Matenda a C. diff (Clostridioides difficile): Tiyeni tidziwe bwino lomwe kupweteka kwa m'mimba kumeneku.

Kodi nthawi zina mumakhala ndi kupweteka m'mimba kapena kutsegula m'mimba komwe kumatenga masiku angapo? Nthawi zambiri timaganiza kuti, 'Chakudya ichi chiyenera kuti chinali ndi poizoni pang'ono' kapena 'Chiyenera kuti ndi chimfine cha kachilomboka.' Koma nthawi zina zizindikirozi zimatha kuyambitsidwa ndi matenda oopsa kwambiri a bakiteriya omwe angawononge matumbo athu. Limodzi mwa matenda otere ndi C. diff (Clostridioides difficile).

Kodi C. diff (Clostridioides difficile) ndi chiyani?

Mwachidule, C. diff ndi mtundu wa mabakiteriya. Dzina lenileni ndi `(Clostridioides difficile)`. Mabakiteriyawa amatha kuyambitsa matenda m'matumbo anu akuluakulu, kutanthauza `(colon)`. Pamenepo ndi pomwe zizindikiro zosasangalatsa monga kutsegula m'mimba zimawonekera. Tsopano, tiyeni tiwone, nthawi zambiri matumbo athu akuluakulu amadwala matenda a bakiteriya. Ambiri mwa iwo si owopsa kwambiri. Koma matenda a C. diff awa ndi owopsa pang'ono. Chifukwa chake ndi chakuti mabakiteriya awa `(Clostridioides difficile)` amatulutsa poizoni. Ma poizoni awa amawononga maselo mkati mwa matumbo athu. Izi zimayambitsa kutupa kwa matumbo ndi matumbo akulu, kutanthauza kutupa (colitis). Kaya mumakhala ndi zizindikiro komanso momwe zilili zimatengera kuchuluka kwa kuwonongeka komwe kumachitika ndi poizoniyu. Nthawi zina vutoli likhoza kukhala pachiwopsezo cha moyo. Mabakiteriyawa kale ankatchedwa `(Clostridium difficile)`. Tsopano dzina latsopano ndi `(Clostridioides difficile)`.

Kodi matenda a C. diff ndi ofala bwanji?

Matenda a C. diff, kapena CDI, ndi vuto la thanzi padziko lonse lapansi. Komabe, palibe ziwerengero zenizeni za momwe matendawa akufalikira padziko lonse lapansi. Ku United States, akuti pali matenda pafupifupi 500,000 pachaka, ndipo anthu pafupifupi 15,000 amafa. Choncho ichi si chinthu chongofunika kuchitenga mopepuka.

Kodi zizindikiro za matenda a C. diff ndi ziti?

Chizindikiro choyamba komanso chodziwika bwino ndi kutsegula m'mimba kwa madzi. Nthawi zina, kutsegula m'mimba kumachitika katatu patsiku, ndipo pakhoza kukhala kupweteka m'mimba. Pamene matenda a C. diff akupita patsogolo, kuchuluka kwa kutsegula m'mimba kumawonjezeka. Kungachitike mpaka nthawi 10-15 patsiku. Muthanso kuwona magazi m'chimbudzi chanu. Zizindikiro zina ndi izi:

• Kukhala ndi kupweteka m'mimba kosalekeza
• Mimba yadzaza ndipo yatupa.
• Kusanza ndi kusanza
• Chilakolako cha chakudya
• Malungo
• Kuwonjezeka kwa kugunda kwa mtima

Poyamba, zizindikiro za C. diff zingamveke ngati poizoni wa chakudya kapena chimfine cha m'mimba. Ngati mukumwa maantibayotiki, mungaganize kuti kutsegula m'mimba ndi zotsatira zoyipa za mankhwala.

Koma kumbukirani, nthawi zina matenda a C. diff amatha kuchitika popanda kutsegula m'mimba .

Kodi ndowe zimawoneka bwanji mukakhala ndi C. diff? Zimanunkhiza bwanji?

