Clin Gastroenterology H: 粪菌移植治疗对儿童艰难梭菌感染的疗效

2020-02-23 不详 MedSci原创

粪便菌群移植(FMT)通常用于治疗艰难梭菌感染(CDI)。CDI是小儿患者腹泻病的日益增加的原因,但是FMT对儿童的作用尚未得到很好的研究。本项研究对儿童和年轻成人患者进行了多中心回顾性队列研究,以评估与成功进行FMT治疗CDI相关的疗效,安全性和因素。

背景与目标
粪便菌群移植(FMT)通常用于治疗艰难梭菌感染(CDI)。CDI是小儿患者腹泻病的日益增加的原因,但是FMT对儿童的作用尚未得到很好的研究。本项研究对儿童和年轻成人患者进行了多中心回顾性队列研究,以评估与成功进行FMT治疗CDI相关的疗效,安全性和因素。

方法
研究人员对2004年2月1日至2017年2月在18个儿科中心接受FMT的372例11个月至23岁的患者进行了回顾性研究; 可从335例患者中获得2个月的结局数据。成功的FMT定义为FMT后2个月内CDI不再复发。研究人员进行了逐步逻辑回归分析,以识别与成功的FMT相关的因素。

结果
在335名接受FMT并随访2个月或更长时间的患者中,有271名(81%)在单次FMT后获得了成功的结果,而86.6%在首次或重复FMT之后获得了成功的结果。接受新鲜供体粪便的FMT([OR],2.66; 95%CI,1.39–5.08)的患者,通过结肠镜检查进行了FMT(OR,2.41; 95%CI,1.26-4.61),没有饲管(OR,2.08; 95%CI,1.05-4.11),或者在FMT之前CDI发作少(OR,1.20; 95%CI,1.04-1.39),成功进行FMT的几率增加。在三个月的随访期内,有17名患者(4.7%)出现严重不良事件,包括10例住院治疗。

结论
根据大型多中心回顾性研究的结果,FMT对于治疗儿童和年轻人的CDI是安全有效的。

原始出处:
Maribeth R. Nicholson. Et al. Efficacy of Fecal Microbiota Transplantation for Clostridium difficile Infection in Children. Clinical Gastroenterology Hepatology. 2020.

本文系梅斯医学(MedSci)原创编译整理,转载需授权!

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    2020-06-07 许安
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    2020-02-23 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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