Yu no bɔt dis bad bad baktri? (Carbapenem-Resistant Enterobacterales - CREs) Lɛ wi tɔk!

Yu go dɔn yɛri se di antibayɔtik we dɔktɔ dɛn kin gi fɔ sɔm sik dɛn, sɔntɛnde nɔ kin wok. Wan pan dɛn kayn tin ya we denja ɛn we de mek pipul dɛn wɔri na di baktriyal infɛkshɔn we dɛn kɔl Carbapenem-Resistant Enterobacterales (CREs). Dɛn bɔdi ya nɔ go ebul fɔ du sɔm pan di antibayɔtik dɛn we dɛn kin gi. So, pan ɔl we dis na siriɔs stori, i impɔtant fɔ mek wi ɔl no bɔt am. Lɛ wi jɔs ɔndastand wetin de apin.

Wetin na `(Carbapenem-Resistant Enterobacterales)` ɔ `(CRE)`?

Fɔ tɔk am simpul wan, `(Enterobacterales)` na grup fɔ baktri dɛm we gɛt fɔ du wit dɛnsɛf, lɛk di sem famili. Dɛn bɔdi ya kin mek wi gɛt difrɛn difrɛn sik dɛn na wi bɔdi. naw, dεn `(Enterobacterales)` baktri dεm ya sכmtεm de sho rεsistεns to wan spεshal, pawaful `(antibiotic)` we dεn kכl `(Carbapenems). dεn `(Enterobacterales)` baktri dεm we de rεsist to `(Carbapenems)` na dεn wi kכl `(Carbapenem-Resistant Enterobacterales)` כ `(CREs)`.

Tink bɔt am, dɔktɔ dɛn kin yuz `(antibiotics)` fɔ trit baktriyal infɛkshɔn. Bɔt, dɛn baktri ya rili kɔni. We dɛn kin gɛt `(antibiotics)` ɔltɛm (espɛshali na ɔspitul ɔ nɔs os), dɛn kin fɛn we fɔ liv ɛn liv agens dɛn `(antibiotics). Dis na wetin wi kɔl `(resistance) . So `(CREs)` na baktri dεm we dεn dכn bi rεsistεnt to di `(Carbapenem)` klas fכ `(antibiotics)`.

sεvεra כda kayn dεm de we de insay dis klas כf antibaytik dεm we dεn kכl ``Carbapenems'':

• `Ertapenem`
• `Imipenem`
• `Mɛropenem`

Dis na pawaful antibayɔtiks we dɛn kin gi fɔ siriɔs infɛkshɔn. So if baktri nɔ ebul fɔ fɛt dɛn tin ya, dat min se di infɛkshɔn kin at smɔl fɔ mɛn.

Wetin na di kayn baktri dɛm (Enterobacterales)?

Sɔm pipul dɛn kin yuz di abrɛvieshɔn `(CRE)` fɔ min `(Carbapenem-resistant Enterobacterales)`, we ɔda wan dɛn kin yuz `(Carbapenem-resistant Enterobacteriaceae)`. `(Enterobacterales)` na big כda we gεt bכku difrεn kayn baktri dεm. I gɛt tri famili dɛn, ɔ sɔbɔda dɛn. wan pan dεn sכbכda dεm ya na `(Enterobacteriaceae).` Dis `(Enterobacteriaceae)` grup na di say we di baktri dεm we wi kin yεri bכt bכku tεm de:

• `Escherichia` (we wi sabi mɔ as `E. coli`)
• `Klebsiella`
• `Salmonella`
• `Shigella`

di CRE dεm we kכmכn pas כl na di antibaytik-rεsistant strayn dεm fכ Klebsiella pneumoniae εn E. coli. I impɔtant fɔ mɛmba se jɔs bikɔs yu gɛt infɛkshɔn wit Klebsiella ɔ E. coli, i nɔ min se i nɔ gɛt antibayɔtik.

