Usulelo lwe-C. diff (Clostridioides difficile): Masifunde ukuba yintoni kanye kanye le ntlungu yesisu.

Ngaba ngamanye amaxesha ukhe ube nesisu esibuhlungu okanye urhudo oluhlala iintsuku ezimbalwa? Sihlala sicinga, 'Owu, oku kutya kumele ukuba bekunetyhefu kancinci' okanye 'Kumele ukuba yintsholongwane yomkhuhlane.' Kodwa ngamanye amaxesha ezi mpawu zinokubangelwa lusulelo olubi kakhulu olunokonakalisa amathumbu ethu. Olunye usulelo olunjalo yi-C. diff (Clostridioides difficile).

Yintoni i-C. diff (Clostridioides difficile)?

Ngamafutshane, i-C. diff luhlobo lwebhaktiriya. Igama elichanekileyo ngu-`(Clostridioides difficile)`. Le bhaktiriya inokubangela usulelo emathunjini akho amakhulu, oko kukuthi, `(colon)`. Kulapho kuvela khona iimpawu ezingathandekiyo ezifana norhudo. Ngoku, makhe sibone, kuqhelekile ukuba amathumbu ethu amakhulu afumane usulelo lwebhaktiriya. Uninzi lwazo alubi nzulu kangako. Kodwa olu sulelo lwe-C. diff lubi ngakumbi. Isizathu kukuba le bhaktiriya `(Clostridioides difficile)` ivelisa ityhefu. Ezi tyhefu zonakalisa iiseli ezingaphakathi kwamathumbu ethu. Oku kubangela ukudumba kolwelo lwamathumbu kunye namathumbu amakhulu, oko kukuthi, ukudumba (i-colitis). Nokuba uvelisa iimpawu kwaye zinzima kangakanani kuxhomekeke kubungakanani bomonakalo obangelwe zezi tyhefu. Ngamanye amaxesha le meko inokuba yingozi kubomi. Le ntsholongwane yayibizwa ngokuba yi-`(Clostridium difficile)` ngaphambili. Ngoku igama elitsha ngu-`(Clostridioides difficile)`.

Ixhaphake kangakanani intsholongwane ye-C. diff?

Usulelo lwe-C. diff, okanye i-CDI, yingxaki yezempilo yehlabathi. Nangona kunjalo, akukho manani achanekileyo okuba lusasazeke kangakanani kwihlabathi liphela. E-United States, kuqikelelwa ukuba kukho malunga ne-500,000 yosulelo ngonyaka, kwaye malunga ne-15,000 yokufa. Ngoko ke oku akuyonto ifanele ithathwe lula.

Zithini iimpawu zosulelo lwe-C. diff?

Uphawu lokuqala noluqhelekileyo lurhudo olumanzi. Kwiimeko ezincinci, urhudo luvela ukuya kuthi ga kathathu ngemini, kwaye kusenokubakho iintlungu zesisu. Njengoko usulelo lwe-C. diff luqhubeka, ukuphindaphinda korhudo kuyanda. Lunokubakho ukuya kuthi ga kwi-10-15 ngemini. Ungabona negazi kwindle yakho. Ezinye iimpawu ziquka:

• Ukuba nesisu esibuhlungu rhoqo
• Isisu sigcwele kwaye sidumbile.
• Isicaphucaphu nokuhlanza
• Umnqweno wokutya
• Ifiva
• Ukunyuka kwesantya sentliziyo

Ekuqaleni, iimpawu ze-C. diff zinokuvakala ngathi kukutya okunobuthi okanye umkhuhlane wesisu. Ukuba uthatha amayeza okubulala iintsholongwane, ungacinga ukuba urhudo lunefuthe elibi elivela kwiyeza.

Kodwa khumbula, ngamanye amaxesha usulelo lwe-C. diff lunokwenzeka ngaphandle korhudo .

Indle ibonakala njani xa une-C. diff? Inuka njani?

I-C. diff diarrhea idla ngokuba nomzimba ofana nentlama, ingabi namanzi ngokupheleleyo. Ngamanye amaxesha inokuba luhlaza, kodwa oku kunokwenzeka nakwezinye izifo zebhaktheriya. Amaxesha amaninzi, igazi, i-mucus, okanye i-pus zinokubonakala kwi-stool. Abantu abaninzi baxela ukuba i-C. diff diarrhea inevumba elikhethekileyo . Bathi ikrakra ngokungaqhelekanga kwaye inencasa emnandi ngendlela engaqhelekanga. Oku kusenokuba kungenxa yokuba i-C. diff yonyusa amanqanaba e-bile acids kwi-stool.

