He bacteria rapthlak tak hi i hre chiang em? (Carbapenem-Resistant Enterobacterales - CREs) Kan sawi dawn nia!

Natna thenkhat damdawi, chu chu `(antibiotics),` tih hi a chang chuan a thawk lo tih i hre tawh ngei ang. Chu chu tunlaia kan sawi tur dinhmun hlauhawm leh ngaihtuahawm tak zinga mi a ni a, chu chu `(Carbapenem-Resistant Enterobacterales)` emaw `(CREs)` bacteria infection te hi a ni. Hengte hian `(antibiotics)` chak tak tak, a tlangpuiin an pek thin thenkhat chu an chhang lo mai thei. Chuvangin, hei hi thawnthu serious deuh ni mahse, kan zavaia tan hian he thil hi kan hriat chian a pawimawh hle. Eng thil nge thleng tih hi i hrethiam mai ang u.

`(Carbapenem-Resistant Enterobacterales)` emaw `(CREs)` emaw chu eng nge ni?

A awlsam zawngin `(Enterobacterales)` hi bacteria pawl, inzawmkhawm, chhungkaw khat ang maia inzawmkhawm a ni. Heng bacteria te hian kan taksaah natna chi hrang hrang a thlen thei a ni. Tunah chuan heng `(Enterobacterales)` bacteria te hian a chang chuan `(Carbapenems) an tih, `(antibiotic)` bik, chak tak, dodalna an lantir fo thin. `(Carbapenems)` laka invenna `(Enterobacterales)` bacteria te chu `(Carbapenem-Resistant Enterobacterales)` emaw `(CREs)` emaw kan tih te hi an ni.

Ngaihtuah teh, Doctor-te hian bacteria infection enkawl nan `(antibiotics)` an hmang thin. Mahse, heng bacteria te hi an fing hle. `(antibiotics)` (a bik takin damdawi in emaw, nursing home emaw-ah) an tawrh reng hian, chu `(antibiotics) lakah chuan dam khawchhuah dan tur leh dam khawchhuah dan tur an zawng chhuak thin. Hei hi `(resistance) kan tih chu a ni. Chuvangin `(CREs)` chu `(Carbapenem)` class `(antibiotics)` laka invenna nei tawh bacteria an ni.

He antibiotics class-a tel damdawi chi dang engemaw zat ``Carbapenems'' an tih hi a awm bawk:

• `Ertapenem` tih a ni
• `Imipenem` tih a ni
• `Meropenem` tih a ni

Hengte hi antibiotics chak tak tak an ni a, natna khirh tak tak tan pawh pek thin an ni. Chuvangin bacteria pakhatin hengte hi a do thei ta a nih chuan a natna chu tihdam a harsa deuh tihna a ni.

Bacteria (Enterobacterales) chi hrang hrangte chu engte nge ni?

Mi thenkhat chuan `(CRE)` tih tawi te hi `(Carbapenem-resistant Enterobacterales)` tihna atan an hmang a, thenkhat erawh chuan `(Carbapenem-resistant Enterobacteriaceae)` an hmang thung. `(Enterobacterales)` hi order lian tak, bacteria chi hrang hrang tam tak awmna a ni. Chhungkaw pathum, a nih loh leh suborder a nei a. Heng suborder pakhat chu `(Enterobacteriaceae) a ni.` He `(Enterobacteriaceae)` group hi kan hriat fo thin bacteria te awmna hmun a ni:

• `Escherichia` (kan hriat tam ber chu `E. coli`) .
• `Klebsiella` tih a ni
• `Salmonella` tih a ni
• `Shigella` tih a ni

CRE awm tam ber chu antibiotic-resistant strain Klebsiella pneumoniae leh E. coli te an ni. Klebsiella emaw E. coli emaw natna i neih vang mai mai chuan antibiotic-resistant a ni tihna a ni lo tih hriat reng a pawimawh.

`(CREs)` avanga hri kai awmte chu engte nge ni?

Heng ``(CREs)`` bacteria te hian i taksa hmun hrang hrangah natna a thlen thei a ni. Heng hri kai te hi a tam ber chu:

• Thisenah chuan(Thisen atanga hri kai) .
• Zun kawng natna (UTI) .
• Lung chhungah (pneumonia) .
• Pum chhunga (intra-abdominal abscess) 1.1.

