So wo yafunu ayɛ wo yaw pɛn bere a woanom nnuru a ekum ɔyare mmoawa awie no? Momma yensua C. diff (Clostridioides difficile) ho ade!

So woafi ase anya akisikuru a emu yɛ den nnansa yi bere a woanom nnuru a ekum ɔyare mmoawa awie no? Anaasɛ wo yafunu mu yɛ wo yaw na wo ho yɛ wo yaw nna pii ni? Ebetumi afi ɔyare mmoawa bi a yɛntee ho asɛm pii, nanso ebetumi ayɛ asiane kɛse. Ɛnnɛ, momma yɛnka nea C. diff yɛ, nea enti a ɛba, ne sɛnea yebetumi abɔ yɛn ho ban ho asɛm.

Dɛn ne C. diff (Clostridioides difficile)?

Sɛ yɛbɛka no tiawa a, C. diff yɛ din tiawa a wɔde frɛ mmoawa bi. Ne din nyinaa ne *Clostridioides difficile*. Saa mmoawa yi tumi nya yɛn dwensɔtwaa kɛse (colon). Sɛ ɛba saa a, ɛde akisikuru ne sɛnkyerɛnne afoforo pii a ɛnyɛ dɛ ba.

Ɛyɛ ade a ɛfata sɛ wubenya ɔyare mmoawa wɔ wo dwensɔtwaa mu, na emu dodow no ara nyɛ nea anibere wom. Nanso saa C. diff yare yi yɛ aniberesɛm kakra, na ebetumi asɛe wo dwensɔtwaa. Eyi te saa efisɛ C. diff mmoawa no yɛ awuduru wɔ wo dwensɔtwaa mu. Saa awuduru yi sɛe nkwammoaa a ɛkata wo dwensɔtwaa so no, na ɛma ɛhohoro. Wɔ aduruyɛ mu no, yɛfrɛ eyi akisikuru . Sɛ́ ebia wubenya yare no ho sɛnkyerɛnne ne sɛnea emu yɛ den no gyina sɛnea awuduru no asɛe wo dwensɔtwaa no so. Wɔ tebea horow bi mu no, saa tebea yi betumi de nkwa ato asiane mu.

Dɛn ne sɛnkyerɛnne ahorow a ɛkyerɛ sɛ obi anya C. diff?

Ɔyare mmoawa yi ho sɛnkyerɛnne titiriw ne nea edi kan ne dwensɔtwaa a nsu wom (akisikuru) . Sɛ ɔyare no mu nyɛ den a, ebia wobɛkɔ wo dwensɔtwaa mu bɛyɛ mprɛnsa da biara, na yafunu mu akisikuru kakra ka ho.

Bere a ɔyare mmoawa no mu yɛ den no, akisikuru no mu yɛ den. Ebia wobɛkɔ wo dwensɔtwaa du anaa dunum da biara. Ebia wubehu mogya nso wɔ wo nsu mu. Eyinom yɛ sɛnkyerɛnne afoforo a ebetumi ada adi bere a tebea no mu yɛ den no.

Mfiase no, saa sɛnkyerɛnne ahorow yi betumi ayɛ te sɛ aduan mu awuduru anaa yafunu mu atiridii. Sɛ worenom nnuru a ekum ɔyare mmoawa a, ebia wubedi mfomso asusuw sɛ saa yafunu a ɛyɛ wo yaw yi yɛ aduru no mu nsunsuanso bɔne a ɛfata.

Dɛn ne nsu a ɛwɔ C. diff yare no mu?

Wɔ C. diff atiridiinini mu no, nsu no taa te sɛ akutu na ɛyɛ den, ɛnyɛ nsu koraa. Ɛtɔ mmere bi a, ne kɔla betumi ayɛ ahabammono. Ɛtɔ mmere bi a, wobetumi ahu mogya, nsu, anaa akisikuru.

