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Crit Care:粪便菌群移植治疗重症患者抗生素相关性腹泻

2019-10-27 xing.T MedSci原创

由此可见,该研究的结果表明在AAD的重症患者中使用FMT,临床效果良好,未察到感染并发症。这些发现会鼓励研究人员进行新的临床试验,从而对ICU中该操作的潜在益处和安全性提供更多见解。

抗生素相关性腹泻(AAD)是加重危重患者预后的危险因素。暴露于抗生素引起的菌群失调揭示了这些患者采用粪便微生物群移植(FMT)的潜在治疗作用。近日,危重病医学领域权威杂志Critical Care上发表了一篇研究文章,该研究旨在评估危重患者AAD时采用FMT的安全性和潜在益处。

从2015年9月至2019年2月,来自中国FMT数据库的AAD重症患者接受了FMT。不良事件(AEs)和FMT成功情况至少在12周随访期间进行评估,FMT成功主要集中在腹部症状和ICU后存活率的改善。

20例AAD的危重患者接受了抢救性FMT,其中18例患者被纳入进行了分析。入住重症监护病房(ICU)时,急性生理和慢性健康评估(APACHE)II分数的平均值为21.7±±8.3(范围为11-37)。13例患者通过鼻空肠管接受FMT,4例患者通过镜接受FMT,1例患者通过灌肠接受FMT。在AAD发作之前和期间,患者接受了四种(4.2±2.1,范围为2-9)抗生素治疗。随访期间38.9%(7/18)的患者发生了FMT相关的AE,包括腹泻频率增加,腹痛,血清淀粉酶增加和发烧。在随访期间发生了8例与FMT无关的死亡。FMT后可腹痛改善率为100%(2/2),腹泻改善为86.7%(13/15),腹胀改善为69.2%(9/13)和血便改善为50%(1/2)。44.4%(8/18)的患者从腹部症状中恢复,没有复发,并且从ICU出院后至少存活了12周。

由此可见,该研究的结果表明在AAD的重症患者中使用FMT,临床效果良好,未察到感染并发症。这些发现会鼓励研究人员进行新的临床试验,从而对ICU中该操作的潜在益处和安全性提供更多见解。 

原始出处:

Min Dai,et al.Rescue fecal microbiota transplantation for antibiotic-associated diarrhea in critically ill patients.Critical Care.2019.https://ccforum.biomedcentral.com/articles/10.1186/s13054-019-2604-5

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