Kutsegula m'mimba kwa C. diff nthawi zambiri kumakhala ngati phala, osati madzi okhaokha. Nthawi zina kumakhala kobiriwira, koma izi zitha kuchitikanso ndi matenda ena a bakiteriya. Nthawi zambiri, magazi, mamina, kapena mafinya amatha kuwoneka m'chimbudzi. Anthu ambiri amanena kuti kutsegula m'mimba kwa C. diff kuli ndi fungo losiyana . Amati ndi lopweteka kwambiri ndipo lili ndi kukoma kokoma kodabwitsa. Izi zitha kukhala chifukwa chakuti C. diff imawonjezera kuchuluka kwa ndulu mu chimbudzi.

Kodi n’chiyani chimayambitsa matenda a C. diff?

Kawirikawiri, munthu amene ali ndi chitetezo chamthupi chabwino amateteza mabakiteriya a C. diff m'matumbo mwawo, kuti asayambitse matenda. Vuto ndilakuti mabakiteriyawa akayamba kukula kwambiri popanda kulamulira koteroko. Chifukwa cha izi ndikuti mgwirizano pakati pa mabakiteriya "abwino" ndi "oyipa" m'matumbo mwathu umatayika. Aliyense amakhala ndi mabakiteriya m'matumbo mwawo. Mabakiteriya abwinowa amathandiza kuti mabakiteriya ena monga C. asamavutike. Chifukwa chachikulu cha matenda a C. diff ndi kugwiritsa ntchito `(maantibayotiki)`. Mankhwala opha tizilombo akagwiritsidwa ntchito, mgwirizano pakati pa mabakiteriya abwino ndi oipa m'matumbo mwathu (`(mabakiteriya a m'matumbo)` umasokonekera. Kenako mabakiteriya a C. diff amatha kukhala amphamvu ndikukula mopitirira muyeso.

Kodi C. diff imafalikira bwanji?

Clostridium difficile imafalikira potulutsa spores. Spores izi ndi zazing'ono kwambiri ndipo zimapezeka pakhungu lathu, pazinthu zotizungulira, komanso pamalo monga matebulo ndi mipando. Izi zikutanthauza kuti ngati mutakhudza chinthu chomwe chili ndi spores izi, kenako nkudya nacho kapena kukhudza pakamwa panu, mutha kutenga C. diff.

Nchifukwa chiyani C. diff imafalikira mofulumira chonchi?

Kunja kwa matupi athu, mabakiteriya a C. diff amapanga spores. Ma spores amenewa ndi ovuta kwambiri kupha, mkati ndi kunja kwa matumbo. Amalimbana ndi kutentha, asidi, maantibayotiki ambiri, ndi mankhwala ophera tizilombo toyambitsa matenda. Amathanso kukhalabe ndi moyo pamalopo kwa miyezi ingapo. Ofufuza akuti pafupifupi 5% ya anthu ali ndi mabakiteriya a C. diff m'matumbo awo popanda kuyambitsa zizindikiro zilizonse. Izi zikutanthauza kuti ngakhale mutakhala ndi C. diff molamulidwa, mutha kufalitsabe kwa ena.

Kodi mungathe kucheza ndi munthu amene ali ndi matenda a C. diff?

Inde, mungathe. Koma pokhapokha ngati mutsatira njira zodzitetezera. Kuti muchepetse kufalikira kwa matenda, muyenera kuchita izi:

• Sambani m'manja mwanu nthawi zonse ndi sopo.
• Pewani kukhudza mphuno yanu, pakamwa, ndi m'maso.
• Thirani mankhwala ophera tizilombo pamalo ozungulira.
• Magolovesi, zophimba nkhopeGwiritsani ntchito zida zodzitetezera, monga madiresi (makamaka ngati mukusamalira wodwala).

Ndani ali pachiwopsezo chachikulu chotenga matenda a C. diff?

Pali matenda ena omwe angachepetse chitetezo cha thupi lanu ku matenda a C. diff. Izi zikuphatikizapo:

• Matenda a m'matumbo otupa ( IBD ): Matenda otupa m'matumbo osatha, monga matenda a Crohn ndi matenda a zilonda zam'mimba, amafooketsa matumbo pakapita nthawi. Izi zimawononga mucosa, mkati mwa matumbo, komanso zimachepetsa chitetezo chamthupi m'matumbo.
• Chitetezo chamthupi chofooka: Ngati muli ndi vuto la chitetezo chamthupi chofooka kapena matenda ena osatha omwe amakhudza chitetezo chamthupi chanu, monga khansa, kachilombo ka HIV , matenda a impso, kapena matenda a shuga, chitetezo chamthupi chanu chonse chikhoza kufooka, osati m'mimba mwanu mokha. Izi ndi zoona makamaka ngati mukumwa mankhwala oletsa chitetezo chamthupi.