Wetin na di infεkshכn dεm we `(CRE)` de kכz?

dis ``(CRE)`` baktri dεm kin mek yu gεt infεkshכn na bכku difrεn pat dεm na yu bכdi. Dɛn kin si dɛn infɛkshɔn ya mɔ pan:

• Insay di blɔd(Blɔdstrim infɛkshɔn) .
• Infεkshכn na di urinary tract (UTI) .
• Na di lɔng dɛn (nyumonia) .
• Abdominal (absεs insay di bכdi) .

Na ples dɛn lɛk dɛn wan ya, dɛn sikrit ya kin izi fɔ mek pɔsin gɛt infɛkshɔn.

Aw kɔmɔn tin na `(CRE)` infɛkshɔn?

If yu luk di statystik fɔ wan kɔntri lɛk Amɛrika, dɛn kin ripɔt lɛk 13,000 pipul dɛn we gɛt di sik ɛvri ia bikɔs ɔf ``(CREs).`` Na lɛk 1,100 pan dɛn kin day. Dɔktɔ dɛn na Sri Lanka de pe atɛnshɔn bak to dis tin we de apin. Na bikɔs dɛn kayn bɔd dɛn ya we nɔ ebul fɔ fɛt di sik de kam bi prɔblɛm ɔlsay na di wɔl.

Wetin na di sayn dɛm fɔ `(CRE)` infɛkshɔn?

di simptom dεm fכ `(Carbapenem-resistant Enterobacterales)` kin difrεn dipכnt pan usay yu gεt di infεkshכn. Sɔm sayn dɛm wae kin kam pan pɔrsin kin gɛt:

• Fiva
• Chills we de mek pɔsin kol
• I nɔ kin izi fɔ yu fɔ blo
• Kɔf
• Bɛlɛ de pen
• Pen we yu de pis
• Rɛd, swel, ɛn it na di say we dɛn du di ɔpreshɔn ɔ wund

Impɔtant: Dɛn sayn ya nɔr de pan `(CRE)` infεkshɔn. Ɔda baktriyal infɛkshɔn kin mek bak dɛn kayn sik ya. So, if yu gɛt ɛni wan pan dɛn sik ya, i go fayn fɔ mek yu go to dɔktɔ.

Wetin na di tin dɛm we kin mek pɔsin gɛt `(CRE)` infɛkshɔn?

Fɔ tɔk am simpul wan, `(CRE)` infɛkshɔn na baktri dɛm we nɔ de gri wit `(antibiotics)` we dɛn kɔl `(Carbapenem)`. difrεn rizin dεm de we mek baktri dεm de divεlכp dis `(antibiotic)` rεsistεns. Wan pan dɛn na di we aw dɛn dɔn evolv fɔ liv togɛda wit ɔda tin dɛn we de na di wɔl.

Insay ɔspitul ɛn ɔda say dɛn we dɛn kin kia fɔ wɛlbɔdi biznɛs, di bɔdi kin gɛt antibayɔtik ɔltɛm. Ɛspɛshali bikɔs dɛn kin yuz pawaful antibayɔtik lɛk kabapɛnɛm fɔ trit siriɔs infɛkshɔn, baktri dɛn gɛt di chans fɔ mek we fɔ mek dɛn nɔ gɛt am. Dɛn baktri ya gɛt wɔndaful abiliti fɔ pas dɛn rɛsistɛns jin to ɔda baktri dɛm . dεn kכl dis כrizכnal jin tכnfכs. Jɔs lɛk fɔ tɛl yu padi sikrit, dɛn bɔdi ya kin sheb di tin dɛn we dɛn kin ebul fɔ fɛt wit ɔda pipul dɛn. If nɔto dat, di baktri dɛm we de liv di antibaytik kin pas dɛn rɛsistɛns jin dɛm, ɛn mek bɔku mɔ baktri dɛm we nɔ de wok.

wan pan di men we dεm we baktri dεn kin bi rεsistant to `(CRE)` na bay we dεn de prodyuz wan εnzym we dεn kכl `(Carbapenemase)`. dis εnzym de brok dכn εn destroy `(Carbapenem antibiotics)`. Dis ɛnzaym de du di sem wok lɛk fɔ kɔt di mɛrɛsin wit smɔl siza. Dɔn di mɛrɛsin nɔ de wok.

