An Ounce of Prevention Is Equivalent to How Much Decolonization Exactly?
An Ounce of Prevention Is Equivalent to How Much Decolonization Exactly?
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一盎司的预防相当于多少非殖民化？
DOI：
10.1093/cid/ciaa1524
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发表时间：
2021
期刊：
影响因子：
--
通讯作者：
Kraft,ColleenS
中科院分区：
文献类型：
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作者：
Woodworth,MichaelH;Kwon,JennieH;Kraft,ColleenS
去殖民化：一个模型，粪便微生物群移植的患者与多重耐药生物体。作为进行粪便微生物组移植的转化微生物组治疗临床试验的传染病医生（FMT; https：//clinicaltrials. gov/ct 2/show/NCT 02922816），以及一家大型学术医疗中心的高级管理人员，我们认识到，在潜在风险日益复杂的情况下，减少抗生素给药、住院时间和血流感染可能是FMT的重要益处。[1]我们感谢作者为促进对FMT应用的理解以应对抗菌素耐药性威胁所做的工作。在审查了手稿和补充材料后，我们失望地发现作者没有在他们的研究中报告绝对的多药耐药微生物（MDRO）去殖民化频率或比例。在试图定义或检测MDRO的肠道定植时存在多个重要挑战，更不用说对治疗的反应了。[2]然而，试图推进FMT和其他微生物组疗法研究的一个主要限制是在关键数据的遗漏和阴性结果研究的发表频率较低方面的发表偏倚。我们鼓励作者提供这些数据，以促进理解，并可能为将来类似临床试验数据的荟萃分析提供信息。
Decolonization: A Model for Fecal Microbiota Transplantation in Patients Colonized with Multidrugresistant Organisms. As infectious disease physicians who conduct translational microbiome therapeutic clinical trials of fecal microbiome transplantation (FMT; https://clinicaltrials. gov/ct2/show/NCT02922816), and a senior administrator in a large academic medical center, we recognize that reduced antimicrobial administration, length of stay, and bloodstream infections may be important benefits of FMT in the increasingly complex landscape of potential risks.[1] We thank the authors for their work towards advancing understanding of the application of FMT to address threats of antimicrobial resistance.After reviewing the manuscript and supplemental materials, we were disappointed to find that the authors did not report the absolute multi-drug resistant organisms (MDRO) decolonization frequencies or proportions in their study. There are multiple important challenges in attempting to define or detect intestinal colonization with MDROs, much less response to a treatment.[2] However, a major limitation in trying to advance the study of FMT and other microbiome therapeutics is publication bias both in terms of omission of key data and the less frequent publication of studies with negative results. We encourage the authors to make these data available, both to advance understanding and to potentially inform future meta-analyses of data from similar clinical trials.