Zina mwa zinthu zomwe zimayambitsa matenda a C. diff ndi izi:

• Zaka: Anthu azaka zopitilira 65 ali pachiwopsezo chachikulu chotenga matenda a C. diff. Izi zitha kukhala chifukwa chakuti chitetezo chawo chamthupi chili chofooka, akumwa mankhwala ambiri nthawi imodzi, kapena amakhala m'zipatala kapena m'nyumba zosungira okalamba. Ana aang'ono amathanso kutenga matenda a C. diff.
• Kugonekedwa m'chipatala kapena malo odzaza anthu (monga ndende): C. diff imafalikira mosavuta m'malo odzaza anthu. Ma spores amatha kukhalapo kwa miyezi ingapo pamalo odziwika. Itha kufalikira kuchokera kwa munthu wina kupita kwa munthu kudzera m'malo ogwiritsidwa ntchito limodzi, monga m'bafa.

Koma nthawi zina palibe chifukwa chomveka bwino cha matenda a C. diff. Ngakhale pali zinthu zambiri zomwe zingakhudze chitetezo cha m'mimba mwanu, ndikofunikira kudziwa kuti mutha kudwala matendawa ngakhale popanda zinthu zilizonse zoopsa .

Kodi ndi mavuto otani omwe amabwera chifukwa cha matenda a C. diff?

Mavuto angachitike ndi matenda oopsa kwambiri. Kuopsa kwa matendawa kumadalira zinthu zingapo, kuphatikizapo mtundu wa mabakiteriya omwe muli nawo, komanso mphamvu ya chitetezo chamthupi chanu. Anthu omwe ali ndi zinthu zomwe zingawapangitse kutenga matenda a C. diff ali pachiwopsezo chachikulu chotenga matenda oopsa kwambiri kapena kudwala mobwerezabwereza. Izi zitha kuwononga kwambiri pakapita nthawi. Mavuto ambiri ndi awa:

• Matenda obwerezabwereza: Pafupifupi 20% ya anthu amadwalanso mkati mwa milungu iwiri kapena isanu ndi itatu atamaliza kulandira chithandizo. Pambuyo pake, ena 40% amathanso kudwalanso.
• Kusowa madzi m'thupi komanso kutayika kwa ma electrolyte:Ngati mutataya madzi ndi ma electrolyte m'thupi lanu mwachangu kuposa momwe mungawabwezeretsere, mutha kukhala ndi zotsatirapo zoopsa monga kuchepa kwa magazi, kuthamanga kwa magazi, komanso kulephera kwa impso pazochitika zazikulu.
• Matenda a m'matumbo otchedwa Pseudomembranous colitis: Uwu ndi mtundu woopsa wa matenda a m'matumbo otchedwa colitis. Pa vutoli, nembanemba yokhuthala komanso yopyapyala imatha kupangika pa matumbo anu.

Pamene kuwonongeka komwe kumachitika chifukwa cha poizoni m'matumbo kukuwonjezeka, mavuto ena angachitike:

• Kutuluka kwa madzi m'thupi: Madzi m'thupi angayambe kutuluka kuchokera m'matumbo mwanu kupita m'mimba mwanu (izi zimatchedwa ascites), zomwe zimapangitsa kuti mimba yanu ituluke. Muthanso kutaya mapuloteni ochokera m'matumbo mwanu, zomwe zimapangitsa kuti kuchuluka kwa albumin m'thupi lanu kuchepe. Izi zingayambitse zizindikiro monga kutupa ndi kutopa.
• Matenda a nyamakazi oyambitsa matenda: Matenda oopsa angayambitse matenda otchedwa "reactive arthritis." Izi zingayambitse kutupa, kutupa, ndi kupweteka m'mafupa anu ndi ziwalo zina za thupi lanu.
• Megacolon yoopsa: Megacolon yoopsa ndi vuto losowa koma loopsa kwambiri. Izi zimachitika pamene kutupa komwe kumachitika chifukwa cha kutupa kwakula kwambiri moti m'matumbo mwathu mumakhala osagwira ntchito bwino. Izi zimatha kuyambitsa sepsis (poizoni m'magazi).

