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在接受长期护理的患者中移植微生物群:哨兵反非随机临床试验

Michael H Woodworth¹, Ahmed Babiker¹, Radhika Prakash-Asrani¹

¹Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.

JAMA network open

|July 24, 2025

概括

便微生物种移植 (FMT) 对于长期急性护理医院患者具有多药耐药生物体 (MDROs) 似乎是安全和可接受的. 需要进一步的研究来确认减少MDRO殖民和抗生素使用的潜在益处.

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:

在长期急性护理医院 (LTACH) 患者中,肠道多药耐药生物体 (MDRO) 殖民是常见的,增加了感染和传播风险.
目前缺乏FDA批准的疗法来减少肠道MDRO殖民.

研究的目的:

评估便微生物群移植 (FMT) 的安全性和可接受性,在用MDROs定居的LTACH患者中.

主要方法:

一个单中心,开放标签,非随机临床试验,涉及42名LTACH患者 (10名FMT接受者,32名对照).
在没有抗生素或肠道制备的情况下,通过胃口管或阴道注射FMT.
通过对长达6个月的不良事件进行安全评估;通过周围培养物监测MDRO殖民.

主要成果:

FMT是安全的,耐受性很好,没有严重的不良事件归因于该程序;报告了轻微的诱导不良事件.
虽然在最后一次访问时,所有FMT接受者仍然服用MDRO,但事后分析表明,与对照人群相比,细菌病症,肠道病原体占主导地位和抗生素使用可能有数量减少.
这些观察到的差异没有达到统计学意义,这可能是由于研究的样本规模有限.

结论:

便微生物群移植 (FMT) 是MDRO殖民的LTACH患者的安全和可接受的干预措施.
初步发现表明,FMT在减少细菌病,病原体主导和抗生素使用方面具有潜在的益处.
需要进行更大规模的随机对照试验,以最终评估FMT在该患者群体中的疗效.

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