Usulelo lwe-C. diff (Clostridioides difficile): Konke okufuneka ukwazi ngesi sifo sesisu - Nirogi Lanka

Ngaba wakha waziva iintlungu zesisu ezingapheliyo kunye norhudo oluthathe iintsuku ezininzi? Sihlala sizithatha njengezinye zeemeko ezilula zokutyhefeka kokutya okanye intsholongwane yesisu. Nangona kunjalo, ezi mpawu ngamanye amaxesha zinokubonisa usulelo olukhulu lwebhaktheriya olunokubangela umonakalo omkhulu kwindlela yakho yokugaya ukutya. Le meko yaziwa ngokuba yi-C. diff (Clostridioides difficile).

Yintoni i-C. diff (Clostridioides difficile)?

Ngamafutshane, i-C. diff luhlobo lwebhaktiriya eyaziwa ngokwesayensi njengeClostridioides difficile . Le bhaktiriya inokosulela amathumbu akho amakhulu (ikholoni), nto leyo ekhokelela kwiimpawu ezingathandekiyo ezifana norhudo.

Nangona ukuba nentsholongwane emzimbeni kuyinto eqhelekileyo, usulelo lwe-C. diff luyingozi kakhulu. Oku kungenxa yokuba iClostridioides difficile ivelisa ityhefu eyonakalisa iiseli ezikwi-colon yakho, nto leyo ebangela ukudumba okwaziwa ngokuba yi-colitis. Ubunzima beempawu zakho buxhomekeke kubungakanani bomonakalo obangelwa yityhefu, kwaye kwezinye iimeko, le meko inokuba yingozi ebomini.

Ngaphambili yayisaziwa ngokuba yiClostridium difficile , igama lezonyango elihlaziyiweyo ngoku yiClostridioides difficile .

Ixhaphake kangakanani intsholongwane ye-C. diff?

Usulelo lwe-C. diff (CDI) luyingxaki enkulu yezempilo kwihlabathi liphela. Nangona izibalo ezichanekileyo zehlabathi zihluka, eMelika kuphela, kukho malunga namatyala angama-500,000 abikiweyo ngonyaka, nto leyo enegalelo ekufeni kwabantu abamalunga ne-15,000. Esi asisosimo esinokuthathwa lula.

Zithini iimpawu zosulelo lwe-C. diff?

Uphawu oluphambili lokuqala kukurhuda okumanzi nokukhululekileyo. Kwiimeko ezincinci, unokufumana urhudo ubuncinane kathathu ngemini kunye nokuqaqamba kancinci kwesisu.

Njengoko usulelo luqhubeka, ukuphindaphinda korhudo kuyanda—ngamanye amaxesha ukuya kuthi ga kwi-10–15 izihlandlo ngemini. Usenokubona neempawu zegazi kwindle yakho. Ezinye iimpawu ziquka:

• Intlungu yesisu engapheliyo
• Ukudumba kwesisu kunye nokuvuvukala kwesisu
• Isicaphucaphu nokuhlanza
• Ukulahlekelwa ngumdla wokutya
• Ifiva
• Isantya sentliziyo esiphakamileyo

Ekuqaleni, iimpawu ze-C. diff zinokufana nokutyhefeka kokutya okanye umkhuhlane wesisu. Ukuba okwangoku usebenzisa amayeza okubulala iintsholongwane, usenokuthi urhudo lubangelwa yimiphumo emibi yeyeza.

Khumbula: Kunokwenzeka ukuba ube nosulelo lwe -C. diff nokuba ungenaso isifo sorhudo.

Injani i-C. diff stool kwaye ivumba njani?

Kwisifo se-C. diff, indle idla ngokuba yi-pasty okanye i-porridge endaweni yokuba ibe yi-fluid ngokupheleleyo. Ngamanye amaxesha isenokubonakala iluhlaza, nangona oku kunokwenzeka nakwezinye izifo zebhaktheriya. Akuqhelekanga ukuba ubone igazi, i-mucus, okanye i-pus kwindle.

