Ua ʻike anei ʻoe i kēia bacteria weliweli? (Carbapenem-Resistant Enterobacterales - CREs) E kamaʻilio kākou!

Ua lohe paha ʻoe ʻaʻole hana nā lāʻau antibiotic a nā kauka e kuhikuhi ai no kekahi mau maʻi. ʻO kekahi ʻano maʻi weliweli a hopohopo hoʻi, ʻo ia ka maʻi bacteria i kapa ʻia ʻo Carbapenem-Resistant Enterobacterales (CREs). ʻAʻole paha e pane kēia mau bacteria i kekahi o nā lāʻau antibiotic i kuhikuhi pinepine ʻia. No laila, ʻoiai he moʻolelo koʻikoʻi kēia, he mea nui iā kākou a pau e makaʻala i ia mea. E hoʻomaopopo wale kākou i ka mea e hana nei.

He aha nā `(Carbapenem-Resistant Enterobacterales)` a i ʻole `(CREs)`?

I ka ʻōlelo maʻalahi, ʻo `(Enterobacterales)` he hui o nā bacteria e pili ana kekahi i kekahi, e like me ka ʻohana hoʻokahi. Hiki i kēia mau bacteria ke hana i nā maʻi like ʻole i loko o ko kākou kino. I kēia manawa, hōʻike kēia mau bacteria `(Enterobacterales)` i ke kūʻē ʻana i kahi `(antibiotic)` kūikawā a ikaika i kapa ʻia ʻo `(Carbapenems). ʻO kēlā mau bacteria `(Enterobacterales)` i kūʻē i `(Carbapenems)` ʻo ia ka mea a mākou e kapa nei he `(Carbapenem-Resistant Enterobacterales)` a i ʻole `(CREs)`.

E noʻonoʻo e pili ana i ia mea, hoʻohana nā kauka i nā `(antibiotics)` e mālama i nā maʻi bacteria. Akā, he maalea loa kēia mau bacteria. Ke hoʻopili mau ʻia lākou i nā `(antibiotics)` (ʻoi aku hoʻi ma ka haukapila a i ʻole ka home hānai), loaʻa iā lākou nā ala e ola ai a ola kūʻē i kēlā mau `(antibiotics). ʻO kēia ka mea a mākou e kapa nei he `(resistance) . No laila, ʻo nā `(CREs)` he mau bacteria i kūʻē i ka papa `(Carbapenem)` o nā `(antibiotics)`.

Aia kekahi mau ʻano lāʻau ʻē aʻe e pili ana i kēia papa o nā antibiotic i kapa ʻia ʻo "Carbapenems":

• ʻErtapenem
• ʻImipenem
• ʻO Meropenem

He mau lāʻau antibiotic ikaika kēia i hāʻawi pinepine ʻia no nā maʻi koʻikoʻi. No laila, inā kūpaʻa kahi bacteria i kēia mau mea, ʻo ia hoʻi, e paʻakikī iki ka hoʻōla ʻana i ka maʻi.

He aha nā ʻano bacteria (Enterobacterales)?

Hoʻohana kekahi poʻe i ka pōkole `(CRE)` e manaʻo ai he `(Carbapenem-resistant Enterobacterales)`, aʻo kekahi poʻe e hoʻohana ana i ka `(Carbapenem-resistant Enterobacteriaceae)`. ʻO `(Enterobacterales)` kahi kauoha nui nona nā ʻano bacteria like ʻole. He ʻekolu ʻohana kona, a i ʻole nā ​​​​suborders. ʻO kekahi o kēia mau suborders ʻo `(Enterobacteriaceae). ʻO kēia hui `(Enterobacteriaceae)` kahi e pili ai nā bacteria a mākou e lohe pinepine ai:

• ʻO `Escherichia` (ʻike nui ʻia e mākou ʻo `E. coli`)
• ʻO Klebsiella
• ʻO Salmonella
• ʻO Shigella

ʻO nā CRE maʻamau he mau ʻano antibiotic-resistant o Klebsiella pneumoniae a me E. coli. He mea nui e hoʻomanaʻo ʻoiai he maʻi kou me Klebsiella a i ʻole E. coli, ʻaʻole ia he manaʻo he antibiotic-resistant.

