Ua loaʻa anei iā ʻoe kahi ʻōpū ʻeha ma hope o ka lawe ʻana i nā lāʻau antibiotic? E aʻo kākou e pili ana iā C. diff (Clostridioides difficile)!

Ua hoʻomaka anei ʻoe i ka maʻi palahēhē nui ma hope o ka lawe ʻana i kahi lāʻau antibiotic? A i ʻole ua loaʻa iā ʻoe ka ʻeha ʻōpū a me ka maʻi palahēhē no nā lā? Hiki ke kumu o kahi maʻi bacteria a mākou i lohe ʻole ai, akā hiki ke lilo i mea weliweli loa. I kēia lā, e kamaʻilio kākou e pili ana i ke ʻano o C. diff, no ke aha e hana ʻia ai, a pehea e hiki ai iā mākou ke pale iā mākou iho.

He aha ka C. diff (Clostridioides difficile)?

I ka ʻōlelo maʻalahi, ʻo C. diff ka inoa pōkole i hāʻawi ʻia i kahi ʻano bacteria. ʻO kona inoa piha ʻo *Clostridioides difficile*. Hiki i kēia bacteria ke hoʻopilikia i ko mākou ʻōpū nui (colon). Ke hana ia, hoʻoulu ia i ka maʻi diarrhea a me nā hōʻailona ʻoluʻolu ʻole ʻē aʻe.

He mea maʻamau ka loaʻa ʻana o nā maʻi bacteria i loko o kou ʻōpū, a ʻo ka hapa nui o lākou ʻaʻole koʻikoʻi. Akā ʻoi aku ka koʻikoʻi o kēia maʻi C. diff, a hiki iā ia ke hōʻino i kou kolona. ʻO kēia no ka mea hana nā bacteria C. diff i nā mea ʻawaʻawa i loko o kou ʻōpū. Hoʻopōʻino kēia mau mea ʻawaʻawa i nā ʻāpana e uhi ana i kou ʻōpū, e hoʻoulu ai iā lākou e pehu. Ma nā ʻōlelo lapaʻau, kapa mākou i kēia he colitis . Inā loaʻa iā ʻoe nā hōʻailona a pehea ka koʻikoʻi o lākou, pili ia i ka nui o ka pōʻino a nā mea ʻawaʻawa i hana ai i kou ʻōpū. I kekahi mau hihia, hiki i kēia kūlana ke hoʻoweliweli i ke ola.

He aha nā hōʻailona o ka maʻi C. diff?

ʻO ka hōʻailona nui a me ka hōʻailona mua o kēia maʻi, ʻo ia ka neʻe ʻana o ka ʻōpū wai (diarrhea) . Inā ʻaʻole koʻikoʻi ka maʻi, hiki iā ʻoe ke loaʻa ma kahi o ʻekolu mau neʻe ʻana o ka ʻōpū i ka lā, me ka ʻeha iki o ka ʻōpū.

I ka wā e ʻoi aku ka ʻino o ka maʻi, e ʻoi aku ka ʻino o ka maʻi kahe. Loaʻa paha iā ʻoe he ʻumi a ʻumikūmālima paha mau neʻe ʻana o ka ʻōpū i ka lā. Hiki paha iā ʻoe ke ʻike i ke koko i loko o kou ʻōpala. ʻO kēia nā hōʻailona ʻē aʻe e ʻike ʻia ke koʻikoʻi ke ʻano.

I ka wā mua, ʻike ʻia paha kēia mau hōʻailona e like me ka lāʻau make i ka meaʻai a i ʻole ka maʻi ʻōpū. Inā ʻoe e lawe ana i nā lāʻau antibiotic, manaʻo hewa paha ʻoe he hopena maʻamau kēia ʻōpū ʻeha o ka lāʻau.

He aha ke ʻano o ka ʻōpala i ka maʻi C. diff?

I ka maʻi diarrhea C. diff, ua like ka ʻōpala me ka porridge a mānoanoa, ʻaʻole wai loa. I kekahi manawa he ʻōmaʻomaʻo ke kala. I kekahi manawa, ʻike ʻia ke koko, ka mucus, a i ʻole ka pus.