Izigulane ezininzi zixela ivumba elikhethekileyo nelikrakra elinxulunyaniswa norhudo lwe-C. diff. Ludla ngokuchazwa njengelinamandla ngokungaqhelekanga elinevumba elimnandi nelingathandekiyo, elinokubangelwa ngamanqanaba aphezulu e-bile acids kwindle ngenxa yosulelo.

Yintoni ebangela usulelo lwe-C. diff?

Kumntu ophilileyo, amathumbu adla ngokulawula iintsholongwane ze-C. diff. Ingxaki ivela xa ibhalansi yendalo phakathi kweentsholongwane "ezilungileyo" nezi "zimbi" emathunjini akho iphazamiseka. Ezo ntsholongwane ziluncedo zibalulekile ekulawuleni iintsholongwane ezinobungozi ezifana ne-C. diff.

Eyona nto ibangela usulelo lwe-C. diff kukusetyenziswa kwee-antibiotics. Ii-antibiotics zinokuphazamisa i-microbiome yamathumbu akho, zivumele i-C. diff ukuba yande ngaphandle kokuba ijongiwe.

Isasazeka njani i-C. diff?

I-Clostridioides difficile isasazeka ngokukhululwa kwee-spores. Ezi spores ezincinci zingaphila kwiindawo eziphezulu, ezitulweni, etafileni, nasesikhumbeni. Ukuba uchukumisa indawo engcolileyo uze uchukumise umlomo wakho okanye utye ngezandla zakho, ungosuleleka.

Kutheni le nto i-C. diff isasazeka lula kangaka?

Ngaphandle komzimba womntu, i-C. diff iguquka ibe yi-spores. Ezi spores zinamandla kakhulu—zimelana nobushushu, ii-asidi, uninzi lwee-antibiotics, kunye nezibulali-ntsholongwane eziqhelekileyo. Zingaphila phezu komhlaba kangangeenyanga.

Abaphandi baqikelela ukuba malunga ne-5% yabantu banesi sifo se-C. diff kumathumbu abo ngaphandle kokubonisa iimpawu. Oku kuthetha ukuba nokuba unokuyilawula, unokuyidlulisela kwabanye.

Ndingaba kufutshane nomntu one-C. diff?

Ewe, kodwa kufuneka ulandele amanyathelo okhuseleko angqongqo ukuze unciphise ukusasazeka kwesifo:

• Hlamba izandla zakho kakuhle kwaye rhoqo ngesepha namanzi.
• Kuphephe ukuchukumisa impumlo yakho, umlomo, okanye amehlo akho.
• Hlambulula iintsholongwane kwiindawo zasekhaya rhoqo.
• Sebenzisa izixhobo zokuzikhusela (PPE) ezifana neeglavu, iimaski , kunye neengubo zokugqoka ukuba unyamekela isigulana.

Ngubani osengozini enkulu ye-C. diff?

Ezinye iimeko zempilo ezingabonakaliyo zinokwenza buthathaka ukhuseleko lomzimba wakho kwi-C. diff, kuquka:

• Isifo samathumbu esivuthayo (IBD): Iimeko ezifana nesifo sikaCrohn kunye ne-ulcerative colitis zibangela umonakalo ongapheliyo kulwelo lwamathumbu (mucosa), nto leyo enciphisa amajoni omzimba asekuhlaleni.
• Ubuthathaka benkqubo yomzimba yokuzikhusela : Ukuba unesifo sokungakwazi ukuzikhusela komzimba, umhlaza, i-HIV , isifo sezintso, okanye isifo seswekile, impendulo yakho yomzimba yokuzikhusela isenokuba buthathaka. Oku kuyinyaniso nokuba uthatha amayeza okunciphisa uxinezeleko lwemizimba.