Yintoni ebangela usulelo lwe-C. diff?

Ngokwesiqhelo, umntu onenkqubo yomzimba yokuzikhusela esempilweni ugcina iintsholongwane ze-C. diff zilawulekile emathunjini akhe, ukuze zingabangeli usulelo. Ingxaki kukuba xa ezi ntsholongwane ziqala ukukhula kakhulu ngaphandle kolawulo olunjalo. Isizathu soku kukuba ibhalansi phakathi kweentsholongwane "ezilungileyo" kunye neentsholongwane "ezimbi" emathunjini ethu iyalahleka. Wonke umntu uneentsholongwane emathunjini akhe. Ezi ntsholongwane zilungileyo zinceda ukugcina ezinye iintsholongwane ezifana ne-C. zilawuleka. Isizathu esiphambili sosulelo lwe-C. diff kukusetyenziswa kwe-`(antibiotics)`. Xa kusetyenziswa ii-antibiotics, ibhalansi phakathi kweentsholongwane ezilungileyo nezimbi emathunjini ethu (`(gut microbiome)` iyaphazamiseka. Emva koko iintsholongwane ze-C. diff zinokuba namandla kwaye zikhule kakhulu.

Idluliselwa njani i-C. diff?

I-Clostridium difficile isasazeka ngokukhupha ii-spores. Ezi spores zincinci kakhulu kwaye zinokufumaneka eluswini lwethu, kwizinto ezisingqongileyo, nakwimiphezulu efana neetafile nezitulo. Oku kuthetha ukuba ukuba uchukumisa into enale spores kuyo, uze utye nayo okanye uchukumise umlomo wakho, unokufumana i-C. diff.

Kutheni i-C. diff isasazeka ngokukhawuleza kangaka?

Ngaphandle kwemizimba yethu, iintsholongwane ze-C. diff zenza ii-spores. Ezi spores kunzima kakhulu ukuzibulala, ngaphakathi nangaphandle kwamathumbu. Ziyakwazi ukumelana nobushushu, i-asidi, ii-antibiotics ezininzi, kunye nezibulali-ntsholongwane. Zingaphila nakwiindawo eziphezu komhlaba kangangeenyanga. Abaphandi baqikelela ukuba malunga ne-5% yabemi bane-C. diff bacteria kwi-colon yabo ngaphandle kokubangela naziphi na iimpawu. Oku kuthetha ukuba nokuba une-C. diff ephantsi kolawulo, usenokuyisasaza kwabanye.

Ngaba ungachitha ixesha nomntu one-C. diff?

Ewe, unako. Kodwa kuphela ukuba ulandela amanyathelo okhuseleko. Ukunciphisa ukusasazeka kosulelo, kufuneka wenze oku kulandelayo:

• Hlamba izandla zakho ngesepha rhoqo.
• Kuphephe ukuchukumisa impumlo yakho, umlomo, namehlo.
• Bulala iintsholongwane kwiindawo ezingqongileyo.
• Iiglavu, iimaski zobusoSebenzisa izixhobo zokuzikhusela, ezifana neengubo zokwaleka (ingakumbi ukuba unyamekela isigulana).

Ngubani osengozini enkulu yokufumana i-C. diff?

Kukho ezinye iimeko zempilo ezinokunciphisa ukhuseleko lomzimba wakho kwi-C. diff sulelo. Ezi ziquka:

• Isifo samathumbu avuthayo ( IBD ): Izifo zamathumbu ezingapheliyo ezivuthayo, ezifana nesifo sikaCrohn kunye ne-ulcerative colitis, zenza amathumbu abe buthathaka ngokuhamba kwexesha. Ezi zinto zonakalisa i-mucosa, ulwelo lwamathumbu, kwaye zinciphisa amandla omzimba okuzikhusela emathunjini.
• Inkqubo yomzimba yokuzikhusela ebuthathaka: Ukuba unesifo sokungakhuseleki komzimba okanye esinye isifo esingapheliyo esichaphazela inkqubo yomzimba yokuzikhusela, njengomhlaza, i-HIV , isifo sezintso, okanye isifo seswekile, inkqubo yakho yomzimba yokuzikhusela isenokuba buthathaka, kungekuphela nje kwamathumbu akho. Oku kuyinyani ngakumbi ukuba uthatha amayeza okunciphisa uxinzelelo lomzimba.

