ABSTRACT

Introduction

Toxigenic Clostridium difficile (C. difficile) is the main cause of antibiotic-associated diarrhea and can induce pseudomembranous colitis and infrequent toxic megacolon, which are potentially fatal. The standard antibiotic therapy for C. difficile infection (CDI) is limited by antibiotics’ broad spectrum and further disruptive effects on indigenous microbiota. Probiotics may offer a prospective and alternative strategy for the prevention and treatment of CDI.

Areas covered

In this article, the mechanisms implying the probiotic effect against C. difficile and the safety profile highlighting the patient groups with inappropriate application of probiotics were reviewed from 2015 to 2020.

Expert opinion

Although many strains with ability against C. difficile have been reported, the usage of probiotics for CDI prevention and/or treatment is scarce since the number of clinical trials is not sufficient to prove probiotics’ efficacy and safety in CDI treatment, especially for premature infant and immunocompromised patient. Especially, there are few well-defined clinical studies supporting safety of probiotics for CDI. A few strains from Lactobacillus and Saccharomyces genus have been studied more extensively than other probiotic strains through clinical trials for CDI. Thus, more clinical intervention studies regarding the benefit and the comprehensive safety assessments of probiotics for CDI are needed.

中文翻译：

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益生菌对抗产毒性艰难梭菌的机理和安全性。

摘要

介绍

产毒素的梭状芽胞杆菌（C. difficile）是引起抗生素相关性腹泻的主要原因，可诱发假膜性结肠炎和罕见的毒性巨结肠，这可能是致命的。艰难梭菌感染（CDI）的标准抗生素治疗受到抗生素的广谱以及对本地微生物群的进一步破坏作用的限制。益生菌可能为CDI的预防和治疗提供了一种前瞻性的替代策略。

覆盖区域

在本文中，从2015年到2020年回顾了暗示益生菌对艰难梭菌的作用的机制以及强调不适当使用益生菌的患者人群的安全性概况。

专家意见

尽管已经报道了许多具有艰难梭菌能力的菌株，但由于临床试验的数量不足以证明益生菌在CDI治疗中的有效性和安全性，特别是对于早产儿，益生菌在CDI预防和/或治疗中的应用很少。和免疫功能低下的患者。特别是，很少有明确的临床研究支持益生菌对CDI的安全性。通过CDI的临床试验，与其他益生菌菌株相比，对乳酸菌和酿酒酵母属的一些菌株进行了更广泛的研究。因此，需要更多有关益生菌对CDI的益处和全面安全性评估的临床干预研究。