Ezinye izinto ezinobungozi ziquka:

• Ubudala: Abantu abangaphezu kweminyaka engama-65 basengozini enkulu ngenxa yokuncipha kwe-immune system, i-polypharmacy, okanye ukuhlala kwiindawo ezizimeleyo. Iintsana ezincinci nazo zisengozini ye-C. diff.
• Ukulaliswa esibhedlele okanye ukuhlala nabantu bonke: I-C. diff isasazeka lula kwiindawo ezixineneyo ezifana nezibhedlele okanye iindawo zokhathalelo. Iintsholongwane zinokuhlala kwindawo eqhelekileyo kangangeenyanga, kwaye izindlu zangasese ezisetyenziswa kunye zinceda ukudluliselwa ngokukhawuleza kwesifo.

Ngamanye amaxesha, akunakwenzeka ukucacisa unobangela ochanekileyo wosulelo lwe-C. diff. Nangona zininzi izinto ezichaphazela impilo yamathumbu akho, kubalulekile ukuqonda ukuba ungalufumana olu sulelo nangona kungekho zizathu zicacileyo zomngcipheko.

Ziziphi iingxaki ezinokubakho ngenxa yosulelo lwe-C. diff?

Usulelo oluqatha lunokubangela iingxaki ezinkulu. Ubunzima bemeko yakho buxhomekeke kwizinto ezahlukeneyo, kuquka uhlobo oluthile lwebhaktheriya, amandla enkqubo yakho yokuzikhusela komzimba, kunye nempilo yakho iyonke.

Ukuba unezinto ezinobungozi obukhulu, usengozini enkulu yokugula kakhulu okanye usulelo oluphindaphindayo, nto leyo enokukhokelela kumonakalo oqhubekayo ngokuhamba kwexesha.

Iingxaki eziqhelekileyo ziquka:

• Usulelo oluphinda luvele: Malunga nama-20% ezigulana ziphinda zibuye emva kweeveki ezimbini ukuya kwezisibhozo emva kokugqiba unyango, kwaye kukho umngcipheko we-40% wokuphinda zibuye emva koko.
• Ukuphelelwa ngamanzi emzimbeni kunye nokulahleka kwe-electrolyte: Ukuba umzimba wakho ulahlekelwa lulwelo kunye ne-electrolyte ngokukhawuleza kunokuba unokuzitshintsha, unokujongana nemiphumo emibi eyingozi efana nomthamo wegazi ophantsi kunye noxinzelelo lwegazi oluphantsi. Kwiimeko ezinzima, oku kunokukhokelela ekungasebenzini kwezintso.
• I-Pseudomembranous colitis: Olu luhlobo olubi lwe-colitis olubonakaliswa kukukhula kwee-membrane ezijiyileyo, ezifana ne-crust-inflammatory ecaleni kwe-inside lining ye-colon yakho.

Njengoko umonakalo ovela kwiityhefu zebhaktheriya usanda, kunokubakho ezinye iingxaki:

• Ukuvuza kolwelo: Ulwelo lunokuvuza lusuka kumathumbu amakhulu luye kwisisu sakho (imeko eyaziwa ngokuba yi-ascites), nto leyo ebangela ukudumba okukhulu kwesisu. Ungalahlekelwa naziiproteni, nto leyo ekhokelela kumanqanaba aphantsi e-albumin, nto leyo enokubangela ukudumba nokudinwa okungakumbi.
• I-Reactive arthritis: Usulelo olunzima lunokubangela i-reactive arthritis, okubangela ukudumba, ukudumba, kunye nentlungu kumalungu akho nakwamanye amalungu omzimba.
• I-megacolon enetyhefu: Nangona ingaqhelekanga, le yimeko esongela ubomi apho ukudumba okukhulu kubangela ukuba ikholoni iyeke ukusebenza. Oku ekugqibeleni kunokukhokelela kwi-sepsis (ityhefu yegazi).

Ifunyanwa njani intsholongwane ye-C. diff?

Ukuba iimpawu zakho zibonisa ukuba une-C. diff virus, ugqirha wakho uza kuqokelela isampuli yendle ukuze ayithumele kwilebhu ukuze kuhlolwe ukuba ikhona na i-C. diff toxicity.

