Antibiotics i ei hnuah i pum a na tawh ngai em? C. diff (Clostridioides difficile) chungchang hi i zir dawn teh ang!

Tun hnaiah antibiotic i ei hnuah riltam na tak i nei tan tawh em? A nih loh leh ni tam tak chhung chu pum na leh riltam i nei tawh em? Kan hriat tam loh bacteria infection vang pawh a ni thei a, mahse a hlauhawm khawp mai. Vawiin hian C. diff chu eng nge a nih, engvangin nge a lo awm tih leh engtin nge kan inven theih ang tih te han sawi ila.

C. diff (Clostridioides difficile) tih hi eng nge ni?

A awlsam zawngin C. diff tih hi bacteria chi khat hming tawi a ni. A hming pum chu *Clostridioides difficile* a ni. He bacteria hian kan intestine lian (colon) a kai thei a ni. A tih chuan ril\am leh natna dang tam tak a thlen \hin.

I intestines-a bacteria infection i neih hi thil pangngai a ni a, a tam zawk hi chu a na lo hle. Mahse he C. diff infection hi a na zawk deuh a, i colon a tichhia thei bawk. Hei hi C. diff bacteria hian i intestine-ah toxin a siam vang a ni. Heng toxins te hian i intestines lining cell te chu a tichhia a, a ti hring chhuak thin. Damdawi lam hawi chuan hei hi colitis kan ti a ni. Symptoms i neih leh neih loh leh a nasat dan chu toxins hian i intestines a tihchhiat nasat danah a innghat a ni. Thil engemaw takah chuan he natna hi nunna atana hlauhawm tak a ni thei.

C. diff natna lan chhuah dan chu engte nge ni?

He natna lan chhuah dan ber leh hmasa ber chu tui chhuak (diarrhea) a ni. Infection a na lo a nih chuan ni khatah vawi thum vel i ril a tam thei a, chu chu pum chhunga natna (mild abdominal cramping) nen a inzawm thei bawk.

Infection a na zual zel chuan diarrhea pawh a na zual sauh sauh bawk. Ni khatah ril sawm emaw sawm leh panga emaw i nei thei. I ek chhungah thisen i hmu thei bawk. Hengte hi natna lan chhuah dan dang, natna a nasat huna lo lang thei te an ni.

A tirah chuan heng symptoms te hi food poisoning emaw stomach flu emaw ang maiin a lang thei. Antibiotics i ei a nih chuan he pum natna hi damdawi avanga side effect pangngai a ni tih i ngaihtuah sual mai thei.

C. diff infection ah hian stool hi eng ang nge a nih?

C. diff diarrhea-ah chuan ek chu porridge ang mai leh thuk tak a ni tlangpui a, tui tak tak a ni lo. A châng chuan a rawng chu greenish a ni thei bawk. A chang chuan thisen, mucus, emaw pus emaw hmuh tur a awm thei bawk.

Mi tam tak chuan C. diff diarrhea hian rim danglam tak a nei tih an sawi . Anni chuan stool pangngai aiin a rimtui zawk, a danglam bik zawk niin an sawi. Hei hi C. diff bacteria hian kan bawlhhlawh chhunga bile acids level a tihsan vang pawh a ni thei.

Engvangin nge C. diff kan hmuh?

Kan gut hi pangpar huan mawi tak angin han ngaihtuah teh. He huanah hian pangpar tha tak tak leh buh chi thenkhat a awm a. Mihring taksa hriselna tha tak nei gut-ah hian bacteria "tha" (pangpar ang chi) tam tak a awm a, bacteria "tha lo" (hnim ang chi) te chu an thunun thei a ni. C. diff hi bacteria a ni a, a tlangpuiin kan gut-ah hian a tlem berah a awm a.

He balance hi tihbuai a nih chuan bacteria tha an tlem tihna a ni a, C. diff ang chi bacteria tha lo te hian thlai ang maia darh a, an luah theihna hun remchang an nei a ni.

Engtin nge C. diff hi a kai darh?

C. diff bacteria hi a rukbo hle a ni. Taksa atanga a chhuah chuan spore an tih chu a khauh hle. Heng spore te hi bacteria chi te tak te ang mai an ni. Kan kut leh kan khawih thil (kawngkhar, dawhkan, bathroom fixture)-ah te an awm thei. Heng spore awmna hmun kan khawih chuan kan na thei a, kut khata chaw ei emaw, kan ka chhunga kut dah emaw pawh nise.

Heng spore te hi tihhlum a harsa hle. Khua lum, acid leh antibiotics leh disinfectant tam tak lakah an do thei a ni. Thla tam tak chhung chu lei chung lamah pawh an dam thei bawk. Chuvang chuan he natna hi a darh chak em em a, a bik takin damdawi in ang hmunah te hian a darh chak em em a ni.

Tute nge C. diff vei theihna chance sang zawk?

Mi thenkhat chuan he natna hi an vei tam zawk. Anni chu:

• Kum 65 chunglam: Kum upat deuh deuhin immunity a tlahniam a, natna dang damdawi tam tak an ei a, damdawi in emaw, nursing home emaw-ah an awm avangin a hlauhawmna a sang zawk.
• Nausen naupang: A chhan chu an taksa hriselna (immune system) a la thang kim loh vang a ni.
• Damdawi ina mite: Damdawi in hi C. diff spores awlsam taka darh theihna hmun a ni. Mipui inbualna leh toilet kaltlangin awlsam takin a kai theih a ni.
• Immune system chak lote: Cancer, HIV, kidney disease, leh diabetes ang chi natna nei te hian immune system a chak lo hle. Immunosuppressant ei thinte pawh hi an hlauhawmna a sang zawk.
• Intestinal disease nei te: Inflammatory Bowel Disease (IBD) , Crohn’s disease leh ulcerative colitis ang chi natna nei te hian intestinal protective layer a chak loh avangin natna kai an vei awlsam zawk a ni.

