碳青霉烯类耐药肠杆菌科细菌去定植策略研究现状  

Research status of decolonization strategy of carbapenem-resistant Enterobacteriaceae

作　　者：邹成韵 杨红梅 王海英 ZOU Chengyun;YANG Hongmei;WANG Haiying(Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China;Department of Clinical Laboratory,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)

机构地区：[1]上海中医药大学,上海201203 [2]上海中医药大学附属岳阳中西医结合医院检验科,上海200437

出　　处：《检验医学》2020年第10期974-978,共5页Laboratory Medicine

基　　金：上海中医药大学研究生创新培养专项(Y201942)。

摘　　要：目前,多药耐药细菌尤其是碳青霉烯类耐药肠杆菌科细菌(CRE)感染的治疗选择有限,而且往往效果较差。CRE定植会增加患者感染CRE的风险,临床死亡率也随之上升。文章概括了CRE的流行病学特点、定植的危害及现有防控措施,主要探讨了预防CRE定植进展的策略,包括选择性消化道净化(SDD)与最近备受关注的粪菌移植(FMT)技术的可行性和有效性,列举了2种去定植手段的优缺点,及未来需要集中解决的问题。尽管FMT去定植有效的研究证据还很缺乏,但依旧不失为CRE去定植的可靠选择。The treatment options of multi-drug resistance bacterial infection are limited,and are often inefficient,especially for carbapenem-resistant Enterobacteriaceae(CRE).The colonization of CRE will increase the risk of CRE infection,and the clinical mortality will increase.This review summarizes the epidemiological characteristics of CRE,the hazard of colonization and the existing prevention and control measures,which discusses the feasibility and effectiveness of 2 decolonization strategies,including selective digestive decontamination(SDD)and fecal bacterium transplantation(FMT),which have attracted international attention recently.This review also enumerates the advantages and disadvantages of the 2 methods of decolonization and the problems that need to be solved in the future.Although there is little research evidence on the effectiveness of FMT to decolonize CRE,it is none the less a reliable choice for CRE decolonization.

关 键 词：碳青霉烯类耐药肠杆菌科细菌 去定植 选择性消化道净化 粪菌移植 

分 类 号：R446.5[医药卫生—诊断学]