Hetiang hmunah hian heng bacteria rukbo te hian awlsam takin natna an thlen thei a ni.

`(CRE)` hri kai hi engtiang chiahin nge a awm?

United States ang ram statistics i en chuan kum tin ``(CREs) vangin hri kai 13,000 vel an awm thin.`` Chung zinga 1,100 vel chu an thi thin. Sri Lanka-a Doctor-te pawhin he dinhmun hi an ngaihven hle a ni. A chhan chu chutiang resistant bacteria chu khawvel hmun hrang hrangah harsatna a lo ni chho zel a ni.

`(CRE)` hri kai chhinchhiahnate chu engte nge ni?

`(Carbapenem-resistant Enterobacterales)` natna lan chhuah dan hi i natna hmun azirin a inang lo. A lan chhuah dan tlangpui thenkhat chu:

• Khawsik
• Chills a awm
• Thâwk harsa
• Khuh
• Pum natna
• Zun laiin natna
• Surgery emaw hliam emaw hmuna sen, hring, leh hnim hring

Pawimawh: Heng symptoms te hi `(CRE)` infection chauh a ni lo. Bacteria infection dang pawhin heng symptoms te hi a thlen thei bawk. Chuvangin heng symptoms te hi eng emaw tal i neih chuan Doctor pan a tha ber.

`(CRE)` hri kai chhante chu engte nge ni?

A awlsam zawngin `(CRE)` infection hi `(Carbapenem)` an tih `(antibiotics)` laka inven thei bacteria atanga lo chhuak a ni. Hetiang `(antibiotic)` resistance hi bacteria te hian an neih chhan hrang hrang a awm a. Pakhat chu thilsiam chhunga thil nung dangte nena awm dun tura an lo thanglian dan hi a ni.

Damdawi in leh healthcare setting dang dangah chuan bacteria te hi antibiotics an dawng fo thin. A bik takin carbapenems ang chi antibiotics chak tak takte hi natna khirh tak enkawlna atana hman a nih avangin bacteria te hian an do theih dan tur an siam chhuak thei a ni. Heng bacteria te hian an resistance genes te chu bacteria dangte hnenah an hlan chhawn theihna mak tak an nei a . Hei hi horizontal gene transfer an ti a. Thian hnena thuruk hrilh ang bawkin heng bacteria te hian an do theihna chu midangte hnenah an sawi chhuak thin. Chutiang a nih loh chuan antibiotics atanga dam khawchhuak bacteria te hian an resistance genes te chu an pass thei a, resistant bacteria tam zawk an siam thei a ni.

Bacteria te `(CRE)` laka an do theih dan ber pakhat chu enzyme pakhat `(Carbapenemase)` siam chhuah hi a ni. He enzyme hian a tichhia a, `(Carbapenem antibiotics)` a tichhia a ni. He enzyme hian scissors te tak te hmanga damdawi a tan ang chiah hian hna a thawk a ni. Tichuan damdawi chu a thawk thei lo.

Engtin nge CRE te hi an inthlunzawm?

Carbapenem-resistant Enterobacterales bacteria hi i vunah emaw, i gastrointestinal tract (guts)-ah emaw natna siam lovin i awm thei a ni. Hei hi colonization an ti a.CREs hi CRE natna vei damlo atanga kai theih a ni a, a nih loh leh bacteria nena inzawm lo, symptomatically colonized atanga kai theih a ni bawk.

Damdawi in emaw, healthcare setting dang emaw-ah `(CRE)` infection i vei theihna hlauhawm ber i ni. Hei hi a chhan chu kan vunah leh kan taksaa awm bacteria te hian antibiotics an tawrh hian an do thei lo thei a ni. `(CRE)` infection hi a hnuaia mi ang hian i hmu thei ang:

• An vunah bacteria nei mi pakhat khawih hmangin (entir nan, chu mi chuan a kut a silfai tha lo a nih chuan).
• From dirty surfaces , a bik takin sink leh toilet te.
• Damdawi hmanraw bawlhhlawh leh damdawi hmanrua i taksaa dah (e.g., central venous line, thawkna tube) atang hian.

