Schizophrenia is a heterogeneous disorder with several potential pathophysiological mechanisms, including immune activation. Infections have been identified as a significant contributing risk factor for schizophrenia; this association is reviewed together with the potential impact of antibiotic treatment and alterations of the intestinal microbiota. Both infections and the treatment with antibiotics may alter the composition of the gut microbiota, causing dysbiosis, which in animal studies has been associated with alterations of behavior. Of the few studies that have been conducted on humans, some have suggested alterations in the microbial composition of individuals with schizophrenia compared to healthy controls, albeit with conflicting results. Recently, increased attention has emerged regarding potential adverse effects from antibiotics, as a number of these have been associated with an increased risk of psychotic episodes. Particularly, the fluoroquinolones have been associated with neurotoxic adverse events. The association between schizophrenia and infections, antibiotic treatment and dysbiosis, may be an epiphenomenon, which could be explained by other confounding factors. However, these associations could be causal and could therefore be important risk factors in a subgroup of patients. Large-scale well-matched longitudinal studies are needed with measurements of immune markers from multiple biological samples, ranging from material close to the brain, as cerebrospinal fluid and brain-scans targeting neuroinflammation, to analysis of blood and intestinal microbiota. This would help to obtain more definite results on the association between infections, immune components and microbiota alterations in relation to schizophrenia.

中文翻译：

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感染、抗生素治疗和与精神分裂症相关的微生物组

精神分裂症是一种异质性疾病，具有多种潜在的病理生理机制，包括免疫激活。感染已被确定为精神分裂症的重要危险因素；这种关联与抗生素治疗的潜在影响和肠道微生物群的改变一起进行了审查。感染和抗生素治疗都可能改变肠道微生物群的组成，导致生态失调，这在动物研究中与行为改变有关。在对人类进行的少数研究中，一些研究表明，与健康对照相比，精神分裂症患者的微生物组成发生了变化，尽管结果相互矛盾。最近，人们越来越关注抗生素的潜在副作用，因为其中一些与精神病发作的风险增加有关。特别是，氟喹诺酮类药物与神经毒性不良事件有关。精神分裂症与感染、抗生素治疗和生态失调之间的关联可能是一种附带现象，可以用其他混杂因素来解释。然而，这些关联可能是因果关系，因此可能是一部分患者的重要危险因素。需要进行大规模、匹配良好的纵向研究，测量来自多个生物样本的免疫标记物，范围从靠近大脑的材料，如针对神经炎症的脑脊液和大脑扫描，到血液和肠道微生物群的分析。这将有助于获得关于感染之间关联的更明确的结果，