Kodi mukudziwa za mabakiteriya oopsa awa? (Carbapenem-Resistant Enterobacteriales - CREs) Tiyeni tikambirane!

Mwina mwamvapo kuti mankhwala omwe madokotala amapereka pa matenda ena, kutanthauza kuti, `(mankhwala opha tizilombo toyambitsa matenda),` nthawi zina sagwira ntchito. Imeneyo ndi imodzi mwa matenda oopsa komanso odetsa nkhawa omwe tikambirane lero, matenda a bakiteriya a `(Carbapenem-Resistant Enterobacteriales)` kapena `(CREs)`. Izi sizingayankhe ku ena mwa `(mankhwala opha tizilombo)` amphamvu omwe nthawi zambiri amaperekedwa. Chifukwa chake, ngakhale kuti iyi ndi nkhani yoopsa, ndikofunikira kwambiri kuti tonsefe tidziwe izi. Tiyeni timvetse zomwe zikuchitika.

Kodi `(Carbapenem-Resistant Enterobacteriales)` kapena `(CREs)` ndi chiyani?

Mwachidule, `(Enterobacteriales)` ndi gulu la mabakiteriya omwe ali ofanana, monga banja lomwelo. Mabakiteriyawa amatha kuyambitsa matenda osiyanasiyana m'thupi lathu. Tsopano, mabakiteriya awa a `(Enterobacteriales)` nthawi zina amawonetsa kukana mankhwala apadera amphamvu otchedwa `(Carbapenems). Mabakiteriya a `(Enterobacteriales)` omwe amakana mankhwala otchedwa `(Carbapenems)` ndi omwe timawatcha `(Carbapenem-Resistant Enterobacteriales)` kapena `(CREs)`.

Taganizirani izi, madokotala amagwiritsa ntchito `(antibiotics)` pochiza matenda a bakiteriya. Koma, mabakiteriyawa ndi ochenjera kwambiri. Akamakumana ndi `(antibiotics)` nthawi zonse (makamaka kuchipatala kapena kunyumba yosungira okalamba), amapeza njira zopulumukira ndikukhalabe ndi moyo motsutsana ndi `(antibiotics)`. Izi ndi zomwe timazitcha `(resistance) . Chifukwa chake `(CREs)` ndi mabakiteriya omwe akhala olimbana ndi `(Carbapenem)` gulu la `(antibiotics)`.

Pali mitundu ina yambiri ya mankhwala omwe ali m'gulu la maantibayotiki otchedwa ``Carbapenems'':

• `Ertapenem`
• `Imipenem`
• `Meropenem`

Awa ndi maantibayotiki amphamvu omwe nthawi zambiri amaperekedwa pa matenda akuluakulu. Choncho ngati mabakiteriya ayamba kukana matendawa, zikutanthauza kuti matendawa amakhala ovuta kuchiza.

Kodi mitundu ya mabakiteriya (Enterobacteriales) ndi iti?

Anthu ena amagwiritsa ntchito chidule cha `(CRE)` kutanthauza `(Carbapenem-resistant Enterobacteriaceae)`, pomwe ena amagwiritsa ntchito `(Carbapenem-resistant Enterobacteriaceae)`. `(Enterobacteriales)` ndi gulu lalikulu lomwe lili ndi mitundu yosiyanasiyana ya mabakiteriya. Lili ndi mabanja atatu, kapena ma suborders. Limodzi mwa ma suborders awa ndi `(Enterobacteriaceae).` Gulu la `(Enterobacteriaceae)` ili ndi komwe mabakiteriya omwe timamva nthawi zambiri amakhala:

• `Escherichia` (yomwe imadziwika kwambiri ndi dzina lakuti `E. coli`)
• `Klebsiella`
• Salmonella
• `Shigella`

Ma CRE odziwika bwino ndi mitundu ya Klebsiella pneumoniae ndi E. coli yomwe siingathe kupha maantibayotiki. Ndikofunikira kukumbukira kuti chifukwa chakuti muli ndi matenda a Klebsiella kapena E. coli, sizikutanthauza kuti siingathe kupha maantibayotiki.

Kodi matenda omwe amayamba chifukwa cha `(CREs)` ndi ati?

Mabakiteriya a ``(CREs)`` amenewa angayambitse matenda m'mbali zosiyanasiyana za thupi lanu. Matendawa amapezeka kwambiri mu:

• Mu magazi(Matenda a m'magazi)
• Matenda a mkodzo (UTI)
• M'mapapo (chibayo)
• M'mimba (chifuwa chamkati mwa m'mimba)

Ndi m'malo ngati awa kumene mabakiteriya obisikawa angayambitse matenda mosavuta.