Kodi matenda a C. diff amapezeka bwanji?

Ngati dokotala wanu akukayikira kuti muli ndi matenda a C. diff kutengera zizindikiro zanu, adzatenga chitsanzo cha ndowe yanu ndikutumiza ku labu kuti akaone ngati muli ndi poizoni wa C. diff. Ngati zotsatira za mayeso anu zili zabwino, zomwe zikutanthauza kuti muli ndi matendawa, dokotala wanu angachite mayeso ambiri kuti adziwe kuopsa kwa matendawa. Izi zitha kuphatikizapo mayeso a magazi ndi mayeso ojambulira kuti ayang'ane mkati mwa m'matumbo mwanu.

Kodi matenda a C. diff amachiritsidwa bwanji?

Matenda a C. diff amachiritsidwa kutengera kuopsa kwake. Ngati mwayamba kudwala C. diff mukumwa maantibayotiki, dokotala wanu angasiye kaye kumwa mankhwalawo. Kwa anthu ena, ndicho chokhacho chomwe chimafunika. Chitetezo chawo cha m'mimba chidzayambanso kugwira ntchito ndikuwongolera matendawa. Ngati sichingatero, dokotala wanu angakupatseni mitundu ina ya maantibayotiki omwe angaletse C. diff. Mitundu ina ya maantibayotiki a C. diff ndi awa:

• `(Metronidazole)`
• `(Vancomycin)`
• `(Fidaxomicin)`

Ngati muli ndi matenda ofooka, mutha kupita kunyumba ndikumwa mankhwala anu. Anthu ambiri amayamba kuchira pakatha masiku ochepa. Koma ngati matendawa ndi aakulu, muyenera kukhala kuchipatala. Mu chipatala, dokotala wanu adzakupatsani maantibayotiki, mwina kudzera mu mtsempha (IV - intravenous). Adzakupatsaninso zinthu monga saline kuti mupewe kutaya madzi m'thupi. Nthawi zina, mankhwalawo angapatsidwe mwachindunji m'matumbo ngati enema.

Kodi mungachite chiyani ndi matenda ovuta a C. diff?

Ngati muli ndi mavuto aakulu, mungafunike chithandizo m'chipinda chosamalira odwala kwambiri. Nthawi zambiri, madokotala angakulangizeni opaleshoni yadzidzidzi (colectomy) kuti muchotse komwe kwayambitsa matenda m'matumbo mwanu. Ngati mukuchira koma mukupitirizabe kulandira matenda obwerezabwereza mutalandira chithandizo, mungasankhe izi:

• Chithandizo cha maantibayotiki kachiwiri: Dokotala wanu angakupatseni mankhwala osiyana, kapena mankhwala omwewo kwa nthawi yayitali. Pambuyo pa maantibayotiki, dokotala wanu angakulangizeninso kumwa ma probiotics kuti mubwezeretse mabakiteriya m'matumbo mwanu.
• Kusamutsa Fecal Microbiota Transplant (FMT): Njirayi yawonetsedwa kuti ndi yothandiza kwambiri popewa matenda obwerezabwereza a C. diff pambuyo poti mankhwala obwerezabwereza alephera. Ikuphatikizapo kusamutsa ndowe kuchokera kwa munthu wathanzi kupita ku m'matumbo odwala. Chitsanzochi chimagwiritsidwa ntchito kukonzanso microbiome ya m'mimba mwanu. Taganizirani izi ngati kuwonjezera dothi labwino m'munda wokhala ndi zomera zoyipa ndikubzala zomera zabwino.

Kodi ndi njira ziti zodzitetezera zomwe zingatengedwe kuti mupewe kufalikira kwa C. diff?