Nnipa pii bɔ amanneɛ sɛ C. diff atiridiinini wɔ hua soronko bi . Wɔka ho asɛm sɛ ɛyɛ hua a ano yɛ den na ɛyɛ dɛ soronko sen nsu a ɛyɛ dɛ a ɛyɛ soronko. Ebia eyi te saa efisɛ C. diff mmoawa no ma bile acid dodow a ɛwɔ yɛn nsu mu no yɛ kɛse.

Dɛn nti na yenya C. diff?

Susuw yɛn dwensɔtwaa ho sɛ nhwiren turo fɛfɛ. Turo yi mu no, nhwiren pa ne nwura bi wɔ hɔ. Wɔ obi a ɔwɔ nipadua mu ahoɔden a ɛko tia nyarewa a ɛyɛ papa no akyi berɛmo mu no, mmoawa "papa" pii (te sɛ nhwiren) na mmoawa "bɔne" (te sɛ nwura) na wodi so. C. diff yɛ mmoawa a wɔtaa tra yɛn dwensɔtwaa mu kakraa bi.

Sɛ wɔsɛe saa kari pɛ yi, a ɛkyerɛ sɛ mmoawa pa kakraa bi na ɛwɔ hɔ a, mmoawa bɔne te sɛ C. diff nya hokwan trɛw te sɛ nwura na wodi wɔn so.

Ɔkwan bɛn so na wɔde C. diff kɔ?

C. diff mmoawa no yɛ sum ase adwuma yiye. Sɛ efi nipadua no mu a, ɛyɛ abon a ɛyɛ den yiye a wɔfrɛ no spore. Saa nkwaboaa yi te sɛ mmoawa no aba nketenkete. Wobetumi ayɛ yɛn nsa ne nneɛma a yɛde yɛn nsa ka (apon ano nhama, apon, aguaree nneɛma). Sɛ yɛde yɛn nsa ka baabi a saa nkwaboaa yi wɔ a, yebetumi ayare, sɛ́ ɛyɛ aduan a yɛde nsa koro bedi anaasɛ yɛde yɛn nsa bɛhyɛ yɛn anom.

Ɛyɛ den yiye sɛ wobekum saa mmoawa yi. Wɔko tia ɔhyew, acid, ne nnuru pii a ekum ɔyare mmoawa ne nnuru a ekum ɔyare mmoawa. Wotumi nso tra ase wɔ nneɛma a ɛwɔ soro so asram pii. Ɛno nti na saa yare yi trɛw ntɛmntɛm, titiriw wɔ mmeae te sɛ ayaresabea.

Hena na ɔwɔ asiane kɛse mu sɛ obenya C. diff?

Nnipa binom taa nya saa yare yi. Wɔne:

• Nnipa a wɔadi boro mfe 65: Asiane no yɛ kɛse efisɛ nipadua no mu tumi a ɛko tia nyarewa no so tew bere a obi nyin no, wɔnom nnuru pii ma nyarewa afoforo, na wɔte ayaresabea anaa nkwakoraa ne mmerewa afie.
• Nkokoaa nkumaa: Efisɛ wɔn nipadua mu tumi a ɛko tia nyarewa no nnya nnyinii koraa.
• Nnipa a wɔwɔ ayaresabea: Ayaresabea yɛ beae a ɛnyɛ den sɛ C. diff mmoawa betumi atrɛw. Ɛnyɛ den sɛ wobetumi afa ɔmanfo aguaree ne tiafi so akɔ.
• Nnipa a wɔn nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw: Nnipa a wɔwɔ nyarewa te sɛ kokoram, HIV, asaabo mu yare, ne asikreyare no nipadua mu tumi a ɛko tia nyarewa no ayɛ mmerɛw. Nnipa a wɔnom nnuru a ɛma nipadua no tumi ko tia nyarewa nso wɔ asiane kɛse mu.
• Nnipa a wɔwɔ dwensɔtwaa mu nyarewa: Nnipa a wɔwɔ nyarewa te sɛ Inflammatory Bowel Disease (IBD) , te sɛ Crohn yare ne ulcerative colitis no tumi nya ɔyare mmoawa kɛse efisɛ dwensɔtwaa no fã a ɛbɔ wɔn ho ban no yɛ mmerɛw.