He aha nā maʻi i hoʻokumu ʻia e nā `(CREs)`?

Hiki i kēia mau bacteria "(CREs)" ke hoʻoulu i nā maʻi ma nā ʻāpana like ʻole o kou kino. ʻIke pinepine ʻia kēia mau maʻi ma:

• I loko o ke koko(Nā maʻi koko)
• ʻO ka maʻi ʻaʻai mimi (UTI)
• I loko o nā māmā (pneumonia)
• ʻŌpū (ʻōpū i loko o ka ʻōpū)

Ma nā wahi e like me kēia e hiki ai i kēia mau bacteria malū ke hoʻoulu maʻalahi i nā maʻi.

Pehea ka maʻamau o nā maʻi `(CRE)`?

Inā ʻoe e nānā i nā helu helu o kahi ʻāina e like me ʻAmelika Hui Pū ʻIa, ma kahi o 13,000 mau maʻi i hōʻike ʻia i kēlā me kēia makahiki ma muli o nā "(CREs). Ma kahi o 1,100 o lākou e make ana. Ke nānā nei nā kauka ma Sri Lanka i kēia kūlana. No ka mea, ke lilo nei kēlā mau bacteria kū'ē i mea pilikia ma ka honua holoʻokoʻa.

He aha nā hōʻailona o ka maʻi `(CRE)`?

ʻOkoʻa nā hōʻailona o ka `(Carbapenem-resistant Enterobacterales)` ma muli o kahi i loaʻa ai iā ʻoe ka maʻi. ʻO kekahi mau hōʻailona maʻamau e komo pū me:

• kuni
• Anuanu
• Paʻakikī ka hanu ʻana
• Kuke
• ʻEha ʻōpū
• ʻEha i ka wā e mimi ai
• ʻUlaʻula, pehu, a me ka maneʻo ma kahi o ke ʻoki ʻana a i ʻole kahi ʻeha

He mea nui: ʻAʻole i kaupalena ʻia kēia mau hōʻailona i nā maʻi `(CRE)`. Hiki i nā maʻi bacteria ʻē aʻe ke hana i kēia mau hōʻailona. No laila, inā ʻike ʻoe i kekahi o kēia mau hōʻailona, ​​​​ʻoi aku ka maikaʻi o ke ʻike ʻana i ke kauka.

He aha nā kumu o nā maʻi `(CRE)`?

I ka ʻōlelo maʻalahi, ʻo nā maʻi `(CRE)` i hoʻokumu ʻia e nā bacteria i kūʻē i nā `(antibiotics)` i kapa ʻia ʻo `(Carbapenem)`. Nui nā kumu e hoʻomohala ai nā bacteria i kēia kūʻē `(antibiotic)`. ʻO kekahi ke ala i ulu ai lākou e noho pū me nā meaola ʻē aʻe ma ke ʻano.

Ma nā haukapila a me nā wahi mālama ola kino ʻē aʻe, ua hoʻopilikia mau ʻia nā bacteria i nā antibiotics. ʻOiai ʻo nā antibiotics ikaika e like me nā carbapenems e hoʻohana ʻia e mālama i nā maʻi koʻikoʻi, loaʻa i nā bacteria ka manawa kūpono e hoʻomohala i nā ala e kūʻē ai iā lākou. Loaʻa i kēia mau bacteria kahi hiki kupaianaha ke hoʻoili i kā lākou mau genes kūʻē i nā bacteria ʻē aʻe . Ua kapa ʻia kēia he hoʻoili gene horizontal. E like me ka haʻi ʻana i kahi mea huna i kahi hoaaloha, kaʻana like kēia mau bacteria i ko lākou kūʻē me nā poʻe ʻē aʻe. A i ʻole, hiki i nā bacteria e ola ana i nā antibiotics ke hoʻoili i kā lākou mau genes kūʻē, e hana ana i nā bacteria kūʻē he nui.