Ua hōʻike mai ka nui o ka poʻe he ʻala ʻokoʻa ko ka maʻi diarrhea C. diff. Ua wehewehe lākou iā ia he ʻala ikaika a ʻono ʻē aʻe ma mua o ka ʻōpala maʻamau. Malia paha kēia no ka mea hoʻonui ka bacteria C. diff i nā pae o nā waikawa bile i loko o kā mākou ʻōpala.

No ke aha mākou e loaʻa ai iā C. diff?

E noʻonoʻo i ko kākou ʻōpū e like me kahi māla pua nani. Ma kēia māla, aia nā pua maikaʻi a me kekahi mau nāhelehele. Ma ka ʻōpū o ke kanaka me kahi ʻōnaehana pale olakino, nui nā bacteria "maikaʻi" (e like me nā pua) a ʻo nā bacteria "maikaʻi ʻole" (e like me nā nāhelehele) ke kaohi nei. ʻO C. diff kahi bacteria e noho maʻamau i loko o ko kākou ʻōpū i nā liʻiliʻi.

Inā hoʻopilikia ʻia kēia kaulike, ʻo ia hoʻi, ua emi nā bacteria maikaʻi, loaʻa i nā bacteria ʻino e like me C. diff ka manawa kūpono e laha e like me nā nāhelehele a lawe i ke aupuni.

Pehea e hoʻoili ʻia ai ʻo C. diff?

He ʻano maalea loa ka bacteria C. diff. Ke haʻalele ia i ke kino, hana ia i pūpū paʻakikī loa i kapa ʻia he spore. Ua like kēia mau spores me nā hua liʻiliʻi o ka bacteria. Hiki iā lākou ke noho ma ko kākou mau lima a ma nā mea a kākou e hoʻopā ai (nā puka, nā papa ʻaina, nā lako o ka lumi ʻauʻau). Inā hoʻopā kākou i kahi ʻili i loaʻa kēia mau spores, hiki iā kākou ke maʻi, inā paha he ʻai ʻana i ka meaʻai me ka lima hoʻokahi a i ʻole ke kau ʻana i ko kākou mau lima i loko o ko kākou waha.

He paʻakikī loa ka pepehi ʻana i kēia mau spores. Kūleʻa lākou i ka wela, nā waikawa, a me nā antibiotics a me nā disinfectants he nui. Hiki iā lākou ke ola ma luna o nā ʻili no nā mahina. ʻO ia ke kumu e laha koke ai kēia maʻi, ʻoi aku hoʻi ma nā wahi e like me nā haukapila.

ʻO wai ka mea i ʻoi aku ka pilikia o ka loaʻa ʻana o C. diff?

ʻOi aku ka nui o ka loaʻa ʻana o kēia maʻi i kekahi poʻe. ʻO lākou kēia:

• ʻO ka poʻe ma luna o 65 mau makahiki: ʻOi aku ke kiʻekiʻe o ka pilikia no ka mea e emi ana ka palekana me ka ʻelemakule, lawe lākou i nā lāʻau lapaʻau he nui no nā maʻi ʻē aʻe, a noho lākou i nā haukapila a i ʻole nā ​​​​hale mālama.
• Nā pēpē ʻōpio: No ka mea, ʻaʻole i hoʻomohala piha ʻia kā lākou ʻōnaehana pale.
• Nā kānaka ma nā haukapila: ʻO nā haukapila kahi e laha maʻalahi ai nā spores C. diff. Hiki ke laha maʻalahi ma o nā lumi ʻauʻau lehulehu a me nā lua.
• ʻO ka poʻe me nā ʻōnaehana pale nāwaliwali: ʻO ka poʻe me nā maʻi e like me ke kanesa, ka maʻi HIV, nā maʻi puʻupaʻa, a me ka maʻi diabetes ua nāwaliwali ko lākou ʻōnaehana pale. ʻOi aku ka pilikia o ka poʻe e lawe ana i nā immunosuppressants.
• ʻO ka poʻe me nā maʻi ʻōpū: ʻO ka poʻe me nā maʻi e like me ka Inflammatory Bowel Disease (IBD) , e like me ka maʻi Crohn a me ka ulcerative colitis, ʻoi aku ka maʻalahi o ka maʻi no ka mea ua nāwaliwali ka papa pale o ka ʻōpū.

