Microbiota Therapy for Clostridium difficile and Antibiotic Resistant Enteric Infections.
Lewis BB, Pamer EG
Annu Rev Microbiol. Jun 2017. doi: 10.1146/annurev-micro-090816-093549
Bacterial pathogens are increasingly antibiotic resistant, and development of clinically effective antibiotics is lagging. Curing infections increasingly requires antimicrobials that are broader spectrum, more toxic, and more expensive, and mortality attributable to antibiotic-resistant pathogens is rising. The commensal microbiota, comprising microbes that colonize the mammalian gastrointestinal tract, can provide high levels of resistance to infection, and the contributions of specific bacterial species to resistance are being discovered and characterized. Microbiota-mediated mechanisms of colonization resistance and pathogen clearance include bactericidal activity, nutrient depletion, immune activation, and manipulation of the gut's chemical environment. Current research is focusing on development of microbiota-based therapies to reduce intestinal colonization with antibiotic-resistant pathogens, with the goal of reducing pathogen transmission and systemic dissemination. Expected final online publication date for the Annual Review of Microbiology Volume 71 is September 8, 2017. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.