Mahse, heng risk factors zinga pakhat mah nei lo pawhin C. diff a vei thei tih hre reng ang che.

C. diff hian eng harsatna nge a thlen theih?

A tam zawkah chuan C. diff infection hi a na lo hle. Mahse a chang chuan, a bik takin enkawl loh chuan harsatna lian tak tak a thleng thei a ni.

• Recurrent infection: Inenkawl hnuah pawh kar hnih atanga kar riat chhungin mi 20% velin he natna hi an nei leh ang.
• Dehydration: Diarrhea tam lutuk hian taksaah tui leh electrolyte tam tak a hloh thin. Hei hi a nasat chuan thisen sang a tihhniam bakah kal (kidney failure) thlengin a thlen thei a ni.
• Pseudomembranous colitis hi a awm thei lo.Hei hi natna khirh tak (colitis) a ni. Intestine chhung chu a inflamed a, membrane ang maiin a thick ta a ni.
• Toxic megacolon: Hei hi a awm lo hle a, mahse a hlauhawm hle. Colon chu a hring nasa lutuk a, a thawk thei tawh lo. Hei hian sepsis a thlen thei a, chu chu natna hrik taksa pum puiah a darh thei a ni.

Hetiang natna khirh takah hian intestine-a natna hrik awm chu lakchhuah nan operation neih a ngai pawh a ni thei.

Doctor, engtin nge he natna hi i hriat theih ang? Eng nge a enkawl dan?

I doctor chuan i symptoms a zirin C. diff infection a rinhlelh chuan stool sample pe turin a ti ang che. Lab-ah thawn a ni ang a, C. diff toxins a awm leh awm loh enfiah a ni ang.

Natna hi a dik tih finfiah a nih chuan thisen test leh a nih loh leh scan hmanga intestine chhunga en theih a ni a, a natna a nasat dan hriat theih a ni.

Enkawl dan tur

Enkawlna chu hri kai nasat danah a innghat a ni.

• Antibiotics tihtawp: Condition dang atana antibiotics i ei laiin C. diff i neih chuan i doctor-in a tih hmasak ber tur chu damdawi ei kha tihtawp a ni. Mi thenkhat tan chuan chu chu an tih tur awm chhun a ni. I gut chhunga bacteria tha tak takte chu a lo thang lian leh ang a, infection chu a mah chauhin a thianghlim ang.
• C. diff-specific antibiotics: Chu chuan hna a thawk lo a nih chuan i doctor chuan C. diff bacteria that thei antibiotic bik a pe thei ang. Entirnan , (Metronidazole) , (Vancomycin) , emaw (Fidaxomicin) te hi a ni.
• Damdawi ina dah: Infection a nasat chuan damdawi inah dah a ngai mai thei a, chutah chuan saline (IV fluids) leh thisenah antibiotics pek i ni thei bawk.

Infection lo awm leh tur chungchangah eng nge tih tur?

Mi thenkhat chuan enkawl hnuah relapses an nei thin. Chutiang hunah chuan duhthlan tur awmte chu:

• Antibiotic hmanga enkawl nawn leh: Antibiotic dang emaw, hun rei tak chhung damdawi emaw pek theih a ni.
• Fecal Microbiota Transplant (FMT): He hming hi a mak deuhin a lang thei a, mahse C. diff lo lang leh thin enkawlna tha tak a ni. A awlsam zawngin sawi ila, mi hrisel tak atanga bawlhhlawh sample atanga bacteria ‘tha’ te chu isolate a, damlo gut-ah inject a ni. Hei hian gut chhunga bacteria tha bo tawh balance chu a siam tha leh thin.

C. diff darh zel tur ven nan eng nge kan tih ang?

He natna hi a kai theih em avangin kan fimkhur hle a ngai a ni. A bik takin chhungkuaa tu emaw hian he natna hi a vei a nih chuan heng thilte hi tih ngei ngei tur a ni.

• Isolation: A theih chuan hri kai chu pindan hranah dah a tha ber. Toilet hran an hman theih chuan a tha zawk. Mipui inthiarna i hman chuan i hman zawhah toilet chunglam chu bleach awmna cleaner hmangin phih thla fo ang che.
• Surface cleaning: Hmun khawih fo thin (doorknob, light switch) te chu bleach awmna solution hmangin silfai thin ang che.
• Antibiotics dik taka hman: Doctor-in a pek loh antibiotics ei ngai suh. Damdawi ei tur chu a pek angin ei tur a ni.

Engtikah nge Doctor ka hmuh ang?

Heng symptoms te hi i neih chuan doctor pan nghal tur a ni.

• Antibiotics ei tan hnua ril\am i neih chuan.
• Diarrhea a nasat chuan (ni khatah vawi 10 aia tam).
• I bawlhhlawh ah thisen i hmuh chuan.
• Pum natna leh khawsik na tak i neih chuan.
• Ei leh in theih loh khawpa i luak a nih chuan.

Heng symptoms te hi i neih chuan damdawi in Emergency Department (ETU) ah kal nghal rawh:

• Dehydration chhinchhiahna (kawng a vawt, mit a pil, zun chhuah tlem lutuk, hah lutuk).
• Pum natna nasa tak, tuar theih loh.
• Memory a buaithlak.

C. diff hi natna chi hrang hrang ngaihthah tur a ni lo. Mahse, hlauthawng suh. A hun takah Doctor i hmuh a, enkawl i hmuh chuan a dam kim thei a ni.