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Krankenhaushygiene up2date 2015; 10(04): 277-285
DOI: 10.1055/s-0041-110499
Antibiotikaanwendung
© Georg Thieme Verlag KG Stuttgart · New York

Das intestinale Mikrobiom – Bedeutung und Stabilität unter Antibiotikatherapie

Kerstin Gronbach
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Publication Date:
28 December 2015 (online)

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Kernaussagen

  • Antibiotika sind essenzielle Medikamente zur Behandlung von bakteriellen Infektionserkrankungen.

  • Gleichzeitig sollte unser intestinales Mikrobiom aber so wenig wie möglich aus dem Gleichgewicht gebracht werden, um das Risiko für Fehlbesiedelungen mit antibiotikaresistenten Bakterien so gering wie möglich zu halten.

  • Das Antibiotic Stewardship könnte ein wichtiger Mechanismus sein, um bei bakteriellen Infektionen Antibiotika auszuwählen, deren Wirkspektrum so schmal wie möglich und so breit wie nötig ist.

  • Gleichzeitig sollten neue Therapieansätze, wie z. B. die FMT, in klinischen, placebokontrollierten Studien evaluiert werden, um ggf. vorhandene Indikationen neben der rekurrierenden, therapierefraktären C. difficile assoziierten Diarrhoe zu identifizieren.

  • Auch Langzeitstudien sollten angestrebt werden, da eine Dysbiose u. U. auch erst nach Jahren zu Komplikationen führt.

  • Zudem ist zu beachten, dass momentan weder für den Begriff Dysbiose noch für den Begriff „gesundes“ Mikrobiom Referenzwerte vorliegen.

 