Kodi matenda a `(CRE)` ndi ofala bwanji?

Mukayang'ana ziwerengero za dziko ngati United States, matenda pafupifupi 13,000 amanenedwa chaka chilichonse chifukwa cha ``(CREs).`` Pafupifupi 1,100 mwa iwo amafa. Madokotala ku Sri Lanka nawonso akulabadira izi. Chifukwa mabakiteriya oterewa omwe sagonjetsedwa akukhala vuto padziko lonse lapansi.

Kodi zizindikiro za matenda a `(CRE)` ndi ziti?

Zizindikiro za `(Carbapenem-resistant Enterobacteriales)` zimasiyana malinga ndi komwe muli ndi kachilomboka. Zizindikiro zina zodziwika bwino zitha kuphatikizapo:

• Malungo
• Kuzizira
• Kuvuta kupuma
• Chifuwa
• Kupweteka m'mimba
• Ululu pokodza
• Kufiira, kutupa, ndi kuyabwa pamalo ochitira opaleshoni kapena bala

Chofunika: Zizindikiro izi sizimangokhala matenda a `(CRE)` okha. Matenda ena a bakiteriya angayambitsenso zizindikirozi. Chifukwa chake, ngati mukukumana ndi zizindikiro izi, ndi bwino kupita kwa dokotala.

Kodi zimayambitsa matenda a `(CRE)` ndi ziti?

Mwachidule, matenda a `(CRE)` amayamba chifukwa cha mabakiteriya omwe sagonjetsedwa ndi `(antibiotic)` otchedwa `(Carbapenem)`. Pali zifukwa zosiyanasiyana zomwe mabakiteriya amakhalira ndi kukana kwa `(antibiotic)` kumeneku. Chimodzi mwa zifukwazi ndi momwe adasinthira kuti azikhala limodzi ndi zamoyo zina m'chilengedwe.

Mu zipatala ndi malo ena azaumoyo, mabakiteriya nthawi zonse amakumana ndi maantibayotiki. Makamaka popeza maantibayotiki amphamvu monga carbapenems amagwiritsidwa ntchito pochiza matenda akuluakulu, mabakiteriya ali ndi mwayi wopanga njira zowatetezera. Mabakiteriyawa ali ndi mphamvu zodabwitsa zopatsira majini awo okana kukana kwa mabakiteriya ena . Izi zimatchedwa kusamutsa majini opingasa. Monga kuuza mnzanu chinsinsi, mabakiteriyawa amagawana kukana kwawo ndi ena. Kupanda kutero, mabakiteriya omwe amapulumuka maantibayotiki amatha kupatsira majini awo okana kukana, ndikupanga mabakiteriya ambiri okana kukana.

Njira imodzi yayikulu yomwe mabakiteriya amakhalira osagonjetsedwa ndi `(CRE)` ndi kupanga enzyme yotchedwa `(Carbapenemase)`. Enzyme iyi imaphwanya ndikuwononga `(maantibayotiki a Carbapenem)`. Enzyme iyi imagwira ntchito yofanana ndi kudula mankhwala ndi lumo laling'ono. Kenako mankhwalawo sagwira ntchito.

Kodi ma CRE amafalikira bwanji?

Mabakiteriya a Enterobacteriales omwe sagonjetsedwa ndi carbapenem amatha kukhala pakhungu lanu kapena m'mimba mwanu popanda kukudwalitsani. Izi zimatchedwa colonization.Ma CRE amatha kufalikira kuchokera kwa munthu amene akudwala matenda a CRE, kapena kuchokera kwa munthu amene alibe mabakiteriya omwe ali nawo.

Muli pachiwopsezo chachikulu chotenga matenda a `(CRE)` kuchipatala kapena malo ena azaumoyo. Izi zili choncho chifukwa mabakiteriya omwe amapezeka mwachibadwa pakhungu lathu komanso m'matupi athu amatha kukhala osagonjetsedwa ndi maantibayotiki mwa kuwapeza. Mutha kutenga matenda a `(CRE)` m'njira zotsatirazi:

• Mwa kukhudza munthu amene ali ndi bakiteriya pakhungu lake (mwachitsanzo, ngati munthuyo sanasambe m'manja mwake bwino).
• Kuchokera pamalo odetsedwa , makamaka masinki ndi zimbudzi.
• Kuchokera ku zipangizo zachipatala zodetsedwa ndi zipangizo zachipatala zomwe zayikidwa m'thupi lanu (monga mzere wapakati wa mitsempha, chubu chopumira).

Ndani amene ali pachiwopsezo chachikulu cha matenda a `(CRE)`?