Ezinye izinto ezibangela umngcipheko ezinxulumene nosulelo lwe-C. diff ziquka:

• Ubudala: Abantu abangaphezu kweminyaka engama-65 ubudala basengozini enkulu yokufumana i-C. diff. Oku kusenokuba kungenxa yokuba banenkqubo yomzimba yokuzikhusela ebuthathaka, bathatha amayeza amaninzi ngaxeshanye, okanye bahlala ezibhedlele okanye kumakhaya abantu abadala. Abantwana abancinci banokufumana i-C. diff.
• Ukulaliswa esibhedlele okanye kwiindawo ezixineneyo (umz., iintolongo): I-C. diff isasazeka lula kwiindawo ezixineneyo. Iintsholongwane zingaphila iinyanga kwiindawo ezixhaphakileyo. Ingasasazeka ukusuka komnye umntu ukuya komnye kwiindawo ezixhaphakileyo, njengezindlu zangasese.

Kodwa ngamanye amaxesha akukho sizathu sicacileyo sosulelo lwe-C. diff. Nangona kukho izinto ezininzi ezinokuchaphazela inkqubo yomzimba yokuzikhusela, kubalulekile ukwazi ukuba ungalufumana olu sulelo nokuba akukho mingcipheko .

Ziziphi iingxaki ezinokubakho ngenxa yosulelo lwe-C. diff?

Iingxaki zinokwenzeka xa usulelo lunzima ngakumbi. Ubunzima bosulelo lwakho buxhomekeke kwizinto ezininzi, kuquka uhlobo lwebhaktheriya osulelwe yiyo, kunye namandla omzimba wakho. Abantu abaneengxaki zosulelo lwe-C. diff basengozini enkulu yokuba nosulelo olunzima ngakumbi okanye ukuba nosulelo oluphindaphindwayo. Oku kunokubangela umonakalo omkhulu ngokuhamba kwexesha. Iingxaki eziqhelekileyo ziquka:

• Usulelo oluphindaphindayo: Malunga nama-20% abantu balufumana kwakhona kwiiveki ezimbini ukuya kwezisibhozo emva kokugqiba unyango. Emva koko, amanye ama-40% asenokulufumana kwakhona.
• Ukuphelelwa ngamanzi emzimbeni kunye nokulahleka kwee-electrolytes:Ukuba ulahlekelwa zizinto eziphuma emzimbeni wakho ngokukhawuleza kunokuba unokuzitshintsha, unokuba nemiphumo emibi efana nomthamo wegazi ophantsi, uxinzelelo lwegazi oluphantsi, kwanokungasebenzi kakuhle kwezintso kwiimeko ezinzima.
• I-Pseudomembranous colitis: Olu luhlobo olubi kakhulu lwe-colitis. Kule meko, i-membrane etyebileyo neqinileyo inokwenziwa kulwelo lwekholoni yakho.

Njengoko umonakalo obangelwa zityhefu kumathumbu amakhulu usanda, iingxaki ezingaphezulu zinokwenzeka:

• Ukuvuza kolwelo: Ulwelo lusenokuqala ukuvuza lusuka kumathumbu amakhulu lungene kwisisu sakho (oku kubizwa ngokuba yi-ascites), nto leyo ebangela ukuba isisu sakho sidumbe. Usenokulahlekelwa yiproteni kumathumbu amakhulu, nto leyo ebangela ukuba amanqanaba e-albumin yakho ehle. Oku kunokubangela iimpawu ezifana nokudumba nokudinwa.
• I-Reactive arthritis: Usulelo olunzima lunokubangela imeko ebizwa ngokuba yi-"reactive arthritis." Oku kunokubangela ukudumba, ukudumba, kunye nentlungu emalungwini akho nakwamanye amalungu omzimba wakho.
• I-megacolon enetyhefu: I-megacolon enetyhefu yimeko engaqhelekanga kodwa eyingozi kakhulu. Oku kwenzeka xa ukudumba okubangelwa kukudumba kuba nzima kangangokuba ikholoni iba yinto engasebenzi kakuhle. Oku ekugqibeleni kunokukhokelela kwi-sepsis (ityhefu yegazi).

