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Recurrent clostridium difficile infections:The importance of the intestinal microbiota

World Journal of Gastroenterology 2014年第23期20卷 7416-7423页

作者： marie céline zanella terrier Martine Louis Simonet Philippe Bichard Jean Louis Frossard Service of General Internal Medicine Geneva University Hospital1211 GenevaSwitzerland Service of Gastroenterology and Hepatology Geneva University Hospital1211 GenevaSwitzerland

clostridium difficile infections(cDI)are a leading cause of antibiotic-associated and nosocomial *** effective antibiotic treatments,recurrent infections are *** the recent emergence of hypervirulent isolates of ***,cDI is a growing epidemic with higher rates of recurrence,increasing severity and *** microbiota transplantation(FMT)is an alternative treatment for recurrent cDI.A better understanding of intestinal microbiota and its role in cDI has opened the door to this promising therapeutic *** is thought to resolve dysbiosis by restoring gut microbiota diversity thereby breaking the cycle of recurrent *** the first reported use of FMT for recurrent cDI in 1958,systematic reviews of case series and case report have shown its effectiveness with high resolution rates compared to standard antibiotic *** article focuses on current guidelines for cDI treatment,the role of intestinal microbiota in cDI recurrence and current evidence about FMT efficacy,adverse effects and acceptability.

关键词： clostridium difficile infection clostridium difficile recurrence Fecal microbiota transplantation Stool transplantation Microbiota

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Vitamin D in addition to peg-interferon-alpha/ribavirin in chronic hepatitis c virus infection: ANRS-Hc25-VITAVIc study

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World Journal of Gastroenterology 2015年第18期21卷 5647-5653页

作者： Benjamin terrier Nathanael Lapidus Stanislas Pol Lawrence Serfaty Vlad Ratziu Tarik Asselah Vincent Thibault Jean-claude Souberbielle Fabrice carrat Patrice cacoub Inflammation-ImmunopathologyBiotherapy Department (DHU i2B) Sorbonne Universités Department of Internal Medicine Groupe Hospitalier Cochin AP-HP Université Paris Descartes INSERM UMR_S 1136 Institut Pierre Louis d’Epidémiologie et de Santé Publique Sorbonne Universités UPMC Univ Paris 06 UMR_S 1136 Institut Pierre Louis d’ Epidémiologie et de Santé Publique Public Health Department Saint-Antoine Hospital Department of Hepatology Groupe Hospitalier Cochin AP-HP Université Paris Descartes Department of Hepatology H?pital SaintAntoine AP-HP Université Pierre et Marie Curie Department of Hepatology Groupe Hospitalier Pitié-Salpetrière AP-HP Université Pierre et Marie Curie Department of Hepatology H?pital Beaujon Department of Virology Groupe Hospitalier Pitié-Salpetrière AP-HP Université Pierre et Marie Curie Explorations Fonctionnelles H?pital Necker-Enfants Malades AP-HP Université Paris Descartes INSERM UMR_S 959 F-75013 Paris France cNRS UMR 7211 F-75005 Paris France Department of Internal Medicine and clinical Immunology H?pital Pitié-Salpétrière AP-HP 47-83 boulevard de l’H?pital

AIM: To investigate if correction of hypovitaminosis D before initiation of Peg-interferon-alpha/ribavirin(Peg IFN/RBV) therapy could improve the efficacy of Peg IFN/RBV in previously null-responder patients with chronic genotype 1 or 4 hepatitis c virus(HcV) ***:Genotype 1 or 4 HcV-infected patients with null response to previous Peg IFN/RBV treatment and with hypovitaminosis D(ctively received cholecalciferol 100000 IU per week for 4 wk[from week-4(W-4)to W0],followed by 100000 IUper month in combination with Peg IFN/RBV for 12 mo(from W0 to W48).The primary outcome was the rate of early virological response defined by an HcV RNAcluded,19(59%)and 13(41%)patients were HcV genotype1 and 4,*** median baseline vitamin D level was 15 ng/m L(range:7-28).In modified intention-to-treat analysis,29 patients who received at least one dose of Peg IFN/RBV were included in the *** patients except one normalized their vitamin D serum *** rate of early virologic response was 0/29(0%).The rate of HcV RNAc response in previously null-responders with chronic genotype 1or 4 HcV infection.

关键词： Vitamin D Hepatitis c virus chronic hepatitis Pegylated interferon Ribavirin

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