Aw dɛn kin transmit CRE dɛn?

Carbapenem-resistant Enterobacterales bacteria kin liv pan yu skin ɔr na yu gastrointestinal tract (guts) we nɔ go mek yu sik. Dɛn kɔl dis kɔlonizashɔn.CRE kin pas frɔm pɔrsin wae sik wit CRE infεkshɔn, ɔr frɔm pɔrsin wae nɔr gɛt ɛni sayn fɔ kɔloniz wit di baktri.

Yu kin gɛt mɔ risk fɔ gɛt `(CRE)` infɛkshɔn na ɔspitul ɔ ɔda wɛlbɔdi biznɛs. Dis na bikɔs baktri dɛm we de liv na wi skin ɛn na wi bɔdi na wi bɔdi kin ebul fɔ bia wit antibayɔtiks bay we dɛn de pan dɛn. Yu kin gɛt `(CRE)` infɛkshɔn na dɛn we ya:

• Na bay we yu tɔch pɔsin we gɛt di baktri na in skin (fɔ ɛgzampul, if da pɔsin de nɔ was in an fayn fayn wan).
• Frɔm dɔti say dɛn , mɔ di sink ɛn tɔylɛt dɛn.
• Frɔm dɔti mɛdikal ikwipmɛnt ɛn mɛdikal divays dɛn we dɛn put insay yu bɔdi (e.g., wan sɛntral venɔs layn, wan tyub we yu de blo).

Udat de pan denja pas ɔl fɔ gɛt `(CRE)` infɛkshɔn?

Yu kin gɛt ay risk fɔ gɛt `(CRE)` infɛkshɔn if yu:

• if yu gεt sεntri venus layn (tכb we dεn put insay wan men vein), brith tכb, fidin tyub, כ כda tiub כ divays we dεn put insay yu bכdi, CRE dεm kin kכmכt na yu bכdi frכm do tru dεn wan ya.
• If yu dɔn de tek antibayɔtik fɔ lɔng tɛm ɔ if yu de tek am ɔltɛm, i pɔsibul se baktri dɛn go gɛt rɛsistɛns to dɛn as tɛm de go. dis kin kil di "gud" (we nכ de harmful) baktri dεm na wi gכt, we de alaw כda baktri dεm fכ gro aut כf kכntrol εn mek infεkshכn.
• If yu gɛt ɔndalayn wɛlbɔdi prɔblɛm we de mek yu imyun sistɛm wik . Fɔ ɛgzampul, if yu gɛt HIV, blɔd kansa, dayabitis, ɔ yu dɔn gɛt ɔgan transplant ɔ stem sɛl transplant, yu go gɛt mɔ risk. Dis na bikɔs i kin at fɔ mek di bɔdi fɛt di infɛkshɔn ɔnda dɛn kɔndishɔn ya.
• If yu nid ɛp fɔ du tin dɛn we yu kin du ɛvride, lɛk fɔ was ɛn yuz tɔylɛt , yu kin gɛt mɔ prɔblɛm fɔ kam nia yu fes (ɛn baktri dɛn we de kɔmɔt na di bɛlɛ), we kin mek CRE dɛn skata.
• If yu dɔn de na ɔspitul fɔ lɔng tɛm , mɔ if yu dɔn de na ɔspitul we nɔ de na Amɛrika insay di las siks mɔnt. Pan ɔl we CRE dɛn de bɔku na Amɛrika, dɛn kin bɔku mɔ na di kɔntri.