Ifunyaniswa njani intsholongwane ye-C. diff?

Ukuba ugqirha wakho urhanela ukuba une-C. diff virus ngokusekelwe kwiimpawu zakho, uza kuthatha isampuli yendle yakho ayithumele kwilebhu ukuze kuhlolwe i-C. diff toxicity. Ukuba iziphumo zovavanyo lwakho zilungile, oko kuthetha ukuba une-HIV, ugqirha wakho unokwenza uvavanyo olongezelelekileyo ukuze afumanise ukuba ingakanani na i-HIV. Oku kungabandakanya uvavanyo lwegazi kunye novavanyo lwemifanekiso ukuze kujongwe ngaphakathi kwikholoni yakho.

Inyangwa njani i-C. diff infection?

Usulelo lwe-C. diff lunyangwa ngokuxhomekeke kubukhali balo. Ukuba ufumene i-C. diff ngelixa usela amayeza okubulala iintsholongwane, ugqirha wakho usenokuyeka ukusebenzisa amayeza kuqala. Kwabanye abantu, yiloo nto kuphela efunekayo. Inkqubo yabo yokuzikhusela yamathumbu iya kuqala ukusebenza kwakhona kwaye ilawule usulelo. Ukuba ayisebenzi, ugqirha wakho unokukunika ezinye iintlobo zamayeza okubulala iintsholongwane anokuthintela i-C. diff. Ezinye iintlobo zamayeza okubulala iintsholongwane ze-C. diff ziquka:

• `(iMetronidazole)`
• `(I-Vancomycin)`
• `(Fidaxomicin)`

Ukuba unosulelo oluncinci, ungaya ekhaya uye kuthatha amayeza akho. Uninzi lwabantu luqala ukuba bhetele kwiintsuku ezimbalwa. Kodwa ukuba usulelo lunzima, kuya kufuneka uhlale esibhedlele. Esibhedlele, ugqirha wakho uza kukunika amayeza okubulala iintsholongwane, mhlawumbi ngomthambo (IV - intravenous). Baza kukunika nezinto ezifana ne-saline ukuthintela ukuphelelwa ngamanzi emzimbeni. Kwezinye iimeko, amayeza anokunikwa ngqo kwikholoni njenge-enema.

Yintoni omawuyenze xa usulelo lwe-C. diff lunzima?

Ukuba uneengxaki ezinzima, unokufuna unyango kwicandelo lokhathalelo olunzulu. Amaxesha amaninzi, oogqirha banokucebisa utyando olungxamisekileyo (i-colectomy) ukususa umthombo wosulelo kumathumbu akho amakhulu. Ukuba uyachacha kodwa uqhubeka ufumana usulelo oluphindaphindayo emva konyango, ukhetho lwakho zezi:

• Unyango lwee-antibiotic kwakhona: Ugqirha wakho unokukunika elinye iyeza elahlukileyo, okanye elinye iyeza ixesha elide. Emva kwee-antibiotics, ugqirha wakho unokucebisa ukuba uthathe ii-probiotics ukunceda ukubuyisela iintsholongwane emathunjini akho.
• Ukufakelwa kweFecal Microbiota (FMT): Le ndlela ibonakalisiwe ukuba iyasebenza kakhulu ekuthinteleni usulelo lwe-C. diff oluphindaphindayo emva kokuba unyango oluphindaphindwayo lwe-antibiotic lungaphumelelanga. Ibandakanya ukudlulisa isampuli yendle evela kumntu ophilileyo iye kwikholoni enesifo. Le sampuli isetyenziselwa ukulungelelanisa i-microbiome yakho yamathumbu. Cinga ngayo njengokongeza umhlaba olungileyo kwigadi enezityalo ezimbi kunye nokutyala izityalo ezilungileyo.

Ngawaphi amanyathelo okhuseleko anokuthathwa ukuthintela ukusasazeka kwe-C. diff?