ʻO kekahi o nā ala nui e kūʻē ai ka bacteria i ka `(CRE)` ʻo ia ka hana ʻana i kahi enzyme i kapa ʻia ʻo `(Carbapenemase)`. Hoʻopau kēia enzyme a luku i nā `(Carbapenem antibiotics)`. Hana kēia enzyme i kahi hana like me ka ʻoki ʻana i ka lāʻau lapaʻau me kahi ʻoki liʻiliʻi. A laila, ʻaʻole hana ka lāʻau.

Pehea e hoʻoili ʻia ai nā CRE?

Hiki i nā bacteria Enterobacterales kū'ē i ka Carbapenem ke ola ma kou ʻili a i ʻole i loko o kou ʻōpū me ka ʻole o ka hoʻomaʻi ʻana iā ʻoe. Ua kapa ʻia kēia he colonization.Hiki ke hoʻoili ʻia nā CRE mai kahi mea maʻi me ka maʻi CRE, a i ʻole mai kahi mea i noho pū ʻia me ka bacteria me nā asymptomatic ʻole.

ʻO ʻoe ka mea i pilikia nui i ka loaʻa ʻana o kahi maʻi `(CRE)` ma kahi haukapila a i ʻole kahi mālama ola kino ʻē aʻe. ʻO kēia no ka mea hiki i nā bacteria e noho maoli ana ma ko mākou ʻili a ma loko o ko mākou kino ke kū i nā antibiotics ma ka hōʻike ʻia ʻana iā lākou. Hiki iā ʻoe ke loaʻa kahi maʻi `(CRE)` ma nā ʻano penei:

• Ma ka hoʻopā ʻana i kahi mea i loaʻa ka bacteria ma ko lākou ʻili (no ka laʻana, inā ʻaʻole i holoi pono kēlā kanaka i ko lākou mau lima).
• Mai nā ʻili lepo , ʻoiai hoʻi nā poho holoi a me nā lua.
• Mai nā lako lapaʻau haumia a me nā mea lapaʻau i hoʻokomo ʻia i loko o kou kino (e.g., kahi laina venous waena, kahi paipu hanu).

ʻO wai ka mea i pilikia nui no nā maʻi `(CRE)`?

Aia paha ʻoe i kahi pilikia kiʻekiʻe o ka loaʻa ʻana o kahi maʻi `(CRE)` inā ʻoe:

• Inā loaʻa iā ʻoe kahi laina venous waena (kahi paipu i hoʻokomo ʻia i loko o kahi aʻa nui), ka paipu hanu, ka paipu hānai, a i ʻole kekahi paipu a mea hana ʻē aʻe i hoʻokomo ʻia i loko o kou kino, hiki i nā CRE ke komo i kou kino mai waho ma o kēia mau mea.
• Inā ua lōʻihi kou lawe ʻana i nā lāʻau antibiotic a inā ʻoe e lawe mau iā lākou, hiki i ka bacteria ke kūʻē iā lākou i ka hala ʻana o ka manawa. Hiki i kēia ke pepehi i nā bacteria "maikaʻi" (ʻaʻole ʻino) i loko o ko kākou ʻōpū, e ʻae ana i nā bacteria ʻē aʻe e ulu aʻe ma waho o ke kaohi a hoʻoulu i nā maʻi.
• Inā loaʻa iā ʻoe kahi maʻi olakino e hoʻonāwaliwali ana i kou ʻōnaehana pale . No ka laʻana, inā loaʻa iā ʻoe ka maʻi HIV, nā maʻi ʻaʻai koko, ka maʻi diabetes, a i ʻole ua loaʻa iā ʻoe kahi hoʻoili kino a i ʻole ka hoʻoili cell stem, ʻoi aku ka nui o kou pilikia. ʻO kēia no ka mea ʻoi aku ka paʻakikī o ke kino ke hakakā i nā maʻi ma lalo o kēia mau kūlana.
• Inā makemake ʻoe i ke kōkua me nā hana o kēlā me kēia lā, e like me ka ʻauʻau ʻana a me ka hoʻohana ʻana i ka lua , ʻoi aku paha kou pilikia o ka launa pū ʻana me nā feces (a me nā bacteria mai ka ʻōpū gastrointestinal), hiki ke hoʻolaha i nā CRE.
• Inā ua lōʻihi kou noho ʻana ma ka haukapila , ʻoiai inā ua noho ʻoe ma kahi haukapila ma waho o ʻAmelika Hui Pū ʻIa i loko o nā mahina ʻeono i hala. ʻOiai ke piʻi nei nā CRE ma ʻAmelika Hui Pū ʻIa, ʻoi aku ka nui o lākou ma waho o ka ʻāina.