Nanso kae sɛ obi a onni asiane ahorow yi mu biara mpo betumi anya C. diff.

Dɛn ne nsɛnnennen a ebetumi aba wɔ C. diff ho?

Mpɛn pii no, C. diff yare mmoawa no nyɛ aniberesɛm. Nanso ɛtɔ mmere bi a, titiriw sɛ wɔansa a, nsɛnnennen a emu yɛ den betumi aba.

• Nyarewa a ɛsan ba bio: Sɛ wɔsa yareɛ wie mpo a, nnipa bɛyɛ 20% bɛsan anya yareɛ no bio wɔ adapɛn mmienu kɔsi awotwe mu.
• Nsu a ɛtɔ: Atiridiinini a ɛboro so ma nipadua no hwere nsu ne anyinam ahoɔden pii. Sɛ eyi mu yɛ den a, ebetumi ama mogya mmoroso akɔ fam na asaabo mpo asɛe.
• Pseudomembranous colitis a ɛyɛ akisikuru:Eyi yɛ tebea a emu yɛ den (colitis). Dwotwaa no mu yɛ hyew na ɛyɛ den te sɛ ntini.
• Megacolon a awuduru wom: Eyi yɛ tebea a ɛntaa nsi nanso ɛyɛ hu yiye. Akisikuru no hohoro araa ma egyae adwumayɛ koraa. Eyi betumi ama obi anya sepsis, tebea a mmoawa trɛw kɔ nipadua no mu nyinaa.

Wɔ tebea horow a emu yɛ den te sɛ eyi mu no, ebia ɛho behia mpo sɛ wɔyɛ no oprehyɛn de yi dwensɔtwaa no fã a ɔyare no wom no.

Oduruyɛfo, wobɛyɛ dɛn ahu yare yi? Dɛn ne ayaresa no?

Sɛ wo duruyɛfo susuw sɛ wowɔ C. diff yare mmoawa bi a egyina wo sɛnkyerɛnne ahorow so a, ɔbɛka akyerɛ wo sɛ fa nsu a ɛwɔ wo mu ho nhwɛso ma. Wɔde bɛkɔ lab bi akɔhwɛ sɛ C. diff awuduru wɔ mu anaa.

Sɛ wohu sɛ yare no wɔ hɔ a, wobetumi ayɛ mogya mu nhwehwɛmu na ebia wɔayɛ scan de ahwɛ dwensɔtwaa no mu de ahu sɛnea ɔyare no mu yɛ den.

Akwan a wɔfa so sa yare

Ayaresa no gyina sɛnea ɔyare no mu yɛ den so.

• Nnuru a ekum ɔyare mmoawa a wubegyae: Sɛ wunya C. diff bere a worenom nnuru a ekum ɔyare mmoawa ama tebea foforo a, ade a edi kan a wo duruyɛfo bɛyɛ ne sɛ wubegyae nnuru no. Wɔ nnipa binom fam no, ɛno ara ne nea ɛsɛ sɛ wɔyɛ. Mmoawa pa a ɛwɔ wo dwensɔtwaa mu no bɛsan anyin na ɔyare mmoawa no ankasa afi hɔ.
• C. diff-specific antibiotics: Sɛ ɛno anyɛ adwuma a, wo duruyɛfo betumi akyerɛw wo nnuru pɔtee bi a ekum ɔyare mmoawa a ebetumi akum C. diff mmoawa no. Sɛ nhwɛso no , (Metronidazole) , (Vancomycin) , anaa (Fidaxomicin) .
• Ayaresabea: Sɛ ɔyare no mu yɛ den a, ebia ebehia sɛ wɔde wo kɔ ayaresabea, baabi a wobetumi ama wo nkyene (IV nsu) ne nnuru a ekum ɔyare mmoawa a wɔde fa ntini mu.

Dɛn na ɛsɛ sɛ wɔyɛ wɔ nyarewa a ɛsan ba no ho?

