Iintsholongwane ezisibhozo ezibangela uC

Imfundo yezeMpilo

Ukungeniswa kwamayeza okubulala iintsholongwane ngokungathandabuzekiyo kwaguqula amayeza kule nkulungwane idlulileyo. Kodwa ezinye zezi ziyobisi ziyamangalisa, njengoko zazibizwa njalo, zinokushiya umzimba usengozini yesifo esosulelayo esibizwa ngokuba yiC.Difficile.

Yintoni uC.

Clostridioides ezahlukeneyo , eyayisaziwa njenge IClostridium difficile , okanye uC.Diff, ngu iintsholongwane ezosulelayo oko kunokubangela urhudo oluqatha. Ezinye izinto eziqhelekileyo C. Iimpawu eziqaqambileyo zibandakanya umkhuhlane, isicaphucaphu, ukuphelelwa ngumdla wokutya, kunye nentlungu esiswini.

Kuqikelelwa ukuba kungunobangela phantse i-500,000 ukugula eMelika kunye Ukufa kwabantu abali-15,000 ngonyaka ngamnye, ngokwe Amaziko oLawulo noThintelo lwezifo . Okwangoku ihlelwa yiCDC njenge Isongelo esingxamisekileyo -Awona mazinga aphezulu asoyikisayo- kwimpilo yabantu evela kwintsholongwane e-US (ICDC iceba ukukhupha Ingxelo ehlaziyiweyo ngokubhekisele kule datha ekwindla ngo-2019.)

Ngawaphi amayeza okubulala iintsholongwane abangela uC.

Ke ukusetyenziswa kwe-antibiotiki kumenza njani umntu abe nesifo esisesichengeni njengo-C. Diff? Xa uthatha isibulala-zintsholongwane, siyasebenza ukubulala usulelo lwebacteria emzimbeni wakho. Kwinkqubo, la machiza anokutshabalalisa ibacteria esempilweni egcina abahlaseli njengoC. Diff bejongile. Kubalulekile ukuba uqaphele, ayizizo zonke i-antibiotics ezibangela i-C.Diff, kwaye ayinguye wonke umntu onomngcipheko ofanayo. Nangona phantse nayiphi na i-antibiotic inokubangela, oyena mntu unobangela, kule meko, uhlala ebanzi njengezibulala-ntsholongwane. Abona basemngciphekweni kakhulu zizigulana ezineminyaka engama-65 okanye nangaphezulu esele zikwindawo yokhathalelo lwempilo, ezinje ngesibhedlele okanye ikhaya labongikazi.

Amayeza okubulala iintsholongwane ebanzi anento ayenzayo ngokuchasene [ne] zininzi zebacteria ezihlala emathunjini, uyacacisa UGqr. UHana Axelrod , unjingalwazi oncedisayo kwezamayeza kwiCandelo lezifo ezosulelayo e Isikolo saseGeorge Washington sezeMpilo kunye neSayensi yezeMpilo . Kubaluleke kakhulu ukuba nabemi abasempilweni nabangafaniyo kwezi bhaktheriya. Xa abantu benikwa i-antibiotics ebanzi, i-bacterial gut yabo iyancipha, ngaloo ndlela ivumela iintlobo zezilwanyana, ezifana neC.Diff, ukuba zenze i-bacteria ekhulayo eyenza i-toxins eyonakalisa isilonda kwaye idale ukugula kakhulu.

U-Erika Prouty, uFarm.D., Owayesakuba ngunjingalwazi ongumncedisi e Ikholeji yaseNtshona yeNew England yaseKhemesti eSpermfield, eMassachusetts, iyayaphula iqhubeke: Amayeza okubulala iintsholongwane ebanzi anokuba sisongelo kwizigulana kuba azijolisisi kuphela ibhaktiriya embi esizama ukuyiphelisa, kodwa zikwabulala neebhaktiriya ezininzi ezilungileyo ezikwinkqubo yethu yokwetyisa. .