Mungakhale pachiwopsezo chachikulu chotenga matenda a `(CRE)` ngati:

• Ngati muli ndi mzere wapakati wa mitsempha (chubu cholowetsedwa mu mtsempha waukulu), chubu chopumira, chubu chodyetsera, kapena chubu china kapena chipangizo china cholowetsedwa m'thupi lanu, ma CRE amatha kulowa m'thupi lanu kuchokera kunja kudzera mu izi.
• Ngati mwakhala mukumwa maantibayotiki kwa nthawi yayitali kapena ngati mumawamwa nthawi zonse, n'zotheka kuti mabakiteriya adzayamba kukana mabakiteriyawo pakapita nthawi. Izi zitha kupha mabakiteriya "abwino" (osavulaza) m'matumbo mwathu, zomwe zimalola mabakiteriya ena kukula mosalamulirika ndikuyambitsa matenda.
• Ngati muli ndi vuto linalake la thanzi lomwe limafooketsa chitetezo chanu cha mthupi . Mwachitsanzo, ngati muli ndi kachilombo ka HIV, khansa ya m'magazi, matenda a shuga, kapena munasamutsidwa ziwalo kapena maselo oyambira, muli pachiwopsezo chachikulu. Izi zili choncho chifukwa zimakhala zovuta kuti thupi lizilimbana ndi matenda m'mikhalidwe imeneyi.
• Ngati mukufuna thandizo pa zochita za tsiku ndi tsiku, monga kusamba ndi kugwiritsa ntchito chimbudzi , mungakhale pachiwopsezo chachikulu chokhudzana ndi ndowe (ndi mabakiteriya ochokera m'mimba), zomwe zingafalitse matenda a CRE.
• Ngati mwakhala m'chipatala kwa nthawi yayitali , makamaka ngati mwakhala m'chipatala kunja kwa United States m'miyezi isanu ndi umodzi yapitayi. Ngakhale kuti matenda a CRE akuchulukirachulukira ku United States, amapezeka kwambiri kunja kwa dzikolo.

Kodi mavuto omwe angakhalepo chifukwa cha `(CREs)` ndi ati?

Ngati madokotala sangathe kuletsa matenda a bakiteriya pogwiritsa ntchito maantibayotiki, amatha kufalikira m'thupi lonse ndikuyambitsa mavuto oopsa monga kulephera kwa ziwalo. Ichi ndiye chiopsezo chachikulu cha matenda a CRE.

Kodi mungazindikire bwanji matenda a `(CRE)`?

Ngati muli ndi zizindikiro za matenda a bakiteriya ndipo sakutha ndi maantibayotiki, dokotala wanu angaganize kuti muli ndi matenda a CRE. Kenako adzatenga zitsanzo kuchokera m'thupi lanu kuti akaone ngati mabakiteriyawo ali m'thupi. Zitsanzozi zingaphatikizepo:

• Magazi
• Mkodzo
• Chopondapo
• Madzi kapena minofu yochokera pabala

Laboratory ikhoza kudziwa ngati mabakiteriya omwe ali mu zitsanzozi ndi ``CREs''. Musaiwale kuuza dokotala wanu za zipangizo zilizonse zachipatala zomwe mwaika m'thupi lanu kapena ngati mwangogonekedwa m'chipatala posachedwapa.

Kodi ma CRE amachiritsidwa bwanji?

Kuchiza ma CRE kungakhale kovuta chifukwa maantibayotiki omwe mumagwiritsa ntchito nthawi zambiri sagwira ntchito. Chifukwa chake, dokotala wanu angakupatseni maantibayotiki ena. Kapena, angakupatseni maantibayotiki a carbapenem pamodzi ndi mankhwala ena omwe amaletsa enzyme ya mabakiteriya ya carbapenemase. Ma laboratories amatha kuyesa mankhwala osiyanasiyana kuti awone omwe amagwira ntchito pa ma CRE.

Mitundu ya `(Maantibayotiki)` yogwiritsidwa ntchito pochiza `(Ma CRE)`

Nazi mitundu ina ya maantibayotiki omwe madokotala amagwiritsa ntchito - kaya payekha kapena mophatikizana - pochiza ma CRE:

• `Polymyxin/Colistin`
• `Tigecycline`
• `Fosfomycin`
• Aminoglycosides (monga gentamicin kapena tobramycin)
• `Rifampin`
• `Carbapenem` (yokhala ndi choletsa)

Mankhwalawa amasankhidwa kutengera momwe wodwalayo alili, mtundu wa matenda, komanso momwe mabakiteriya amakanira.

Kodi matenda a `(CRE)` ndi oopsa bwanji?

Matenda a CRE angayambitse matenda aakulu komanso ovuta kuchiza. Anthu ena amadwala matenda oopsa. Ngati mutadwala matenda a CRE, mudzalandira chithandizo kuchipatala komwe ogwira ntchito zachipatala angakuyang'anireni mosamala.

