促进获得肠道微生物群移植:弥合国家实践与欧洲战略之间的差距。

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Liliana Dinis, Helder Pinheiro, Pedro Póvoa, Conceição Calhau, Diogo Pestana, Cláudia Marques
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引用次数: 0

摘要

艰难梭菌是一种机会性病原体,可引起一系列疾病,从无症状携带到严重疾病,由于其高死亡率和高昂的医疗费用,对公共卫生构成重大威胁。包括抗生素在内的传统治疗方案往往不能根除感染,导致复发病例,严重影响患者的生命。肠道菌群移植(IMT)已成为一种有效的去定植病原体的策略,证明了安全性和有效性,特别是在治疗复发性艰难梭菌感染(rCDI)方面。尽管具有潜力,但由于安全问题、后勤挑战和缺乏适当的指导,IMT的获取受到限制,这凸显了对结构化肠道微生物群库(imb)的迫切需要。这些有组织的设施对于肠道菌群制剂的收集、筛选、加工和分发至关重要,从而促进了IMT的临床应用。在这篇叙述性综述中,我们讨论了在欧洲应用IMT治疗rCDI的相关性,重点是葡萄牙。我们强调imb在欧洲的存在和分布,以及它们在改善IMT获取方面的重要性。本综述还讨论了在葡萄牙建立IMB和发展这样一个结构作为高质量、标准化微生物群制剂的集中储存库所面临的挑战,使IMT能够为国家医院所用。此外,它强调需要提高医疗保健提供者和公众的认识,以支持更广泛地采用IMT。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Advancing Access to Intestinal Microbiota Transplant: Bridging the Gap Between National Practices and the European Strategy.

Clostridioides difficile is an opportunistic pathogen that can cause a range of conditions, from asymptomatic carriage to severe illness, posing a significant public health threat due to its high mortality rates and substantial healthcare costs. Traditional treatment options, including antibiotics, often fail to eradicate the infection, leading to recurrent cases that severely impact patients' lives. Intestinal microbiota transplant (IMT) has emerged as an effective strategy for decolonizing pathogenic agents, demonstrating safety and efficacy, particularly in treating recurrent Clostridioides difficile infection (rCDI). Despite its potential, access to IMT is limited due to safety concerns, logistical challenges, and a lack of proper guidance, underscoring the urgent need for structured intestinal microbiota banks (IMBs). These organized facilities are crucial for the collection, screening, processing, and distribution of intestinal microbiota preparations, thereby facilitating the clinical application of IMT. In this narrative review, we discuss the relevance of applying IMT for the treatment of rCDI in Europe, with a focus on Portugal. We highlight the existence and distribution of IMBs across Europe and their importance in improving access to IMT. This review also addresses the challenges in creating an IMB and the development of such a structure in Portugal as a centralized repository for high-quality, standardized microbiota preparations, making IMT accessible for national hospitals. Additionally, it emphasizes the need to raise awareness among healthcare providers and the public to support the broader adoption of IMT.

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来源期刊
Acta medica portuguesa
Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
16.70%
发文量
256
审稿时长
6-12 weeks
期刊介绍: The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.
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