Microbiome：重新定义“卫生”的概念

最新推荐文章于 2023-04-29 07:03:41 发布

刘永鑫Adam

最新推荐文章于 2023-04-29 07:03:41 发布

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标题：干净的含义——协调“卫生”概念与现代菌群视角

背景

人类卫生的概念己经根深蒂固将清洁与维持健康联系在了一起。
大家广泛接受的细菌致病理论，认为健康就是无菌。
本综述回顾手部健康的文献，发现无一例外是简单粗暴的全面灭菌来实现降低细菌传播。
而这一行为与近年来的研究相悖，因为人类从初始与菌长期进化和共生的结果，存在多种有益功能。

综述

在手部等皮肤表面，栖息着种类和数量众多的微生物，它们组成了一个生态系统，其中病原体只占极小比例；
传统的“卫生”定义是指简单粗暴地清除皮肤上的细菌，而共生微生物相关研究提示，正确的“卫生”定义应该是减少致病菌的扩散或传播，从而降低疾病发生率；
清晰而一致的“卫生”定义，将避免科学文献中的概念混淆，对手部卫生、皮肤菌群、洗手、手部烘干等研究提供准确指导标准；
这也有助于提供更准确实用的卫生建议和监管标准。

英文摘要原文：

Cleanliness in context: reconciling hygiene with a modern microbial perspective
DOI: 10.1186/s40168-017-0294-2
Abstract:
The concept of hygiene is rooted in the relationship between cleanliness and the maintenance of good health. Since the widespread acceptance of the germ theory of disease, hygiene has become increasingly conflated with sterilization. In reviewing studies across the hygiene literature (most often hand hygiene), we found that nearly all studies of hand hygiene utilize bulk reduction in bacterial load as a proxy for reduced transmission of pathogenic organisms. This treatment of hygiene may be insufficient in light of recent microbial ecology research, which has demonstrated that humans have intimate and evolutionarily significant relationships with a diverse assemblage of microorganisms (our microbiota). The human skin is home to a diverse and specific community of microorganisms, which include members that exist across the ecological spectrum from pathogen through commensal to mutualist. Most evidence suggests that the skin microbiota is likely of direct benefit to the host and only rarely exhibits pathogenicity. This complex ecological context suggests that the conception of hygiene as a unilateral reduction or removal of microbes has outlived its usefulness. As such, we suggest the explicit definition of hygiene as “those actions and practices that reduce the spread or transmission of pathogenic microorganisms, and thus reduce the incidence of disease.”