Wetin na di poshubul komplikashɔn dɛm fɔ `(CREs)`?

If dɔktɔ nɔ ebul fɔ kɔntrol baktriyal infɛkshɔn wit antibayɔtik, i kin skata ɔlsay na di bɔdi ɛn mek prɔblɛm dɛn we kin kil pɔsin lɛk we di ɔgan dɛn nɔ wok fayn. Dis na di big denja fɔ CRE infɛkshɔn.

Aw fɔ no if yu gɛt `(CRE)` infɛkshɔn?

If yu gɛt sayn dɛm fɔ baktriyal infɛkshɔn ɛn i nɔ go go wit antibayɔtik, yu dɔktɔ kin tink se yu gɛt CRE infɛkshɔn. Dɔn dɛn go tek sɛmpul frɔm yu bɔdi fɔ chɛk fɔ di baktri. Dɛn sampul ya kin bi:

• Blɔd
• Urine we dɛn kin yuz
• Sidɔm ples
• Fluid ɔ tisu we kɔmɔt na wund

wan labכtכri kin no if di baktri dεm we de insay dεn sεmpl dεm ya na ``CRE''. Nɔ fɔgɛt fɔ tɛl yu dɔktɔ bɔt ɛni mɛrɛsin we yu dɔn put na yu bɔdi ɔ if yu jɔs dɔn go na ɔspitul.

Aw dɛn kin trit CRE dɛn?

Fɔ trit CRE kin tranga bikɔs di antibayɔtik we yu kin yuz nɔ kin wok. So, yu dɔktɔ kin gi yu difrɛn antibayɔtik. Ɔ, dɛn kin gi yu wan kabapenem antibaytik wit ɔda mɛrɛsin we de stɔp di baktri in kabapenem ɛnzaym. Labɔrɔtɔri dɛn kin tɛst difrɛn mɛrɛsin dɛn fɔ si uswan dɛn de wok pan CRE dɛn.

Di kayn `(Antibiotics)` we dɛn kin yuz fɔ trit `(CRE)`

Na sɔm kayn antibayɔtiks we dɔktɔ dɛn kin yuz – dɛn wan ɔ we dɛn jɔyn togɛda – fɔ trit CRE dɛn:

• `Polymyxin/Kɔlistin`
• `Tigesayklin`
• `Fosfomaysin`
• Aminoglycosides (e.g. jεntamaysin כ tobramaysin) .
• `Rifampin`
• `Carbapenem` (wit wan inhibito) .

Dɛn kin pik dɛn mɛrɛsin ya bay aw di pɔsin de fil, di kayn sik we i gɛt, ɛn di we aw di bɔdi de fɛt di sik.

Aw siriɔs wan na `(CRE)` infɛkshɔn?

CRE kin mek pɔrsin gɛt siriɔs sik wae nɔr kin izi fɔ trit. Sɔm pipul dɛn kin gɛt sik dɛn we kin mek dɛn layf de pan denja. If yu gɛt CRE infɛkshɔn, dɛn go trit yu na ɔspitul usay di mɛdikal wokman dɛn go ebul fɔ wach yu gud gud wan.

Wetin na di rikavari ret frɔm `(CRE)`?

stכdi dεm sho se di mכtalman rεt fכ CRE dεm de difrεn dipכnt pan usay di infεkshכn de apin. fכ egzampl, di mכtalman rεt fכ urinary tract infεkshכn (UTI) we CRE kכz na bכt 13%, we di mכtalman rεt fכ bכdi infεkshכn we CRE kכz kin bi 50% כ pas dat. We yu luk dɛn statystik ya, yu go si aw dis kin rili siriɔs, nɔto so?

Yu tink se dɛn kin mek dɛn nɔ gɛt CRE?

