便微生物群移植对第一或第二 Clostridioides difficile 感染的现实世界的有效性
Sara Ellegaard Paaske1, Simon Mark Dahl Baumwall2, Tone Rubak3
1Department of Hepatology and Gastroenterology, Aarhus University Hospital, Aarhus, Denmark; Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
概括
便微生物种移植 (FMT) 有效地治疗第一个或第二个Clostridioides difficile感染 (CDI),重复治疗可以改善结果. 这种方法可以提高患者的生存率,并保证将其纳入治疗指南.
科学领域:
- 传染性疾病 传染性疾病
- 胃肠病学 胃肠病学
- 微生物学 微生物学
背景情况:
- 困难菌感染 (CDI) 具有显著的死亡风险.
- 便微生物群移植 (FMT) 已被确立为复发性CDI,但其在初始发作中的使用正在调查中.
- 对于第一个或第二个CDI,关于FMT的现实数据有限.
研究的目的:
- 在临床环境中评估FMT在治疗首次或第二次CDI发作中的有效性.
- 评估非复发性CDI的FMT后的治愈率和死亡率.
- 提供关于早期CDI阶段的FMT指导方针建议的证据.
主要方法:
- 丹麦的一项多站点队列研究包括467名第一或第二次CDI患者,他们接受了FMT治疗.
- 主要终点是FMT后8周治愈C. difficile相关的腹 (CDAD).
- 二级终点包括早期治愈率和90天死亡率.
主要成果:
- 在第一个FMT后的第1周76%的CDAD整体治愈,在第8周55%的CDAD整体治愈.
- 重复的FMT治疗导致CDAD的整体治愈率为79%.
- 在诊断后的90天死亡率为10%.
结论:
- 重复的FMT治疗对于管理第一个或第二次CDI发作是非常有效的.
- 将FMT纳入CDI治疗指南可能会改善患者的生存率.
- 这项研究支持扩大FMT的使用范围,超越经常性CDI.
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