`(CRE)` hri kai vei zingah tute nge hlauhawm ber?

`(CRE)` infection i vei theihna chance sang zawk i nei thei a, chu chu:

• Central venous line (main vein-a dah tube), thawkna tube, feeding tube emaw, tube emaw device dang emaw i taksaa dah i neih chuan heng hmang hian pawn lam atangin CRE te hi i taksaah a lut thei a ni.
• Antibiotics i ei rei tawh emaw, i ei fo chuan hun kal zelah bacteria te hian an do theihna an nei thei a ni. Hei hian kan gut chhunga bacteria "tha" (tha lo) te chu a that thei a, bacteria dangte chu control theih lohvin an lo thang lian thei a, natna hrik a thlen thei bawk.
• I immune system tichak lo thei hriselna dinhmun hnuaia awm i neih chuan . Entirnan, HIV, thisen cancer, zunthlum, emaw, taksa peng dang emaw, stem cell thlak emaw i neih chuan i hlauhawm zawk a ni. Hei hi a chhan chu heng dinhmun hnuaiah hian taksa tan natna hrik dona a harsat zawk vang a ni.
• Nitin hnathawhnaah tanpuina i mamawh a nih chuan, inbual leh toilet hman ang chi , bawlhhlawh (leh gastrointestinal tract atanga bacteria) nena inzawmna i neih theihna a sang zawk thei a, chu chuan CREs a tidanglam thei a ni.
• If you have been hospitalized for a long time , a bik takin thla ruk kalta chhunga United States pawna damdawi inah i awm tawh a nih chuan. United States-ah hian CRE hi a pung chho zel a, mahse ram pawnah chuan a tam zawk hle.

`(CREs)` avanga harsatna awm thei te chu engte nge ni?

Doctor ten antibiotics hmanga bacteria infection an control theih loh chuan taksa pum puiah a darh thei a, organ failure ang chi harsatna thihna thlen thei a ni. Hei hi CRE infection hlauhawmna lian ber a ni.

Engtin nge `(CRE)` infection hriat theih ang?

Bacteria infection symptoms i neih a, antibiotics hmanga a reh loh chuan i doctor chuan CRE infection i nei niin a ngai mai thei. Chumi hnuah chuan i taksa atangin sample an la ang a, bacteria awm leh awm loh an enfiah ang. Heng sample-te hi a hnuaia mi ang hian a ni thei:

• Thisen
• Zun chhuah
• Ek
• Hliam atanga tui emaw tissue emaw

Laboratory chuan heng sample-a bacteria awmte hi ``CRE'' an nih leh nih loh a hre thei a ni. I taksaa damdawi hmanrua i dah tawh emaw, tun hnaia damdawi ina i awm tawh emaw a nih chuan i doctor hnenah hrilh theihnghilh suh.

CRE te hi engtin nge enkawl an nih?

CRE enkawl hi a harsa thei hle a, a chhan chu i hman tlangpui antibiotics te hian hna an thawk lo. Chuvangin, i doctor chuan antibiotic danglam tak a pe mai thei che a ni. A nih loh leh, bacteria carbapenemase enzyme titawp thei damdawi dang nen carbapenem antibiotic an pe thei bawk. Laboratory-ah chuan damdawi chi hrang hrang test theih a ni a, engte nge CRE-a hnathawk tih hriat theih a ni.

`(CREs)` enkawlna atana hman `(Antibiotics)` chi hrang hrang

Doctor-te’n CRE enkawlna atana an hman antibiotics chi hrang hrang – anmahni chauh emaw, an hman dun emaw – chu hetiang hi a ni:

• `Polymyxin/Colistin` tih a ni
• `Tigecycline` tih a ni
• `Fosfomycin` tih a ni
• Aminoglycosides (e.g. gentamicin emaw tobramycin emaw) te hi a tha hle.
• `Rifampin` tih a ni
• `Carbapenem` (inhibitor nei) 1.1.