Ogwira ntchito zachipatala amasamala kwambiri akamalimbana ndi matenda a C. diff kuti ateteze kufalikira kwa matendawa. Mutha kutsata chitsanzo chawo kuti muteteze ena:

• Kudzipatula: Ngati muli ndi matenda, ndi bwino kudzipatula m'chipinda chanu. Aliyense amene amabwera m'chipindamo kudzakusamalirani ayenera kuvala magolovesi otayidwa, ndipo ayenera kuwachotsa akatuluka m'chipindamo. Popeza matendawa amafalikira kudzera m'ndowe zanu, muyenera kupewa kugawana zimbudzi ndi anthu ena. Ngati mukuyenera kugawana, yeretsani chogwirira, mpando wa chimbudzi, ndi malo ozungulira ndi chotsukira chokhala ndi bleach mutachigwiritsa ntchito.
• Kusamba m'manja: Popeza C. diff sikhudzidwa ndi mankhwala oyeretsera m'manja, ndikofunikira kusamba m'manja pafupipafupi ndi sopo ndi madzi otentha. Izi ndizofunikira kwa aliyense amene mumakumana naye.
• Kupha tizilombo toyambitsa matenda: Mankhwala ambiri ophera tizilombo toyambitsa matenda sagwira ntchito pa C. diff. Koma mankhwala okhala ndi bleach amatha. Ndikofunikira kupha tizilombo toyambitsa matenda pamalo aliwonse omwe mwakhudza, makamaka m'bafa.
• Kumwa mankhwala opha majeremusi monga mwalangizidwira: Musamwe mankhwala opha majeremusi a anthu ena, ndipo musasunge mankhwala opha majeremusi kuti mudzagwiritse ntchito pambuyo pake.

Kodi mungayembekezere chiyani ngati mutapeza C. diff?

Matenda ambiri a C. diff ndi ofatsa ndipo amatha ndi chithandizo. Komabe, matenda omwe amayambitsa matenda a C. diff nthawi zina amatha kufalikira mofulumira kwambiri. Matenda a C. diff angabwere mwadzidzidzi ndipo amakhala oopsa. Ngati muli ndi zinthu zomwe zingakuchititseni kuti mukhale ndi matenda a C. diff, muli ndi mwayi waukulu wopeza matenda oopsa, kapena mungakhale ndi matenda obwerezabwereza omwe amafunikira chithandizo chowonjezereka.

Kodi C. diff imatha yokha?

Inde, ngati mabakiteriya anu athanzi m'matumbo angabwerere m'malo abwinobwino ndikulimbana nawo, mutha kuchira nokha. Izi zitha kuchitika ngati mabakiteriya anu am'matumbo nthawi zambiri amakhala amphamvu ndipo mulibe mavuto azaumoyo omwe amawafooketsa kwa nthawi yayitali. Ngati matendawa adayambitsidwa ndi kumwa maantibayotiki, mutha kuchira mukasiya kuwamwa. Koma musadikire nthawi yayitali. Ngati simukumva bwino pakapita masiku ochepa, pitani kwa dokotala nthawi yomweyo.

Mukangopeza C. diff, kodi nthawi zonse imakhalapo?

Pambuyo pa chithandizo, mabakiteriya ena akhoza kukhalabe. Koma mutha kukhalabe kwa kanthawi osatenga matenda. Bola mabakiteriya abwino a m'mimba akadalipo, adzakuthandizani kulamulira Clostridium difficile. Ngati mutenga matenda obwerezabwereza, ndichifukwa chakuti mabakiteriya enawa sanabwererenso ku thanzi lawo. Matenda obwerezabwereza akhoza kukhala kubwereranso kwa matenda oyamba, koma sizili choncho nthawi zonse. Nthawi zina ndi matenda atsopano.

Kodi pali mavuto aliwonse omwe angakhalepo kwa nthawi yayitali pambuyo pa matenda a C. diff?

Vuto lofala kwambiri kwa nthawi yayitali ndi matenda osatha kapena obwerezabwereza a Clostridium difficile. Izi zimachitika pamene m'matumbo mwanu mukuvutika kuchira kwathunthu. M'matumbo mwanu mungachedwe kuchira pazifukwa izi:

• Ngati munali ndi matenda oopsa omwe anawononga matumbo anu.
• Ngati munayenera kumwa maantibayotiki kwa nthawi yayitali, kapena ngati munayenera kumwa maantibayotiki a C. diff mutamwa maantibayotiki ena.
• Ngati muli ndi vuto la thanzi lomwe limakhudza matumbo anu kapena chitetezo cha mthupi lanu kwa nthawi yayitali.
• Ngati muli ndi zaka zoposa 65.