He aha nā pilikia e hiki mai ana o nā `(CREs)`?

Inā ʻaʻole hiki i nā kauka ke kāohi i kahi maʻi bacteria me nā antibiotics, hiki iā ia ke laha ma ke kino a hoʻoulu i nā pilikia make e like me ka hāʻule ʻana o nā ʻōkana. ʻO kēia ka pōʻino nui loa o nā maʻi CRE.

Pehea e ʻike ai i kahi maʻi `(CRE)`?

Inā loaʻa iā ʻoe nā hōʻailona o kahi maʻi bacteria a ʻaʻole ia e nalowale me nā antibiotics, manaʻo paha kāu kauka he maʻi CRE kou. A laila e lawe lākou i nā laʻana mai kou kino e nānā i ka bacteria. Hiki i kēia mau laʻana ke komo pū me:

• Koko
• Mimi
• Noho
• Wai a ʻiʻo paha mai kahi ʻeha

Hiki i kahi keʻena hoʻokolohua ke hoʻoholo inā he "CREs" nā bacteria i loko o kēia mau laʻana. Mai poina e haʻi i kāu kauka e pili ana i nā mea lapaʻau āu i hoʻokomo ai i loko o kou kino a i ʻole inā ua hoʻokomo ʻia ʻoe i ka haukapila i hala koke nei.

Pehea e mālama ʻia ai nā CRE?

Hiki ke paʻakikī ka mālama ʻana i nā CRE no ka mea ʻaʻole hana nā antibiotic āu e hoʻohana mau ai. No laila, hāʻawi paha kāu kauka iā ʻoe i kahi antibiotic ʻokoʻa. A i ʻole, hāʻawi paha lākou iā ʻoe i kahi antibiotic carbapenem me kahi lāʻau ʻē aʻe e kāohi ana i ka enzyme carbapenemase o ka bacteria. Hiki i nā keʻena hoʻokolohua ke hoʻāʻo i nā lāʻau like ʻole e ʻike i nā mea e hana ana ma nā CRE.

Nā ʻano `(Antibiotics)` i hoʻohana ʻia e mālama i nā `(CREs)`

Eia kekahi mau ʻano antibiotic a nā kauka e hoʻohana ai - inā hoʻokahi a i ʻole i hui pū ʻia - e mālama i nā CRE:

• ʻO Polymyxin/Colistin
• ʻO ka Tigecycline
• ʻO Fosfomycin
• ʻO nā aminoglycosides (e like me gentamicin a i ʻole tobramycin)
• ʻO ka Rifampin
• ʻO Carbapenem (me kahi mea hoʻopaʻa)

Koho ʻia kēia mau lāʻau lapaʻau ma muli o ke kūlana o ka mea maʻi, ke ʻano o ka maʻi, a me ke ʻano kūʻē o ka bacteria.

Pehea ke koʻikoʻi o ka maʻi `(CRE)`?

Hiki i nā CRE ke hoʻoulu i nā maʻi koʻikoʻi a paʻakikī ke mālama. Loaʻa i kekahi poʻe nā maʻi e hoʻoweliweli ana i ke ola. Inā loaʻa iā ʻoe kahi maʻi CRE, e mālama ʻia ʻoe ma kahi haukapila kahi e hiki ai i nā limahana lapaʻau ke nānā pono iā ʻoe.

He aha ka helu ho'ōla mai ka `(CRE)`?

Ua hōʻike ʻia nā haʻawina e ʻokoʻa ka nui o ka make no nā CRE ma muli o kahi i loaʻa ai ka maʻi. No ka laʻana, ʻo ka nui o ka make no nā maʻi ʻaʻai mimi (UTI) i hoʻokumu ʻia e nā CRE ma kahi o 13%, ʻoiai ʻo ka nui o ka make no nā maʻi koko i hoʻokumu ʻia e nā CRE hiki ke 50% a ʻoi aku paha. Ke nānā nei i kēia mau helu helu, hiki iā ʻoe ke ʻike i ke koʻikoʻi o kēia, ʻeā?

