美国马萨诸塞州总医院Elizabeth L. Hohmann课题组发现，耐药性大肠杆菌菌血症可通过粪便菌群移植传播。该研究10月30日在线发表于《新英格兰医学杂志》。

据悉，粪便微生物群移植（FMT）是一种治疗复发性难治性艰难梭菌感染的新方法，目前正在积极研究其他适用条件。

该研究团队描述了两名患者，他们在两个独立的临床试验中接受FMT后发生了产超广谱β-内酰胺酶（ESBL）的大肠杆菌菌血症，其中一名患者死亡。通过基因组测序，这两位患者的FMT均源于同一个粪便捐赠者。

因此，有必要对捐献者加强筛查，以限制可能导致不良感染事件的微生物传播，并继续保持警惕，以权衡不同患者人群中实施FMT的利弊。

附：英文原文

Title: Drug-Resistant E. coli Bacteremia Transmitted by Fecal Microbiota Transplant

Author: Zachariah DeFilipp, M.D.,, Patricia P. Bloom, M.D.,, Mariam Torres Soto, M.A.,, Michael K. Mansour, M.D., Ph.D.,, Mohamad R.A. Sater, Ph.D.,, Miriam H. Huntley, Ph.D.,, Sarah Turbett, M.D.,, Raymond T. Chung, M.D.,, Yi-Bin Chen, M.D.,, and Elizabeth L. Hohmann, M.D.

Issue&Volume: 2019-10-30

Abstract: 

Fecal microbiota transplantation (FMT) is an emerging therapy for recurrent or refractory Clostridioides difficile infection and is being actively investigated for other conditions. We describe two patients in whom extended-spectrum beta-lactamase (ESBL)–producing Escherichia coli bacteremia occurred after they had undergone FMT in two independent clinical trials; both cases were linked to the same stool donor by means of genomic sequencing. One of the patients died. Enhanced donor screening to limit the transmission of microorganisms that could lead to adverse infectious events and continued vigilance to define the benefits and risks of FMT across different patient populations are warranted.

DOI: 10.1056/NEJMoa1910437

Source: https://www.nejm.org/doi/full/10.1056/NEJMoa1910437