Kodi chiŵerengero cha kuchira kuchokera ku `(CRE)` ndi chiani?

Kafukufuku akusonyeza kuti chiwerengero cha imfa cha anthu odwala matenda a CRE chimasiyana malinga ndi komwe matendawa achitikira. Mwachitsanzo, chiwerengero cha imfa cha anthu odwala matenda a mkodzo (UTIs) omwe amayamba chifukwa cha matenda a CRE ndi pafupifupi 13%, pomwe chiwerengero cha imfa cha anthu odwala matenda a m'magazi omwe amayamba chifukwa cha matenda a CRE chikhoza kukhala 50% kapena kupitirira apo. Mukayang'ana ziwerengerozi, mutha kuwona momwe izi zingakhalire zoopsa, eti?

Kodi ma CRE angapewedwe?

Opereka chithandizo chamankhwala, monga madokotala ndi anamwino, amatsatira malamulo apadera achitetezo ndi kuyeretsa kuti apewe "matenda omwe amabwera chifukwa cha chisamaliro chaumoyo" monga "ma CRE." Izi zikuphatikizapo:

• Sambani m'manja nthawi zambiri.
• Kupha tizilombo toyambitsa matenda pamalo.
• Onetsetsani kuti maantibayotiki aperekedwa kwa anthu omwe ali ndi matenda a bakiteriya okha. (Maantibayotiki sathandiza pa matenda a mavairasi.)
• Kuyeretsa zida zachipatala.

Mungathandizenso kupewa matenda a CRE mwa:

• Sambani m'manja mwanu pafupipafupi komanso mokwanira. Izi ndizofunikira kwambiri ngati mukusamalira munthu amene ali ndi chitetezo chamthupi chofooka kapena munthu amene akufunika thandizo posamba kapena kugwiritsa ntchito chimbudzi.
• Ngati mwakhala mukugwiritsa ntchito zipangizo zachipatala zomwe zimayikidwa m'thupi lanu, monga ma catheter , funsani dokotala wanu kuti ziyenera kusungidwa nthawi yayitali bwanji komanso zomwe muyenera kuchita kuti mupewe matenda pamene chipangizocho chili pamalo ake.

Ndiyenera kupita kwa dokotala liti?

Ngati muli ndi chipangizo chamankhwala choikidwa m'thupi kapena ngati chitetezo chanu cha mthupi chili chofooka, funsani dokotala wanu zizindikiro za matenda zomwe muyenera kuziyang'anira. Ngati muli ndi zizindikiro zokayikitsa, pitani kwa dokotala.

Ngakhale mutakhala kuchipatala, ndikofunikira kulankhulana bwino ndi gulu lanu lachipatala. Ngati mukuona zizindikiro zilizonse za matenda, monga kupweteka, kugunda kwa mtima mofulumira, kufooka, kapena kutentha thupi, auzeni nthawi yomweyo.

Kodi ndiyenera kupita ku chipinda chodzidzimutsa liti (ER)?

Ngati muli ndi zizindikiro za matenda aakulu, pitani kuchipatala chadzidzidzi. Zizindikiro zake ndi izi:

• Malungo opitirira madigiri 103 Fahrenheit (madigiri 40 Celsius).
• Ululu waukulu.
• Kugwidwa ndi khunyu.
• Kusokonezeka kapena kusokonezeka maganizo.
• Kutsika mwadzidzidzi kwa kuthamanga kwa magazi (zizindikiro: kufooka, chizungulire, kukomoka).

Ndi mafunso ati omwe ndiyenera kufunsa dokotala wanga?

Zingakhale zothandiza kufunsa dokotala wanu mafunso monga awa:

• Kodi ndi njira ziti zochiritsira zomwe ndili nazo?
• Kodi ndingayembekezere kuti ndidzachira liti?
• Kodi ndinatenga bwanji matendawa?
• Kodi ndingatani kuti ndipewe matenda amtunduwu mtsogolo?

Pomaliza, zinthu zoti muzikumbukira (Uthenga Wopita Nawo Kunyumba)

Ma Enterobacteriale osagonjetsedwa ndi carbapenem (CREs) ndi mtundu wa mabakiteriya omwe angayambitse matenda akuluakulu omwe ndi ovuta kuchiza. Ichi ndichifukwa chake opereka chithandizo chamankhwala akugwira ntchito molimbika kuti zipatala ndi malo osamalira odwala nthawi yayitali azikhala aukhondo komanso otetezeka. Madokotala ndi akuluakulu azaumoyo ku Sri Lanka nawonso ali tcheru pankhaniyi.