Hiki ke pale ʻia nā CRE?

Hoʻokō nā mea lawelawe mālama ola, e like me nā kauka a me nā kahu maʻi, i nā lula palekana kūikawā a me ka sterilization e pale aku i nā "maʻi i loaʻa i ka mālama ola" e like me "CREs." ʻO kēia mau mea:

• E holoi pinepine i kou mau lima.
• Ke hoʻomaʻemaʻe nei i nā ʻili.
• E hōʻoia i ka hāʻawi wale ʻia ʻana o nā antibiotics i nā poʻe me nā maʻi bacteria. (ʻAʻole kōkua nā antibiotics no nā maʻi viral.)
• Ka hoʻomaʻemaʻe ʻana i nā lako lapaʻau.

Hiki iā ʻoe ke kōkua i ka pale ʻana i nā maʻi CRE ma o:

• E holoi pinepine a holoi pono i kou mau lima. He mea nui loa kēia inā ʻoe e mālama ana i kahi kanaka me ka ʻōnaehana pale nāwaliwali a i ʻole kekahi e pono ai ke kōkua i ka ʻauʻau ʻana a i ʻole ka hoʻohana ʻana i ka lua.
• Inā ua pono ʻoe e hoʻohana i nā mea lapaʻau i hoʻokomo ʻia i loko o kou kino, e like me nā catheters , e nīnau i kāu kauka i ka lōʻihi o ka mālama ʻia ʻana o lākou a me nā mea āu e hana ai e pale aku i nā maʻi i ka wā e kau ana ka mea hana.

Āhea wau e ʻike ai i kaʻu kauka?

Inā he mea lapaʻau i hoʻokomo ʻia kāu a inā nāwaliwali kou ʻōnaehana pale, e nīnau i kāu kauka i nā hōʻailona o ka maʻi āu e makaʻala ai. Inā he mau hōʻailona kānalua kāu, e ʻike i ke kauka.

ʻOiai ʻoe ma ka haukapila, he mea nui e mālama i ke kamaʻilio maikaʻi me kāu hui lapaʻau. Inā ʻike ʻoe i kekahi mau hōʻailona o ka maʻi, e like me ka ʻeha, ka puʻuwai wikiwiki, ka nāwaliwali, a i ʻole ke kuni, e haʻi koke iā lākou.

Āhea wau e hele ai i ka lumi pilikia (ER)?

Inā loaʻa iā ʻoe nā hōʻailona o kahi maʻi koʻikoʻi, e hele i kahi lumi pilikia. ʻO nā hōʻailona penei:

• Ke kuni ma luna o 103 degere Fahrenheit (40 degere Celsius).
• ʻEha nui.
• Nā ʻōʻili.
• Ka huikau a i ʻole ka pio ʻana.
• Ka hāʻule koke ʻana o ke koko (nā hōʻailona: nāwaliwali, poniuniu, maule).

He aha nā nīnau e pono iaʻu e nīnau aku i kaʻu kauka?

He mea kōkua paha ka nīnau ʻana i kāu kauka i nā nīnau e like me kēia:

• He aha nā koho lapaʻau e loaʻa iaʻu?
• Āhea wau e manaʻo ai e ola hou?
• Pehea i loaʻa ai iaʻu kēia maʻi?
• He aha kaʻu e hana ai e pale aku i kēia ʻano maʻi i ka wā e hiki mai ana?

ʻO ka mea hope loa, nā mea e hoʻomanaʻo ai (Leka Lawe-Home)

ʻO nā Carbapenem-resistant Enterobacterales (CREs) kahi ʻano bacteria e hiki ke hoʻoulu i nā maʻi koʻikoʻi e paʻakikī ke mālama. ʻO ia ke kumu e hana nui nei kāu poʻe lawelawe olakino e mālama i nā haukapila a me nā hale mālama lōʻihi i maʻemaʻe a palekana. Ke makaʻala nei hoʻi nā kauka a me nā luna olakino ma Sri Lanka no kēia kūlana.