Microbiome mediation of infections in the cancer setting.
Microbiome mediation of infections in the cancer setting.
复制标题
DOI：
10.1186/s13073-016-0306-z
复制
发表时间：
2016-04-18
期刊：
影响因子：
12.3
通讯作者：
Pamer EG
中科院分区：
文献类型：
--
作者：
Taur Y;Pamer EG
在癌症环境中遇到的感染可能由密集的癌症治疗引起，也可能由癌症本身引起，通过免疫妥协、解剖屏障破坏和暴露于医院（医院获得性）病原体而导致感染风险。因此，癌症相关感染是独特的，在流行病学上不同于其他患者人群，可能对临床医生治疗特别具有挑战性。越来越多的证据表明，微生物组是癌症患者感染并发症风险的关键因素。经常遇到的与微生物组有联系的病原体包括耐万古霉素的肠球菌、肠杆菌科和艰难梭菌;这些生物体在正常情况下可以在人体内存在而没有疾病，但当微生物组被破坏时，它们都可以作为感染出现。在癌症患者中，这种破坏可能是由于诸如化疗、广谱抗生素或通过手术改变解剖结构等干预措施造成的。在这篇综述中，我们讨论了微生物组在癌症相关感染中的重要作用的证据;如何更好地理解微生物组的作用可以促进我们对这些并发症的理解;以及如何利用这些知识来改善癌症患者的预后并降低感染风险。
Infections encountered in the cancer setting may arise from intensive cancer treatments or may result from the cancer itself, leading to risk of infections through immune compromise, disruption of anatomic barriers, and exposure to nosocomial (hospital-acquired) pathogens. Consequently, cancer-related infections are unique and epidemiologically distinct from those in other patient populations and may be particularly challenging for clinicians to treat. There is increasing evidence that the microbiome is a crucial factor in the cancer patient’s risk for infectious complications. Frequently encountered pathogens with observed ties to the microbiome include vancomycin-resistant Enterococcus, Enterobacteriaceae, and Clostridium difficile; these organisms can exist in the human body without disease under normal circumstances, but all can arise as infections when the microbiome is disrupted. In the cancer patient, such disruptions may result from interventions such as chemotherapy, broad-spectrum antibiotics, or anatomic alteration through surgery. In this review, we discuss evidence of the significant role of the microbiome in cancer-related infections; how a better understanding of the role of the microbiome can facilitate our understanding of these complications; and how this knowledge might be exploited to improve outcomes in cancer patients and reduce risk of infection.