不同种类粪菌移植治疗复发性艰难梭菌感染安全性的系统评价
作者:
作者单位:

1.兰州大学第一医院普外科, 甘肃 兰州 730000;2.兰州大学第一医院老年病三科, 甘肃 兰州 730000;3.兰州大学第一医院重症医学科, 甘肃 兰州 730000;4.兰州大学第一医院护理部, 甘肃 兰州 730000;5.兰州大学循证医学中心, 甘肃 兰州 730000

作者简介:

通讯作者:

寇彩艳  E-mail: 598789101@qq.com

中图分类号:

R442.2

基金项目:

甘肃省自然科学基金(21JR7RA368);兰大一院院内基金(Ldyyyn2019-15)


Safety of different fecal microbiota transplantation for treatment of recurrent Clostridium difficile infection: a systematic review
Author:
Affiliation:

1.Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China;2.Department-3 of Geriatrics, The First Hospital of Lanzhou University, Lanzhou 730000, China;3.Department of Critical Care Medicine, The First Hospital of Lanzhou University, Lanzhou 730000, China;4.Department of Nursing, The First Hospital of Lanzhou University, Lanzhou 730000, China;5.Evidence-Based Medicine Centre, Lanzhou University, Lanzhou 730000, China

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    摘要:

    目的 系统评价粪菌移植(FMT)治疗复发性艰难梭菌感染(RCDI)的安全性。 方法 计算机检索中国知网、中国生物医学文献数据库(CBM)、万方、PubMed、EMbase、Web of Science、The Cochrane Library数据库,检索关于FMT治疗RCDI的随机对照试验研究,检索时限均为建库至2022年1月16日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后进行Meta分析。 结果 共纳入11篇研究,包括756例患者。11篇研究均报告了FMT治疗RCDI后患者不良反应的发生情况。其中7篇研究无发生不良反应的具体数值,仅进行描述性分析。另4篇研究的Meta分析结果显示:冰冻粪菌相比万古霉素或非达霉素治疗RCDI后、冻干粪菌治疗RCDI后、新鲜粪菌治疗RCDI后,以及新鲜粪菌相比自体粪菌治疗RCDI后,患者不良反应发生率比较,差异均无统计学意义(均P>0.05)。 结论 现有证据显示FMT治疗RCDI安全有效,患者出现的不良反应与粪菌移植无直接的相关性。

    Abstract:

    Objective To systematically evaluate the safety of fecal microbiota transplantation (FMT) for the treatment of recurrent Clostridium difficile infection (RCDI). Methods China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), WanFang Data, PubMed, EMbase, Web of Science, The Cochrane Library Database were searched by computer, randomized controlled trials on FMT treatment for RCDI were searched, the search time limit was from the establishment of database to January 16, 2022. Meta-analysis was conducted after two researchers independently screened the literatures, extracted the data and evaluated the bias risk included in the study. Results A total of 11 studies were included, involving 756 patients. All 11 studies reported the occurrence of adverse reactions after FMT treatment for RCDI. Descriptive analysis was conducted on the specific values of 7 studies without adverse reactions. Meta-analysis results of the other four studies showed that: compared with treatment for RCDI with vancomycin or fidaxomicin, freeze-dried fecal microbiota, and fresh fecal microbiota, as well as comparison between fresh fecal microbiota and autogenous fecal microbiota, incidence of adverse reactions in patients receiving frozen fecal microbiota was no significantly different (all P>0.05). Conclusion The available evidence shows that FMT is safe and effective for the treatment of RCDI, and there is no direct correlation between the adverse reactions of patients and FMT.

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杨丽平,寇彩艳,张志刚,等.不同种类粪菌移植治疗复发性艰难梭菌感染安全性的系统评价[J]. 中国感染控制杂志,2022,(12):1222-1228. DOI:10.12138/j. issn.1671-9638.20222845.
Li-ping YANG, Cai-yan KOU, Zhi-gang ZHANG, et al. Safety of different fecal microbiota transplantation for treatment of recurrent Clostridium difficile infection: a systematic review[J]. Chin J Infect Control, 2022,(12):1222-1228. DOI:10.12138/j. issn.1671-9638.20222845.

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  • 收稿日期:2022-05-06
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  • 在线发布日期: 2024-04-28
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