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Appendectomy and Clostridium difficile colitis:Relationships revealed by clinical observations and immunology

查看全文 作  者:Nathan L [1]Sanders;R Randal [1]Bollinger;Ryan [1]Lee;Steven [1]Thomas;William [1]Parker 高影响力作者 机构地区:[1]Department of Surgery,Duke University Medical Center高影响力机构 出  处:《World Journal of Gastroenterology》索引2013年第19卷第34期,共8页高影响力期刊 摘  要:Advances in understanding the interaction between the human immune system and the microbiome have led to an improved understanding of the function of the vermiform appendix as a safe-house for beneficial bacteria in the colon.These advances have been made despite long standing clinical observations that the appendectomy is a safe and effective procedure.However,more recent clinical data show that an appendectomy puts patients at increased risk for recurrent Clostridium difficile(C.difficile)-associated colitis,and probably other diseases associated with an altered microbiome.At the same time,appendectomy does not apparently put patients at risk for an initial onset of C.difficile-associated colitis.These clinical observations point toward the idea that the vermiform appendix might not effectively protect the microbiome in the face of broad spectrum antibiotics,the use of which precedes the initial onset of C.difficile-associated colitis.Further,these observations point to the idea that historically important threats to the microbiome such as infectious gastrointestinal pathogens have been supplanted by other threats,particularly the use of broad spectrum antibiotics. 关 键 词:APPENDECTOMY CLOSTRIDIUM DIFFICILE COLITIS Diarrheal illness Vermiform APPENDIX
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