Ukuba iziphumo zovavanyo lwakho zilungile, ugqirha wakho unokwenza olunye uvavanyo ukuze abone ukuba losulelo lungakanani na. Oku kungabandakanya uvavanyo lwegazi kunye novavanyo lwemifanekiso ukuze kuhlolwe ikholoni yakho.

Inyangwa njani intsholongwane ye-C. diff?

Unyango lwe-C. diff lulungiselelwe ubunzulu bosulelo. Ukuba usulelo lwakho lubangelwe kukusetyenziswa kwee-antibiotics, ugqirha wakho uya kuyeka loo mayeza kuqala.

Kwabanye, oku kwanele, njengoko ukhuselo lwendalo lwamathumbu akho lunokubuyisela ibhalansi kwaye lulawule usulelo. Ukuba akunjalo, ugqirha wakho uya kukunika amayeza athile okubulala iintsholongwane awenzelwe ukujolisa kwi-C. diff.

Ii-antibiotics eziqhelekileyo ezisetyenziselwa i-C. diff ziquka:

• I-Metronidazole
• I-Vancomycin
• I-Fidaxomicin

Ukuba unosulelo oluncinci, unokulawula unyango ekhaya uze uzive ungcono kwiintsuku ezimbalwa. Nangona kunjalo, ukuba usulelo lunzima, ukungeniswa esibhedlele kunokufuneka.

Esibhedlele, ungafumana amayeza okubulala iintsholongwane ngemithambo (IV) kunye nolwelo ukuthintela ukuphelelwa ngamanzi emzimbeni. Kwezinye iimeko, amayeza anokungeniswa ngqo kumathumbu amakhulu nge-enema.

Kuthekani ngezifo ezintsonkothileyo okanye ezinzima ze-C. diff?

Ukuba uneengxaki ezinkulu, unokufuna unyango kwicandelo labagula kakhulu. Kwiimeko ezingaqhelekanga, oogqirha banokucebisa utyando olungxamisekileyo (i-colectomy) ukuze kususwe umthombo wosulelo kumathumbu amakhulu.

Ukuba unengxaki yosulelo oluhlala luhleli noluphindaphindayo emva konyango, ukhetho lwakho luquka:

• Unyango olude lwee-antibiotics: Ugqirha wakho unokukunika olunye uhlobo lwe-antibiotics okanye unyango olude. Banokucebisa neeprobiotics ukunceda ukubuyisela iintsholongwane zamathumbu akho emva kwee-antibiotics.
• Ukufakelwa kweFecal Microbiota (FMT): Xa unyango oluphindaphindwayo lwe-antibiotic lungaphumeleli, i-FMT ibonakalise ukuba iphumelele kakhulu ekuthinteleni ukuphinda kuvele i-C. diff. Oku kubandakanya ukudlulisa ilindle elivela kumntu ophilileyo liye kwikholoni yesigulane ukuze kulungiswe i-gut microbiome—cinga ngayo njengokongeza “umhlaba ophilileyo” emyezweni ukuvumela izityalo ezilungileyo ukuba zikhule ngelixa zixinanisa ukhula.

Ngawaphi amanyathelo onokuwathatha ukuthintela ukusasazeka kwe-C. diff?

Iingcali zonyango zilandela imigaqo engqongqo yokuthintela ukusasazeka kolu sulelo lusulelayo kakhulu. Ungabakhusela abanye ngokulandela le mikhuba:

• Ukuzahlula: Ukuba usulelekile, eyona ndlela ilungileyo kukuhlala kwigumbi elahlukileyo. Nabani na ongena kwigumbi lakho kufuneka anxibe iiglavu ezilahlwayo aze azilahle xa ephuma. Ngenxa yokuba usulelo lusasazeka ngesitulo, kuphephe ukwabelana ngezindlu zangasese. Ukuba ukwabelana ngezindlu zangasese akunakuphepheka, hlamba kakuhle isiphatho, isihlalo sendlu yangasese, kunye nendawo engqongileyo ngesicoci esenziwe nge-bleach emva kokusetyenziswa ngakunye.
• Ukuhlamba izandla: Izicoci zezandla azisebenzi kwi-C. diff, ngoko ke ukuhlamba izandla zakho kakuhle ngesepha namanzi afudumeleyo kubalulekile. Oku kusebenza nakubani na okukhathaleleyo.
• Ukubulala iintsholongwane: Iintsholongwane ezininzi eziqhelekileyo azibulali i-C. diff. Nangona kunjalo, iimveliso ezine-bleach ziyasebenza. Yibulale rhoqo nayiphi na indawo oyichukumisayo, ingakumbi kwigumbi lokuhlambela.
• Sela amayeza okubulala iintsholongwane kanye njengoko kuyalelwe: Ungaze uthathe amayeza okubulala iintsholongwane omnye umntu kwaye ungagcini amayeza okubulala iintsholongwane aseleyo ukuze uwasebenzise kwixesha elizayo.

Yintoni onokuyilindela ukuba uphuhlisa i-C. diff?

Uninzi lwezifo ze-C. diff zithambile kwaye ziyaphela ngonyango. Nangona kunjalo, ngenxa yohlobo lwesifo, ngamanye amaxesha sinokuqhubeka ngokukhawuleza kakhulu.

Ukuba unezinto ezibangela umngcipheko we-C. diff, usengozini enkulu yokugula kakhulu okanye usulelo oluphindaphindayo olufuna unyango oluqhubekayo.

Ingaba i-C. diff iyazisombulula ngokwayo?

Ewe, kunokwenzeka ukuba umzimba wakho ucoce usulelo ukuba iintsholongwane zakho zamathumbu eziphilileyo ziphinda zifumane amandla kwaye ziphumelele i-C. diff. Oku kunokwenzeka ukuba i-gut microbiome yakho inamandla kwaye awunazo iingxaki zempilo ezingapheliyo.

Ukuba usulelo lwakho lubangelwe zii-antibiotics, lunokuphucula xa loo mayeza eyekekile. Nangona kunjalo, musa ukulinda ixesha elide; ukuba awuziva uphucukile kwiintsuku ezimbalwa, funa uncedo lwezonyango ngokukhawuleza.

Ukuba ndifumana i-C. diff kube kanye, ngaba ndiza kuba nayo ngonaphakade?

Ezinye iintsholongwane zisenokuhlala emva konyango, kodwa ungahlala ungenazo iimpawu. Lo gama nje iintsholongwane zakho zamathumbu eziluncedo zihlala ziphilile, zinceda ukugcina *Clostridioides difficile* ikwimeko entle.

Ukuba ufumana usulelo oluphindaphindayo, kudla ngokuba yintsholongwane yakho eluncedo ayikabuyi ngokupheleleyo. Usulelo oluphindaphindayo lunokuba luphawu losulelo lokuqala, nangona ngamanye amaxesha lusulelo olutsha ngokupheleleyo.

Ngaba kukho iingxaki zempilo ezihlala ixesha elide emva kosulelo lwe-C. diff?

Eyona ngxaki ixhaphakileyo yexesha elide kusulelo oluphindaphindayo okanye oluqhubekayo (Clostridioides difficile) . Oku kudla ngokwenzeka kuba ikholoni yakho iyasokola ukuchacha ngokupheleleyo. Inkqubo yokuphiliswa kwekholoni yakho inokulibaziseka ukuba:

• Ufumene usulelo olunzima olonakalisa kakhulu ulwelo lwamathumbu akho.
• Ubudinga unyango lwe-antibiotics ixesha elide, okanye kwafuneka uthathe amanye amayeza okubulala iintsholongwane ukuze unyange i-C. diff ngokwayo.
• Uneengxaki zempilo ezingapheliyo ezichaphazela amathumbu akho okanye inkqubo yomzimba yokuzikhusela.
• Uneminyaka engaphezu kwama-65 ubudala.

