摘要
粪菌移植(fecal microbiota transplantation,FMT)是治疗艰难梭菌感染的一个重要选择。研究表明,FMT也可能在管理与肠道微生物群变化相关的其他疾病方面发挥作用。虽然医疗界正在用最新的观点评估FMT,且患者正在变得越来越了解FMT,但在将非标准化的治疗方案转化为安全和管理恰当的临床实践中存在技术和后勤问题。鉴于此,需要一个基于证据的指南来推动FMT的实际实施。在这个欧洲共识会议上,来自10个国家的28名专家,分成多个小组并通过循证过程对以下事项提供了指南:FMT适应证、供体选择、粪便材料的准备、临床管理和移植实施,以及建立一个FMT中心的基本要求。每个小组提出的指南经过全体成员的评估和投票,首先通过Delphi电子流程,随后经过全体共识会议。指南根据现有最佳证据提出,目的是为计划进行FMT的医师提供指导,以期支持这种疗法的广泛适用性,探讨与FMT有关的其他事项并促进未来在肠道菌群操作领域的临床研究。共识报告强烈建议建立治疗艰难梭菌感染的FMT中心,并提供技术、标准、管理和实验室相关要求。
Fecal microbiota transplantation （FMT） is an important therapeutic option for Clostridium difficile （ C. difficile） infection. Promising findings suggest that FMT may play a role in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 coun- tries collaborated, were divided into working groups and provided statements on the following key issues through an evidence-based process： FMT indications, donor selection, preparation of fecal material, clinical management and fecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommended the implementation of FMT centres for the treatment of C. difficile infection as well as traced the guidelines of technicality, regulatory, administrative and laboratory requirements.
作者
李超
谈路轩
张馨梅
汪志兵
张振玉
Cammarota G
Ianiro G
Tilg H
LI Chao TAN Luxuan ZHANG Xinmei WANG Zhibing ZHANG Zhenyu(Department of Gastroenterology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210000, China)
出处
《胃肠病学和肝病学杂志》
CAS
2017年第9期961-965,共5页
Chinese Journal of Gastroenterology and Hepatology
关键词
粪菌移植
难辨梭状芽孢杆菌感染
欧洲共识
Fecal microbiota transplantation
Clostridium difficile infection
European Consensus
