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目的 对粪便菌群移植(FMT)治疗难辨梭状芽孢杆菌感染(CDI)的有效性及安全性的系统评价进行再评价.方法 计算机检索PubMed、The Cochrane Library、EMbase、CNKI、VIP、WanFang Data和相关网站(http://scholar.google.com/),检索时限均为建库至2016年4月8日,全面搜集FMT治疗CDI的系统评价(SR)/Meta分析,采用系统评价量表(OQAQ)评价SR/Meta分析的偏倚风险,并用GRADE方法对部分系统评价的结局指标进行证据质量分级.结果 共纳入11个SR,其中4个采用了Meta分析方法.OQAQ评分结果显示,除1篇系统评价为2分,其余为5～9分.9个SR报道了CDI患者临床缓解率(CRR),除1篇CRR为36.2％,其余研究结果均表明CRR为90％左右.所有研究均表明下消化道FMT(结肠镜、灌肠等)有较高的CRR;选择粪便供体或随机粪便供体的CRR无差异,但提出须实现规范化的供体筛选表.目前证据显示,FMT有较好安全性,绝大部分的不良事件为自限性,并且符合胃肠道自然属性;GRADE结局指标评价显示证据强度从极低到中等.结论 FMT治疗CDI有显著的有效性和安全性,但是由于其临床转化困境,须更多的高级别证据支持;同时给政策研究者制定FMT规范化临床路径提供参考.“,”Objective To overview the systematic review(SR) of efficacy and safety of fecal microbiota transplantation (FMT) in clostridium difficile infection (CDI).Methods PubMed,The Cochrane Library,EMbase,CNKI,VIP,WanFang Data databases and related website (http://scholar.google.com/) were electronically searched to collect SR and meta-analysis on FMT of CDI.The quality of collected documents and evidences were evaluated by OQAQ (Overview Quality Assessment Questionnaire) and GRADE (Grading of Recommendations Assessment,Development and Evaluation),respectively.Results Eleven SRs were included,in which 4 were completed by meta-analysis.The results of OQAQ showed that the score of one review was 2,the others SR received scores from 5 to 9.There were 9 SRs had reported the CDI clinical resolution rate (CRR),of which one SR showed CRR was 36.2％,and the others showed CRR were about 90％.Compared to upper gastrointestinal FMT,all studies showed lower gastrointestinal FMT (colonoscopy,enemas,etc.) had a higher CRt.The outcomes of selection and random fecal donor had no significant differences,and authors suggested that there should be made a standardization of donor screening table for safe fecal.Present evidence showed FMT were safety,and the majority of adverse events of FMT appeared to be mild,self-limiting and gastrointestinal in nature.The GRADE quality level of SR indicated from very low to moderate.Conclusion FMT,as a treatment for CDI,shows significant efficacy and safety,but need more high-level evidences because of its clinical translation difficulties.The study also give a reference to develop standardized clinical pathways of FMT to policy researchers.