  • Literatur

  • 1 Bäckhed F, Ley RE, Sonnenburg JL et al. Host-bacterial mutualism in the human intestine. Science 2005; 307: 1915-1920
    CrossrefGoogle Scholar
  • 2 Cho I, Blaser MJ. The human microbiome: at the interface of health and disease. Nat Rev. Genet 2012; 13: 260-270
    CrossrefPubMedGoogle Scholar
  • 3 Marchesi JR, Ravel J. The vocabulary of microbiome research: a proposal. Microbiome 2015; 3: 31
    CrossrefGoogle Scholar
  • 4 Dominguez-Bello MG, Costello EK, Contreras M et al. Delivery mode shapes the acquisition and structure of the initial microbiota across multiple body habitats in newborns. PNAS 2010; 107: 11971-11975
    CrossrefGoogle Scholar
  • 5 Schulfer A, Blaser MJ. Risk of antibiotic exposures early in life on the developing microbiome. Plos Pathogens 2015; DOI: 10.1371/journal.ppat.1004903.
    Google Scholar
  • 6 Arrieta MC, Stiemsma LT, Dimitriu PA et al. Early infancy microbial and metabolic alterations affect risk of childhood asthma. Sci Transl Med 2015; 7: 307ra152
    CrossrefGoogle Scholar
  • 7 Tap J, Mondot S, Levenez F et al. Towards the human intestinal microbiota phylogenetic core. Environ Microbiol 2009; 11: 2574-84
    CrossrefGoogle Scholar
  • 8 Arumugam M, Raes J, Pelletier E et al. Enterotypes of the human gut microbiome. Nature 2011; 473: 174-180
    CrossrefGoogle Scholar
  • 9 Wu GD, Chen J, Hoffmann C et al. Linking long-term dietary patterns with gut microbial enterotypes. Science 2011; 334: 105-108
    CrossrefGoogle Scholar
  • 10 Renz H, Brandtzaeg P, Hornef M. The impact of perinatal immune development on mucosal homeostasis and chronic inflammation. Nat Rev Immunol 2011; 12: 9-23
    CrossrefGoogle Scholar
  • 11 Ruff WE, Kriegel MA. 2015. Autoimmune host-microbiota interactions at barrier sites and beyond. Trends Mol Med 2015; 21: 233-244
    CrossrefGoogle Scholar
  • 12 Freter R. The fatal enteric cholera infection in the guinea pig, achieved by inhibition of normal enteric flora. J Infect Dis 1955; 97: 57-65
    CrossrefGoogle Scholar
  • 13 Bonhoff M, Miller C. Resistance of mouse’s intestinal tract to experimental Salmonella infection. J Exp Med 1964; 120: 817-828
    CrossrefGoogle Scholar
  • 14 Thijm HA, van der Waaj D. The effect of three frequently applied antibiotics on the colonization resistance of the digestive tract of mice. J Hyg 1979; 82: 397-405
    CrossrefGoogle Scholar
  • 15 Buffie CG, Pamer EG. Microbiota-mediated colonization resistance against intestinal pathogens. Nat Rev Immunol 2013; 13: 790-801
    CrossrefGoogle Scholar
  • 16 Asahara T, Shimizu K, Nomoto K et al. Probiotic bifidobacteria protect mice from lethal infection with Shiga toxin-producing Escherichia coli O157:H7. Infect Immun 2014; 72: 2240-2247
    Google Scholar
  • 17 Brandl K, Plitas G, Mikum CN et al. Vancomycin-resistant enterococci exploit antibiotic-induced innate immune deficits. Nature 2008; 455: 804-807
    CrossrefGoogle Scholar
  • 18 Ubeda C, Taur Y, Jenq RR et al. Vancomycin-resistant Enterococcus domination of intestinal microbiota is enabled by antibiotic treatment in mice and precedes bloodstream invasion in humans. J Clin Invest 2010; 120: 4332-4341
    CrossrefGoogle Scholar
  • 19 D’Costa VM, King CE, Kalan L et al. Antibiotic resistance is ancient. Nature 2011; 477: 457-461
    CrossrefGoogle Scholar
  • 20 Sullivan A, Edlund C, Nord CE. Effect of antimicrobial agents on the ecological balance of human microflora. Lancet Infect Dis 2001; 1: 101-114
    CrossrefGoogle Scholar
  • 21 Turnbaugh PJ, Ley R, Harnady E et al. The human microbiome project. Nature 2007; 449: 804-810
    CrossrefGoogle Scholar
  • 22 Clemente JC, Pehrsson EC, Blaser MJ et al. The microbiome of uncontacted Amerindians. Sci Adv 2015; 1: e1500183
    Google Scholar
  • 23 Jernberg C, Löfmark S, Edlund C et al. Long-term impacts of antibiotic exposure on the human intestinal microbiota. Microbiology 2010; 156: 3216-3223
    CrossrefGoogle Scholar
  • 24 Buffie CG, Jarchum I, Equinda M et al. Profound alterations of intestinal microbiota following a single dose of clindamycin results in sustained susceptibility to Clostridium difficile-induced colitis. Infect Immun 2012; 80: 62-73
    CrossrefGoogle Scholar
  • 25 Ubeda C, Bucci V, Caballero S et al. Intestinal microbiota containing Barnesiella species cures vancomycin-resistant Enterococcus faecium colonization. Infect Immun 2013; 81: 965-973
    CrossrefGoogle Scholar
  • 26 Taur Y, Xavier JB, Lipuma L et al. Intestinal domination and the risk of bacteremia in patients undergoing allogeneic hematopoietic stem cell transplantation. Clin Infect Dis 2012; 55: 905-914
    CrossrefGoogle Scholar
  • 27 Taur Y, Jenq RR, Perales MA et al. The effects of intestinal tract bacterial diversity on mortality following allogeneic hematopoietic stem cell transplantation. Blood 2014; 124: 1174-1182
    CrossrefGoogle Scholar
  • 28 Pamer E. Fecal microbiota transplantation: effectiveness, complexities, and lingering concerns. Mucosal Immunol 2014; 7: 210-214
    CrossrefGoogle Scholar