Di wan dɛn we de kia fɔ wɛlbɔdi biznɛs, lɛk dɔktɔ ɛn nɔs dɛn, de fala spɛshal sefty ɛn sterilizeshɔn lɔ fɔ mek dɛn nɔ gɛt ``infɛkshɔn we dɛn kin gɛt frɔm wɛlbɔdi biznɛs`` lɛk ``CRE.`` Dɛn tin ya na:

• Wash yu an ɔltɛm.
• Disinfɛkt sɔfays dɛn.
• Mek shɔ se dɛn jɔs gi antibayɔtik to pipul dɛn we gɛt baktriyal infɛkshɔn. (Antibayɔtik nɔ kin ɛp fɔ gɛt vayral infɛkshɔn.)
• Sterilayzeshɔn fɔ di mɛrɛsin ikwipmɛnt dɛn.

Yu kin ɛp bak fɔ mek yu nɔ gɛt CRE infɛkshɔn bay we yu:

• Wash yu an ɔltɛm ɛn fayn fayn wan. Dis impɔtant mɔ if yu de kia fɔ pɔsin we in imyun sistɛm wik ɔ pɔsin we nid ɛp fɔ was ɔ yuz tɔylɛt.
• If yu dɔn gɛt fɔ yuz mɛrɛsin dɛn we dɛn put insay yu bɔdi, lɛk kateshɔn , aks yu dɔktɔ aw lɔng dɛn fɔ de na dɛn ples ɛn wetin yu fɔ du fɔ mek yu nɔ gɛt infɛkshɔn we di divays de.

Ustɛm a fɔ go to mi dɔktɔ?

If yu gɛt mɛrɛsin we dɛn put insay yu bɔdi ɔ if yu imyun sistɛm wik, aks yu dɔktɔ us sayn dɛn fɔ sho se yu gɛt di sik yu fɔ tek tɛm wit. If yu gɛt ɛni sayn we yu nɔ biliv, go to dɔktɔ.

Ivin we yu de na ɔspitul, i impɔtant fɔ mek yu kɔntinyu fɔ tɔk fayn to yu mɛdikal tim. If yu si ɛni sayn fɔ se yu gɛt di sik, lɛk we yu de fil pen, yu at de bit kwik kwik wan, yu wik, ɔ yu gɛt fiva, tɛl dɛn wantɛm wantɛm.

Ustɛm a fɔ go na di imejensi rum (ER)?

If yu gɛt sayn fɔ siriɔs sik, go na imejensi rum. Di sayn dɛm na:

• Fiva pas 103 digri F (40 digri sɛlshiɔs).
• I kin fil pen bad bad wan.
• Di sik dɛn we kin mek pɔsin sik.
• Kɔnfyushɔn ɔ disorienteshɔn.
• Di blɔd prɛshɔn go dɔŋ wantɛm wantɛm (di sayn dɛm: wik, diziz, fɔdɔm).

Us kwɛstyɔn dɛn a fɔ aks mi dɔktɔ?

I go fayn fɔ aks yu dɔktɔ kwɛstyɔn dɛn lɛk dɛn wan ya:

• Us tritmɛnt opshɔn dɛn a gɛt?
• Ustɛm a go tink se a go wɛl?
• Aw a bin gɛt dis infɛkshɔn?
• Wetin a kin du fɔ mek a nɔ gɛt dis kayn sik tumara bambay?

Fɔ dɔn, tin dɛn fɔ mɛmba (Take-Home Message) .

Carbapenem-resistant Enterobacterales (CREs) na wan kayn baktri dɛm we kin mek pɔsin gɛt siriɔs infɛkshɔn we at fɔ trit. Na dat mek di wan dɛn we de kia fɔ yu wɛlbɔdi biznɛs de wok tranga wan fɔ mek di ɔspitul ɛn di say dɛn we dɛn kin kia fɔ lɔng tɛm klin ɛn sef. Dɔktɔ ɛn wɛlbɔdi ɔfisa dɛn na Sri Lanka sɛf de wach fɔ dis tin.