Akā e hoʻomanaʻo, ʻoiai kekahi me ka ʻole o kekahi o kēia mau mea pilikia hiki ke loaʻa iā C. diff.

He aha nā pilikia e hiki mai ana o C. diff?

ʻO ka hapa nui o ka manawa, ʻaʻole koʻikoʻi nā maʻi C. diff. Akā i kekahi manawa, ʻoiai inā ʻaʻole mālama ʻia, hiki ke loaʻa nā pilikia koʻikoʻi.

• Ka maʻi hou: ʻOiai ma hope o ka mālama ʻana, e loaʻa hou ana ka maʻi i kahi 20% o nā kānaka i loko o ʻelua a ʻewalu pule.
• Ka maloʻo ʻana o ka wai: ʻO ka maʻi diarrhea nui ke kumu o ka nalowale ʻana o ke kino i ka nui o ka wai a me nā electrolytes. Inā lilo kēia i mea koʻikoʻi, hiki iā ia ke hoʻohaʻahaʻa i ke koko a me ka hāʻule ʻana o nā puʻupaʻa.
• ʻO ka colitis pseudomembranous:He maʻi koʻikoʻi kēia (colitis). Lilo ka ʻōpū i ka pehu a mānoanoa e like me ka membrane.
• Megacolon ʻawahia: He kūlana kakaikahi kēia akā he mea weliweli loa. Lilo ka kolona i mea pehu loa a hiki i ka pau ʻana o kāna hana. Hiki i kēia ke alakaʻi i ka sepsis, kahi kūlana e laha ai ka bacteria ma ke kino holoʻokoʻa.

I nā hihia koʻikoʻi e like me kēia, pono paha ke hana ʻoki kino e wehe ai i ka ʻāpana i loaʻa i ka maʻi o ka ʻōpū.

E ke kauka, pehea ʻoe e ʻike ai i kēia maʻi? He aha ka lāʻau lapaʻau?

Inā kānalua kāu kauka i kahi maʻi C. diff ma muli o kāu mau hōʻailona, ​​​​e noi aku ʻo ia iā ʻoe e hāʻawi i kahi hāpana ʻōpala. E hoʻouna ʻia ia i kahi keʻena hoʻokolohua e hoʻāʻo ʻia no ke alo o nā mea ʻawahia C. diff.

Inā ua hōʻoia ʻia ka maʻi, hiki ke hana ʻia nā hoʻāʻo koko a me nā scan paha e nānā i loko o nā ʻōpū e hoʻoholo ai i ke koʻikoʻi o ka maʻi.

Nā ʻano lapaʻau

Aia ka lāʻau lapaʻau i ke koʻikoʻi o ka maʻi.

• Ke hoʻōki ʻana i nā lāʻau lapaʻau: Inā loaʻa iā ʻoe ʻo C. diff i ka wā e lawe ana i nā lāʻau lapaʻau no kekahi maʻi ʻē aʻe, ʻo ka mea mua a kāu kauka e hana ai, ʻo ia ke hoʻōki i ka lāʻau lapaʻau. No kekahi poʻe, ʻo ia wale nō kā lākou e hana ai. E ulu hou nā bacteria maikaʻi i loko o kou ʻōpū a e hoʻomaʻemaʻe ka maʻi iā ia iho.
• Nā lāʻau antibiotic C. diff-specific: Inā ʻaʻole holo pono kēlā, hiki i kāu kauka ke kuhikuhi i kahi lāʻau antibiotic kikoʻī e hiki ke pepehi i ka bacteria C. diff. No ka laʻana , (Metronidazole) , (Vancomycin) , a i ʻole (Fidaxomicin) .
• Ka Hoʻokipa ʻana ma ka Halemai: Inā koʻikoʻi ka maʻi, pono paha ʻoe e hoʻokipa ʻia i ka halemai, kahi e hāʻawi ʻia ai ʻoe i ka saline (IV fluids) a me nā lāʻau antibiotic intravenous.

