中科院分区：
文献类型：
--
作者：
Rao K;Young VB
人类肠道微生物群是一个由数千种细菌组成的多样化生态系统。1据认为，这种生态系统的作用之一是防止病原体的入侵。2，3对CDI发病机制的主要理解是，它需要破坏肠道微生物群作为症状性疾病发作的先决条件（图1）。这种破坏通常通过暴露于抗生素而发生，抗生素将微生物组的组成和功能改变为对CDI敏感的状态。5暴露于艰难梭菌孢子后，患者可以无症状地定植或出现症状性感染。6，7艰难梭菌孢子萌发和营养生长后定植。毒素TcdA和TcdB（艰难梭菌的主要毒力因子）的后续表达导致上皮损伤和症状性感染。CDI可以是自限性的8，9，但通常需要使用对艰难梭菌具有活性的抗生素治疗，10尽管治疗是非特异性的，并且对其他肠道细菌具有活性。感染的特征包括腹泻、白细胞增多、发热或假膜性结肠炎。10有些患者可能会出现严重的疾病，包括腹痛、肠梗阻或感染性休克等体征和症状，导致入住重症监护室（ICU）、腹部手术（如结肠切除术），甚至死亡。11
The human gut microbiota is a diverse ecosystem consisting of thousands of bacterial species. 1 It is thought that one role of this ecosystem is to protect against invasion by pathogens. 2, 3 The predominant understanding of the pathogenesis of CDI is that it requires disruption of the gut microbiota as a prerequisite for the onset of symptomatic disease (Fig. 1). 4 This disruption usually occurs through exposure to antibiotics, which alter the composition and function of the microbiome to a state susceptible to CDI. 5 After exposure to C difficile spores, patients can either become asymptomatically colonized or develop symptomatic infection. 6, 7 Colonization follows germination of the C difficile spores and vegetative outgrowth. Subsequent expression of the toxins TcdA and TcdB, the main virulence factors of C difficile, results in epithelial damage and symptomatic infection. CDI can be self-limited8, 9 but usually requires treatment with antibiotics that have activity against C difficile, 10 although the treatments are nonspecific and have activity against other gut bacteria. Features of infection include diarrhea, leukocytosis, fever, or pseudomembranous colitis. 10 Some patients can experience severe disease, including signs and symptoms such as abdominal pain, ileus, or septic shock that results in admission to an intensive care unit (ICU), abdominal surgery such as colectomy, or even death. 11
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DOI：
10.1093/cid/cis499
发表时间：
2012-08
期刊：
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
影响因子：
--
作者：
Crook DW;Walker AS;Kean Y;Weiss K;Cornely OA;Miller MA;Esposito R;Louie TJ;Stoesser NE;Young BC;Angus BJ;Gorbach SL;Peto TE;Study 003/004 Teams
通讯作者：
Study 003/004 Teams
影响因子：
14.2
作者：
Debast, S. B.;Bauer, M. P.;Kuijper, E. J.
通讯作者：
Kuijper, E. J.
影响因子：
9.8
作者：
Angelberger, Sieglinde;Reinisch, Walter;Erry, David B.
通讯作者：
Erry, David B.
影响因子：
15.9
作者：
Britton, Robert A.;Young, Vincent B.
通讯作者：
Young, Vincent B.
影响因子：
2.3
作者：
Bakken, Johan S.
通讯作者：
Bakken, Johan S.