Zombini uGqirha Akselrod kunye noGqirha Prouty bachonga i-clindamycin kunye ne-fluoroquinolones njengezona zaphuli-mthetho zibi. Uluhlu lwee-antibiotics kunokubangela uC kubandakanya:

• cephalosporins
• clindamycin ( UCleocin )
• ciprofloxacin ( Sayiprasi )
• yeeplexacin ( Levaquin )
• moyoxline ( I-Avalox , Vigamox )
• ifumobillin (Amoxil)

Ngelishwa, utshilo uGqirha Akselrod, kuba ezo ntsholongwane zisetyenziswa kakhulu kuyo yonke into ukusuka kwinyumoniya ukuya kusulelo lomchamo. Omnye umcimbi kukudingeka kwee-antibiotics ezithile ze-IV ezisetyenziswa rhoqo ngoogqirha kumagumbi angxamisekileyo esibhedlele, nawo awela phantsi kwesambulela esibanzi. La machiza abandakanya:

• piperacillin / tazobactam (Zosyn)
• meropenem (Ndiyathatha)

Ii-antibiotics ze-IV ziqhelekile kuseto lwe-ER kuba zisetyenziswa njengonyango lodidi lokuqala xa izigulana zingena zigula kwaye aziqinisekanga ukuba yintoni ebangela usulelo, ucacisa uGqirha Akselrod. Kodwa njengobuchwephesha kwezonyango obangene kweli candelo, uyazi kakuhle indlela elungileyo oogqirha ekufuneka behambe ngayo ngokunyanga ukugula okwangoku, ngelixa bengazisi ukosulelwa okongezelelweyo. Ngokuhamba kwexesha siye saqaphela umngcipheko xa kuthelekiswa nezibonelelo zolu hlobo lonyango olubanzi, uthi. Ingaba ngumnxeba onzima nokuba ungaqalisi okanye ungayiqalisi ii-antibiotics ze-IV. Into esincedayo ukuba sithathe isigqibo esifanelekileyo yindlela enobuchule kunye nokuzama ukuba nesizathu esithile sokunika i-antibiotics.

Ngawaphi amayeza okubulala iintsholongwane angenakufane abangele uC.

Ukuba usemngciphekweni omkhulu weC.Diff, kufanelekile ukuba uthethe nogqirha wakho malunga nokukhetha unyango olunomngcipheko osezantsi. Amayeza okubulala iintsholongwane mancinci amathuba okubangela uC zibandakanya:

• izithromycin ( Zithromax , Z-Pak )
• ukucacisa (IBiaxin)
• mzantsiweb ( IOracea , IVibramycin )
• erythromycin ( Eryped )
• fidaxomicin ( Ubunzima )
• minocycline (IMinocin, Isolod )
• Imetronidazole (iFlagyl)

Ngawaphi amayeza okubulala iintsholongwane anyanga uC.

Nangona iimedical spectrum ezibanzi ziphezulu kuluhlu lwezizathu ezibangela ukuba kubekho iintlobo ezimbalwa kuphela zeC.Diff antibiotics ezinokunyanga esi sifo. IVancomycin yeyona antibiotic isetyenziswa rhoqo kuC. C. Diff, utshilo uGqirha Prouty, ecaphula ukubaluleka komlomo, ngokuchaseneyo ne-IV, unyango: I-IV ayingeni ngqo kwinkqubo yamathumbu, ngoko ke ayisebenzi. Kwaye kuba lonke usulelo lubangelwa ziintsholongwane ezahlukeneyo (intsholongwane ebangela izifo), ayizizo zonke iintsholongwane eziza kujolisa kwezi ntsholongwane kwaye zibabulale, utshilo. Ke ngoko, amayeza athile kufuneka asetyenziswe kunyango lweC.

Kucetyisiwe ukuba amaxabiso kaC. ahlile Kwiminyaka yakutshanje ubuncinci ngenxa iinkqubo zobugosa zokulwa nezifo ezibhedlele, ezifuna ukunciphisa ukumiselwa kwee-antibiotics ezingafunekiyo. Kodwa xa kuziwa kwizigulana ezisebenza ngaphezulu kokuthintela u-Diff, uGqr Akselrod uthi eyona nto banokuthi bayenze kukuthetha ngokungafihlisiyo nomboneleli wabo wezonyango malunga nokuba bayayifuna nyhani na le ntsholongwane, kunye nokunciphisa ixesha elichithwe. kuyo.