He aha e hana ai e pili ana i nā maʻi e hoʻi hou mai ana?

Loaʻa i kekahi poʻe ka hoʻi hou ʻana ma hope o ka mālama ʻana. I ia mau hihia, ʻo nā koho:

• E hana hou i ka lāʻau antibiotic: Hiki ke kuhikuhi ʻia kahi lāʻau antibiotic ʻokoʻa a i ʻole ka lāʻau lapaʻau lōʻihi.
• ʻO ka Fecal Microbiota Transplant (FMT): He mea ʻē paha kēia inoa, akā he lāʻau lapaʻau maikaʻi loa ia no ka C. diff e kū hou ana. I ka ʻōlelo maʻalahi, pili ia i ka hoʻokaʻawale ʻana i nā bacteria 'maikaʻi' mai kahi hāpana ʻōpala mai kahi kanaka olakino a hoʻokomo iā lākou i loko o ka ʻōpū o ka mea maʻi. Hoʻihoʻi kēia i ke kaulike o nā bacteria maikaʻi i nalowale i loko o ka ʻōpū.

He aha kā mākou e hana ai e pale aku i ka laha ʻana o C. diff?

No ka mea, he maʻi laha loa kēia, pono kākou e makaʻala loa. ʻOi loa aku inā loaʻa i kekahi o ka ʻohana kēia maʻi, e hana pono i kēia mau mea.

• Ka Hoʻokaʻawale ʻana: ʻOi aku ka maikaʻi o ka mālama ʻana i ka mea i loaʻa i ka maʻi i loko o kahi lumi ʻokoʻa inā hiki. ʻOi aku ka maikaʻi inā hiki iā lākou ke hoʻohana i kahi lua kaʻawale. Inā ʻoe e hoʻohana i kahi lua lehulehu, e holoi mau i ka ʻili o ka lua me kahi mea hoʻomaʻemaʻe me ka bleach ma hope o ka hoʻohana ʻana.
• Ka hoʻomaʻemaʻe ʻili: E hoʻomaʻemaʻe i nā ʻili i hoʻopā pinepine ʻia (nā ʻūmiʻi puka, nā kuapo kukui) me kahi wai i loaʻa ka bleach.
• Ke hoʻohana pono nei i nā lāʻau antibiotic: Mai lawe i nā lāʻau antibiotic i kauoha ʻole ʻia e ke kauka. E lawe i ka papa holoʻokoʻa o ka lāʻau e like me ke kauoha.

Āhea wau e ʻike ai i ke kauka?

Inā loaʻa iā ʻoe kēia mau hōʻailona, ​​e ʻike koke i kāu kauka.

• Inā loaʻa iā ʻoe ka maʻi pākī ma hope o ka hoʻomaka ʻana i nā lāʻau antibiotic.
• Inā nui ka maʻi kahe (ʻoi aku ma mua o 10 mau manawa i ka lā).
• Inā ʻike ʻoe i ke koko i loko o kou ʻeke.
• Inā loaʻa iā ʻoe ka ʻeha nui o ka ʻōpū a me ke kuni.
• Inā ʻoe e luaʻi ana a hiki i kahi e hiki ʻole ai ke ʻai a inu paha.

Inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​e hele koke i ka Emergency Department (ETU) o ka haukapila:

• Nā hōʻailona o ka make wai (waha maloʻo, maka piholo, haʻahaʻa loa ka mimi, luhi nui).
• ʻEha nui a hiki ʻole ke hoʻomanawanui.
• Ka huikau o ka hoʻomanaʻo.

ʻAʻole he maʻi ʻo C. diff e lawe māmā ʻia. Akā, mai hopohopo. Inā ʻike ʻoe i ke kauka i ka manawa kūpono a loaʻa ka lāʻau lapaʻau, hiki ke ho'ōla loa ʻia.