Nnipa binom san nya yare no bio bere a wɔasa wɔn yare awie no. Wɔ tebea horow a ɛtete saa mu no, nneɛma a wubetumi apaw ne:

• Tia nnuru a ekum ɔyare mmoawa a wɔde sa yare no bio: Wobetumi akyerɛw nnuru foforo a ekum ɔyare mmoawa anaa aduru a ɛtra hɔ kyɛ.
• Fecal Microbiota Transplant (FMT): Ebia saa din yi bɛyɛ te sɛ nea ɛyɛ nwonwa kakra, nanso ɛyɛ aduru a etu mpɔn yiye a wɔde sa C. diff a ɛsan ba bio. Sɛ yɛbɛka no tiawa a, nea ɛka ho ne sɛ wobeyi mmoawa ‘pa’ no afi obi a ɔwɔ apɔwmuden nsu a wɔde ayɛ nsu mu na wɔde ahyɛ ɔyarefo no dwensɔtwaa mu. Eyi ma mmoawa pa a wɔayera wɔ dwensɔtwaa no mu no san kari pɛ.

Dɛn na ɛsɛ sɛ yɛyɛ na yɛasiw C. diff ntrɛwmu ano?

Esiane sɛ saa yare yi tumi kɔ nnipa pii nti, ɛsɛ sɛ yɛhwɛ yiye paa. Titiriw sɛ obi a ɔwɔ abusua no mu wɔ saa yare yi a, hwɛ hu sɛ wobɛyɛ saa nneɛma yi.

• Tew a wobɛtew ne ho: Ɛyɛ papa sɛ onipa a ɔwɔ ɔyare no bɛtra dan a ɛyɛ soronko mu sɛ ɛbɛyɛ yiye a. Sɛ wobetumi de tiafi a ɛyɛ soronko adi dwuma a, eye mpo. Sɛ wode ɔmanfo tiafi di dwuma a, bere nyinaa fa ade a wɔde tew tiafi a bleach wom popa tiafi no ani bere a wode adi dwuma awie no.
• Faako a wɔhohoro: Fa aduru a bleach wom hohoro nneɛma a wɔtaa de wo nsa ka (apon ano nhama, kanea a wɔde sesa) ho.
• Nnuru a ekum ɔyare mmoawa a wɔde bedi dwuma yiye: Nnom nnuru a ekum ɔyare mmoawa a oduruyɛfo nkyerɛɛ no ​​da. Fa nnuru no nyinaa sɛnea wɔakyerɛw ama wo no.

Bere bɛn na ɛsɛ sɛ mekɔ oduruyɛfo nkyɛn?

Sɛ wowɔ saa sɛnkyerɛnne ahorow yi a, kɔ wo duruyɛfo nkyɛn ntɛm ara.

• Sɛ wunya akisikuru bere a woafi nnuru a ekum ɔyare mmoawa ase akyi a.
• Sɛ akisikuru no mu yɛ den (boro mpɛn 10 da biara).
• Sɛ wuhu mogya wɔ wo nsu mu a.
• Sɛ wo yafunu mu yɛ wo yaw kɛse na wo ho yɛ wo hyew a.
• Sɛ worefe araa ma wuntumi nnidi anaa nnom a.

Sɛ wuhu saa sɛnkyerɛnne ahorow yi bi a, kɔ ayaresabea Dwumadibea a Ɛhwɛ Ntɛmntɛm (ETU) ntɛm ara:

• Nsɛnkyerɛnne a ɛkyerɛ sɛ nsu nnim (ano a ɛyɛ mmerɛw, aniwa a akɔ fam, nsu a ɛba fam koraa, ɔbrɛ kɛse).
• Yafunu mu yaw a emu yɛ den a wontumi nnyina ano.
• Nkae a ɛyɛ basaa.

C. diff nyɛ yare a ɛsɛ sɛ wobu no adewa. Nanso mma wo ho nnyɛ wo hu. Sɛ wokɔ oduruyɛfo nkyɛn wɔ bere a ɛfata mu na wonya ayaresa a, wobetumi asa koraa.