Kawirikawiri, anthu ena amadwala matenda a autoimmune atatha kudwala kwambiri. Izi zikutanthauza kuti chitetezo chawo chamthupi chimapitirizabe kugwira ntchito ngati kuti pali matenda, ngakhale matendawa atatha. Matenda a autoimmune omwe amayamba pambuyo pa matenda a C. diff ndi monga IBS (irritable bowel syndrome) ndi nyamakazi yodwala matenda opatsirana.

Ndi mafunso ati omwe muyenera kufunsa dokotala wanu okhudza matenda a C. diff?

Mungathe kufunsa mafunso monga awa:

• Kodi matenda anga ndi oipa bwanji?
• Kodi ndili pachiwopsezo cha zovuta?
• Ndingadziwe bwanji ngati C. diff ikuchira?
• Kodi ndiyenera kukuyimbirani foni liti? Kodi ndiyenera kupita ku chipinda chodzidzimutsa liti?
• Kodi ndiyenera kupita kwa dokotala wa gastroenterologist?
• Kodi njira zochiritsira matenda opatsirana omwe amabwereranso ndi ziti?

Clostridium difficile ndi mabakiteriya ofala omwe amakhala m'matumbo mwanu osavulaza. Koma akayamba kukhala amphamvu kwambiri, amatha kukhala oopsa kwambiri. Mungakhale ndi nkhawa yokhudza kutsegula m'mimba nthawi zonse komanso momwe kumakhudzira moyo wanu. Mungakhalenso ndi manyazi kulankhula za vuto lomwe limakhudza matumbo anu. Koma musalole kuti malingaliro amenewo akulepheretseni kufunafuna thandizo.Anthu ambiri sapeza mavuto chifukwa cha matenda a C. diff, ndipo amatha msanga komanso mokwanira. Koma ngati muli pachiwopsezo chachikulu chifukwa cha zinthu zina zomwe zingakubweretsereni chiopsezo, matendawa akhoza kukhala oopsa kwambiri. Amapatsirana kwambiri, amatha kupitirira, ndipo amatha kubwereranso mobwerezabwereza. Ngati muyamba kutsegula m'mimba mutamwa mankhwala opha maantibayotiki, uzani dokotala wanu nthawi yomweyo. Musamwe mankhwala omwe amaletsa kutsegula m'mimba, chifukwa sangathandize ndipo angapangitse kuti vutoli liwonjezeke. Ngati mukuganiza kuti muli ndi matenda a C. diff, pitani kwa dokotala nthawi yomweyo.

Ndiye, ndi zinthu ziti zomwe tiyenera kukumbukira kuchokera munkhaniyi?

C. diff ndi bakiteriya yomwe ingayambitse matenda m'matumbo athu akuluakulu. Izi zimayambitsa zizindikiro monga kutsegula m'mimba ndi kupweteka m'mimba.

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Izi nthawi zambiri zimachitika pamene maantibayotiki amapha mabakiteriya abwino m'matumbo, zomwe zimapangitsa kuti C. diff ikule.

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Izi zimapatsirana kwambiri, choncho kusamba m'manja ndi kusamalira ukhondo n'kofunika kwambiri.

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Okalamba, omwe ali ndi chitetezo chamthupi chofooka, komanso omwe ali m'chipatala ali ndi mwayi waukulu wopeza izi.

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Ngati muli ndi zizindikiro, funsani upangiri wa dokotala nthawi yomweyo. Chifukwa, ngati mutalandira chithandizo choyenera, nthawi zambiri mutha kuchira. Komabe, ngati simulandira chithandizo, mavuto amatha kuchitika.

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Ndikofunikira kumwa mankhwala anu monga momwe dokotala wanu wanenera komanso pa nthawi yake.

Kotero, ndikukhulupirira kuti izi zikuthandizani. Khalani ndi thanzi labwino!