Heng damdawi te hi damlo dinhmun, a kai dan, leh bacteria invenna (resistance pattern) a zirin thlan a ni.

`(CRE)` infection hi engtiang chiahin nge a nasat?

CRE hian natna khirh tak, enkawl harsa tak tak a thlen thei a ni. Mi thenkhat chuan nunna atana hlauhawm infection an nei thin. CRE infection i neih chuan damdawi inah enkawl i ni ang a, chutah chuan medical staff te chuan uluk takin an enkawl thei ang che.

`(CRE)` atanga recovery rate chu engzat nge ni?

Zirna hrang hrangah CREs avanga thihna rate hi natna kai awmna hmun azirin a inang lo tih hmuhchhuah a ni. Entirnan, CRE vanga zun kawng (UTI) vanga thihna rate hi 13% vel a ni a, CREs avanga thisen kai vanga thihna rate hi 50% emaw a aia tam emaw a ni thei. Heng statistics te hi en hian hei hi eng ang taka pawi nge a nih theih tih i hmu thei ang, a dik em?

CRE te hi ven theih a ni em?

Healthcare provider, doctor leh nurse te chuan ``healthcare-acquired infections`` (CREs) ven nan himna leh sterilization dan bik an zawm a ni. Chung zingah chuan:

• Kut sil fo thin ang che.
• Disinfecting surface te pawh a awm bawk.
• Antibiotics hi bacteria infection nei tan chauh pek a nih theih nan hma la rawh. (Viral infection tan antibiotics hi a \angkai lo.)
• Damdawi hmanrua te sterilization.

CRE natna laka invenna kawngah pawh hetiang hian i pui thei bawk:

• Kut sil fo la, uluk takin silfai thin ang che. Hei hi a pawimawh hle a, taksa chak lohna nei emaw, inbual emaw, toilet hmang emaw tanpui ngai emaw i enkawl a nih chuan.
• I taksaa dah damdawi hmanrua, catheter ang chi i hman a ngai tawh a nih chuan , i doctor hnenah eng chen nge a hmunah dah tur tih leh hmanrua a awm laiin natna hrik laka invenna tur eng nge i tih tur tih zawt rawh.

Engtikah nge ka doctor ka hmuh ang?

Damdawi hmanrua dah i neih emaw, i taksa hriselna a chak lo emaw a nih chuan, i doctor hnenah eng natna chhinchhiahna nge i fimkhur tur tih zawt rawh. Symptom rinhlelh awm i neih chuan Doctor pan tur a ni.

Damdawi ina i awm lai pawhin i medical team nen inbiakpawhna tha tak neih a pawimawh. Infection chhinchhiahna eng emaw, natna, thinlung thawk chak, chak lohna emaw, khawsik emaw i neih chuan hrilh nghal rawh.

Engtikah nge emergency room (ER) ah ka kal ang?

Natna khirh tak chhinchhiahna i neih chuan emergency room-ah kal rawh. A lan chhuah dan chu:

• Khawsik chu degree Fahrenheit 103 (40 degree Celsius) aia sang a ni.
• Natna nasa tak a nei.
• Seizures a awm thin.
• Buaina emaw, ngaihtuahna buai emaw.
• Thisen sang tlahniam nghal (symptoms: chak lohna, luak chhuak, muhil).

Doctor hnenah eng zawhna nge ka zawh ang?

I doctor hnenah hetiang zawhna hi zawh hi a \angkai thei ang:

• Eng enkawlna kawng nge ka neih?
• Engtikah nge dam ka beisei theih ang?
• Engtin nge he natna hi ka neih?
• Nakin lawkah hetiang hri kai tur hi eng nge ka tih theih ang?

A tawp berah chuan thil hriat reng tur (Take-Home Message) .

Carbapenem-resistant Enterobacterales (CREs) hi bacteria chi khat a ni a, natna khirh tak tak a thlen thei a, enkawl harsa tak a ni. Chuvangin i healthcare provider-te chuan damdawi in leh hun rei tak enkawlna hmunte chu thianghlim leh him taka awmtir turin nasa takin hma an la a ni. Sri Lanka-a doctor leh health official-te pawh he dinhmun hi an fimkhur hle a ni.