Abasebenzi bezempilo bathatha amanyathelo akhethekileyo okhuseleko xa bejongene nosulelo lwe-C. diff ukunceda ekuthinteleni ukusasazeka kwesi sifo sisulelayo kakhulu. Ungalandela umzekelo wabo ukukhusela abanye:

• Ukuzahlula: Ukuba unesifo, kungcono ukuzihlukanisa kwigumbi lakho. Nabani na oza egumbini ukuzokunyamekela kufuneka anxibe iiglavu ezilahlwayo, kwaye kufuneka azisuse xa ephuma egumbini. Ekubeni isifo sisasazeka ngendle yakho, kufuneka uphephe ukwabelana ngezindlu zangasese nabanye abantu. Ukuba kufuneka wabelane, hlamba isiphatho, isihlalo sendlu yangasese, kunye nendawo engqongileyo ngesicoci esine-bleach emva kokuyisebenzisa.
• Ukuhlamba izandla: Ngenxa yokuba i-C. diff ayichaphazeleki sisicoci sezandla, kubalulekile ukuhlamba izandla zakho rhoqo ngesepha namanzi ashushu. Oku kubalulekile kuye wonke umntu odibana naye.
• Ukubulala iintsholongwane: Uninzi lwezibulali-ntsholongwane ezixhaphakileyo azisebenzi kwi-C. diff. Kodwa iimveliso ezine-bleach ziyakwazi. Kubalulekile ukubulala iintsholongwane kuyo nayiphi na indawo oyichukumisayo, ingakumbi kwigumbi lokuhlambela.
• Ukusela amayeza okubulala iintsholongwane njengoko kuchaziwe: Musa ukuthatha amayeza okubulala iintsholongwane abanye abantu, kwaye musa ukugcina amayeza okubulala iintsholongwane ukuze uwasebenzise kamva.

Yintoni onokuyilindela ukuba ufumana i-C. diff?

Uninzi lwezifo ze-C. diff zilula kwaye ziyaphela xa zinyangwa. Nangona kunjalo, iimeko ezibangela isifo se-C. diff ngamanye amaxesha zinokusasazeka ngokukhawuleza. Usulelo lwe-C. diff lunokufika ngequbuliso kwaye lube nzima. Ukuba unezinto ezinokubangela umngcipheko wosulelo lwe-C. diff, usenokuba nosulelo oluqatha, okanye unokuba nosulelo oluphindaphindayo olufuna unyango olungakumbi.

Ngaba i-C. diff iyaphela yodwa?

Ewe, ukuba iintsholongwane zakho zamathumbu ezisempilweni zinokubuyela esiqhelweni kwaye zilwe nazo, ungaphila wedwa. Oku kunokwenzeka ngakumbi ukuba iintsholongwane zakho zamathumbu zihlala zinamandla kwaye awunazo iingxaki zempilo ezihlala ixesha elide ezizenza buthathaka. Ukuba usulelo lubangelwe kukuthatha amayeza okubulala iintsholongwane, ungaphila wakuyeka ukuwasebenzisa. Kodwa ungalindi ixesha elide. Ukuba awuziva ungcono kwiintsuku ezimbalwa, bona ugqirha ngoko nangoko.

Nje ukuba ufumane i-C. diff, ingaba ihlala ikhona?

Emva konyango, ezinye iintsholongwane zisenokuhlala. Kodwa ungahlala ixesha elithile ungenalo usulelo. Logama nje iintsholongwane ezilungileyo zamathumbu zisekho, ziya kunceda ukulawula iClostridium difficile. Ukuba ufumana usulelo oluphindaphindayo, kungenxa yokuba ezinye iintsholongwane azikabuyeli esiqhelweni. Usulelo oluphindaphindayo lunokuba kukuphinda kosulelo lokuqala, kodwa oko akusoloko kunjalo. Ngamanye amaxesha zizifo ezintsha.

Ngaba kukho naziphi na iingxaki zexesha elide emva kokosuleleka yi-C. diff?