Kwiimeko ezingaqhelekanga, abanye abantu baba neengxaki zokuzikhusela komzimba emva kosulelo olunzima. Oku kwenzeka xa inkqubo yakho yokuzikhusela yomzimba ihlala “ikwimeko esebenzayo,” iqhubeka isebenza ngokungathi kukho usulelo olusekhona nasemva kokuba iintsholongwane zisusiwe.

Iimeko eziqhelekileyo emva kokosuleleka ezinxulumene ne-C. diff ziquka i-post-infectious Irritable Bowel Syndrome (IBS) kunye ne-reactive arthritis.

Imibuzo omele uyibuze ugqirha wakho malunga ne-C. diff

Ungathanda ukuxoxa ngale nto ilandelayo nomboneleli wakho wezempilo:

• Ingaba ingakanani ingozi yosulelo endinalo ngoku?
• Ngaba ndisemngciphekweni omkhulu wokuba neengxaki?
• Ziziphi iimpawu zokuba ndiyachacha?
• Ndifanele ndiqhagamshelane nawe nini, kwaye ndifanele ndifune nini unyango olungxamisekileyo?
• Ngaba ndifuna ukuthunyelwa kwi-gastroenterologist?
• Ziziphi iindlela zonyango endinokukhetha kuzo ukuba usulelo luphinda lubuye?

(Clostridioides difficile) yintsholongwane enokubakho ngokungenabungozi emathunjini akho. Nangona kunjalo, xa iba namandla, inokukhokelela kwiingxaki zempilo ezinzulu. Kuqhelekile ukuba uzive ukhathazekile malunga norhudo oluqhubekayo kunye nendlela oluchaphazela ngayo umgangatho wobomi bakho. Ungaziva uneentloni ukuthetha ngeengxaki zamathumbu. Nceda, ungavumeli ezo mvakalelo zikuthintele ekufuneni uncedo olufunayo.

Kwabaninzi abantu, i-C. diff ayikhokeleli kwiingxaki, kwaye iphila ngokukhawuleza nangokupheleleyo. Nangona kunjalo, ukuba unezinto ezithile ezinobungozi, imeko inokuba mandundu. Khumbula ukuba le meko iyosulela kakhulu, ihlala ihleli, kwaye idla ngokubuyela umva.

Ukuba unesifo sohudo emva kokuthatha amayeza okubulala iintsholongwane (antibiotics) , qhagamshelana nogqirha wakho ngoko nangoko. Musa ukuthatha amayeza okuthintela urhudo athengiswa ngaphandle kwemvume kagqirha, kuba ngamanye amaxesha anokwenza imeko ibe mandundu. Ukuba ukrokrela ukuba unosulelo lwe-C. diff, funa uncedo lukagqirha ngoko nangoko.

Izinto ezibalulekileyo ekufuneka uzikhumbule

I-C. diff yintsholongwane enokubangela usulelo olukhulu lwamathumbu amakhulu, nto leyo ekhokelela kwiimpawu ezifana norhudo kunye nentlungu yesisu.

Ihlala isenzeka emva kokusebenzisa (ii-antibiotics) , ezinokubulala iintsholongwane ezisempilweni emathunjini akho, nto leyo evumela ukuba i-C. diff ikhule kakhulu.

Olu sulelo luyosulela kakhulu, nto leyo eyenza ukuba ukuhlamba izandla kunye nococeko kube yinto ebalulekileyo.

Abantu abadala, abo baneenkqubo zomzimba ezibuthathaka, kunye nabantu abasezibhedlele basengozini enkulu.

Ukuba ubona iimpawu, funa ingcebiso kagqirha ngokukhawuleza. Ngonyango olufanelekileyo, kulula kakhulu ukululawula, kodwa ukulibaziseka kunokukhokelela kwiingxaki.

Soloko ugqiba amayeza akho njengoko ugqirha wakho ekuyalele.

Siyathemba ukuba olu lwazi luza kukunceda kuhambo lwakho lokuchacha. Hlala usempilweni neNirogi Lanka!