Eyona ngxaki ixhaphakileyo yexesha elide kusulelo oluqhubekayo okanye oluphindaphindayo olubangelwa yiClostridium difficile. Oku kwenzeka xa ikholoni yakho inobunzima bokuphola ngokupheleleyo. Ikholoni yakho isenokucotha ukuphola ngenxa yezi zizathu:

• Ukuba ubunosulelo olubi olonakalisa ulwelo lwamathumbu akho.
• Ukuba bekufuneka uthathe amayeza okubulala iintsholongwane ixesha elide, okanye ukuba bekufuneka uthathe amayeza okubulala iintsholongwane ngenxa ye-C. diff emva kokuthatha amanye amayeza okubulala iintsholongwane.
• Ukuba unesifo sempilo esihlala ixesha elide esichaphazela amathumbu akho okanye inkqubo yakho yokuzikhusela komzimba.
• Ukuba uneminyaka engaphezu kwama-65 ubudala.

Amaxesha amaninzi, abanye abantu bahlakulela izifo zokuzikhusela komzimba emva kosulelo olunzima. Oku kuthetha ukuba inkqubo yabo yokuzikhusela yomzimba iyaqhubeka nokusebenza ngokungathi kukho usulelo, nokuba usulelo luphelile. Iingxaki zokuzikhusela komzimba eziqala emva kosulelo lwe-C. diff ziquka i-IBS emva kokosuleleka (i-irritable bowel syndrome) kunye ne-reactive arthritis.

Yeyiphi imibuzo omele uyibuze ugqirha wakho malunga nosulelo lwe-C. diff?

Ungabuza imibuzo efana nale:

• Ingaba ingakanani ingozi yokosuleleka kwam?
• Ngaba ndisengozini yeengxaki?
• Ndingazi njani ukuba i-C. diff iya isiba ngcono?
• Ndingakufowunela nini? Ndingaya nini kwigumbi longxamiseko?
• Ngaba kufuneka ndidibane nogqirha wezifo zesisu?
• Ziziphi iindlela zonyango zokosuleleka okuphindaphindiweyo?

IClostridium difficile yintsholongwane eqhelekileyo enokuhlala emathunjini akho ngaphandle kokubangela monakalo. Kodwa xa iqala ukuba namandla kakhulu, inokuba yingozi kakhulu. Usenokuziva uxhalabile ngokuba nesifo sorhudo ngalo lonke ixesha nendlela esichaphazela ngayo ubomi bakho. Usenokuziva uneentloni ukuthetha ngemeko echaphazela ukuhamba kwakho kwamathumbu. Kodwa musa ukuvumela ezo mvakalelo zikuthintele ekufuneni uncedo.Uninzi lwabantu alufumani ngxaki ngenxa ye-C. diff, kwaye iphela ngokukhawuleza nangokupheleleyo. Kodwa ukuba usemngciphekweni ophezulu ngenxa yezizathu ezithile zomngcipheko, inokuba nzima kakhulu. Ikwasuleleka kakhulu, inokuhlala ixesha elide, kwaye ingabuya kwakhona. Ukuba unesifo sohudo emva kokuthatha amayeza okubulala iintsholongwane, xelela ugqirha wakho ngoko nangoko. Musa ukuthatha amayeza athintela isifo sohudo, kuba awayi kunceda kwaye anokwenza sibe sibi ngakumbi. Ukuba ukrokrela ukuba une-C. diff, bona ugqirha ngoko nangoko.

Ngoko ke, zeziphi izinto esifanele sizikhumbule kweli bali?

I-C. diff yintsholongwane enokubangela usulelo emathunjini ethu amakhulu. Oku kubangela iimpawu ezifana norhudo kunye nentlungu yesisu.

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Oku kwenzeka rhoqo xa ii-antibiotics zibulala iintsholongwane ezilungileyo emathunjini, nto leyo evumela ukuba i-C. diff ikhule.

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Oku kuyasulela kakhulu, ngoko ke ukuhlamba izandla zakho nokugcina ucoceko kubaluleke kakhulu.

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Abantu abadala, abo baneenkqubo zomzimba ezibuthathaka, kunye nabo balaliswe esibhedlele banamathuba amaninzi okuba nale ngxaki.

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Ukuba uneempawu, funa ingcebiso kagqirha ngoko nangoko. Kuba, ukuba unyangwa ngokufanelekileyo, unokuchacha rhoqo. Nangona kunjalo, ukuba awunyangwa, iingxaki zinokubakho.

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Kubalulekile ukuthatha amayeza akho kanye njengoko ugqirha wakho ekuyalele kwaye ngexesha elifanelekileyo.

Ngoko ke, ndiyathemba ukuba olu lwazi luluncedo kuwe. Hlala usempilweni!