Ngaba uyayazi le ntsholongwane imbi kangaka? (Ii-Enterobacteriales ezimelana neCarbapenem - iiCRE) Masithethe!

Mhlawumbi ukhe weva ukuba amayeza anikwa ngoogqirha kwezinye izifo, oko kukuthi, `(amayeza okubulala iintsholongwane)` ngamanye amaxesha awasebenzi. Le yenye yeemeko eziyingozi nezichaphazelayo esiza kuthetha ngazo namhlanje, usulelo lweentsholongwane oluthi `(Carbapenem-Resistant Enterobacteriales)` okanye `(CREs)`. Ezi zisenokungaphenduli kwezinye ze `(amayeza okubulala iintsholongwane)` ezinamandla ezihlala zinikwa. Ngoko ke, nangona eli libali elinzima, kubaluleke kakhulu ukuba sonke siqaphele oku. Masiqonde nje ukuba kwenzeka ntoni.

Zithini ii-`(Carbapenem-Resistant Enterobacteriales)` okanye `(CREs)`?

Ngamafutshane, `(Enterobacteriales)` liqela leebhaktheriya ezinxulumeneyo, njengosapho olunye. Ezi bhaktheriya zinokubangela usulelo olwahlukeneyo emizimbeni yethu. Ngoku, ezi bhaktheriya `(Enterobacteriales)` ngamanye amaxesha zibonisa ukumelana ne-`(antibiotic)` ekhethekileyo, enamandla ebizwa ngokuba yi-`(Carbapenems). Ezo bhaktheriya `(Enterobacteriales)` ezimelana ne-`(Carbapenems)` zezo sizibiza ngokuba yi-`(Carbapenem-Resistant Enterobacteriales)` okanye `(CREs)`.

Cinga nje, oogqirha basebenzisa `(amayeza okubulala iintsholongwane)` ukunyanga usulelo lweentsholongwane. Kodwa, ezi ntsholongwane zinobuqili kakhulu. Xa zihlala zichatshazelwa `(amayeza okubulala iintsholongwane)` (ingakumbi esibhedlele okanye kwikhaya labalupheleyo), bafumana iindlela zokusinda nokusinda kuzo `(amayeza okubulala iintsholongwane). Oku sikubiza ngokuba `(ukuxhathisa) . Ngoko ke `(ii-CRE)` ziintsholongwane eziye zamelana nodidi `(iCarbapenem)` lwe `(amayeza okubulala iintsholongwane)`.

Kukho ezinye iintlobo ezininzi zamayeza akweli qela lee-antibiotics ezibizwa ngokuba yi-"Carbapenems":

• `Ertapenem`
• `Imipenem`
• `I-Meropenem`

Ezi zii-antibiotics ezinamandla ezidla ngokunikezelwa kwiintsholongwane ezinzulu. Ngoko ke ukuba intsholongwane iyamelana nazo, oko kuthetha ukuba intsholongwane iba nzima ukunyanga.

Ziziphi iintlobo zebhaktheriya (i-Enterobacteriales)?

Abanye abantu basebenzisa isifinyezo esithi `(CRE)` ukuthetha `(Carbapenem-resistant Enterobacteriaceae)`, ngelixa abanye basebenzisa `(Carbapenem-resistant Enterobacteriaceae)`. `(Enterobacteriales)` liqela elikhulu eliqulethe iintlobo ezininzi ezahlukeneyo zeebhaktheriya. Ineentsapho ezintathu, okanye ii-suborders. Elinye lala ma-suborders yi `(Enterobacteriaceae).` Eli qela `(Enterobacteriaceae)` kulapho iibhaktheriya esihlala siziva ngazo zifumaneka khona:

• `Escherichia` (esaziwa kakhulu njenge-`E. coli`)
• `Klebsiella`
• `I-Salmonella`
• `Shigella`

Ezona CRE zixhaphakileyo ziintlobo zeKlebsiella pneumoniae kunye ne-E. coli ezinganyangekiyo kumayeza okubulala iintsholongwane. Kubalulekile ukukhumbula ukuba ngenxa yokuba unentsholongwane yeKlebsiella okanye i-E. coli, akuthethi ukuba ayinyangeki kumayeza okubulala iintsholongwane.

Zeziphi izifo ezibangelwa yi-`(CREs)`?

Ezi ntsholongwane "(iiCRE)" zinokubangela usulelo kwiindawo ezahlukeneyo zomzimba wakho. Ezi sulelo zibonakala kakhulu kwi:

• Egazini(Usulelo lwegazi)
• Usulelo lomchamo (UTI)
• Kwimiphunga (i-pneumonia)
• Isisu (ithumba elingaphakathi kwesisu)

Kukwiindawo ezinje apho ezi ntsholongwane zifihlakeleyo zinokubangela khona usulelo ngokulula.

Zixhaphake kangakanani izifo ze-`(CRE)`?

Ukuba ujonga izibalo zelizwe elifana ne-United States, malunga ne-13,000 yosulelo ixelwa minyaka le ngenxa ye-``(ii-CRE).`` Malunga ne-1,100 yazo iyafa. Oogqirha baseSri Lanka nabo bayayiqwalasela le meko. Kuba iintsholongwane ezinjalo ezinganyangekiyo ziya ziba yingxaki kwihlabathi liphela.

Zithini iimpawu zosulelo lwe-`(CRE)`?

Iimpawu ze-`(Carbapenem-resistant Enterobacteriales)` ziyahluka ngokuxhomekeke kwindawo onayo usulelo. Ezinye iimpawu eziqhelekileyo zingabandakanya:

• Ifiva
• Ukugodola
• Ubunzima bokuphefumla
• Ukukhwehlela
• Intlungu yesisu
• Intlungu xa uchama
• Ubomvu, ukudumba, kunye nokurhawuzelela kwindawo yotyando okanye inxeba

Kubalulekile: Ezi mpawu azipheleli nje kwizifo ze-`(CRE)`. Ezinye izifo zebhaktheriya nazo zinokubangela ezi mpawu. Ke ngoko, ukuba ufumana naziphi na kwezi mpawu, kungcono ukubona ugqirha.

Zithini izizathu zosulelo lwe-`(CRE)`?

Ngamafutshane, usulelo lwe-`(CRE)` lubangelwa ziibhaktheriya ezimelana ne-`(antibiotics)` ezibizwa ngokuba yi-`(Carbapenem)`. Kukho izizathu ezahlukeneyo zokuba iibhaktheriya zivelise olu xhathiso lwe-`(antibiotic)`. Enye yindlela eziguquke ngayo ukuze zihlale kunye nezinye izinto eziphilayo kwindalo.

Kwizibhedlele nakwezinye iindawo zonyango, iintsholongwane zihlala zichatshazelwa zii-antibiotics. Ingakumbi kuba ii-antibiotics ezinamandla njenge-carbapenems zisetyenziselwa ukunyanga izifo ezinzulu, iintsholongwane zinethuba lokuphuhlisa iindlela zokuzichasa. Ezi ntsholongwane zinamandla amangalisayo okudlulisela ii-gene zazo zokuchasana kwezinye iintsholongwane . Oku kubizwa ngokuba kukudluliselwa kwe-gene ethe tye. Njengokuxelela umhlobo imfihlo, ezi ntsholongwane zabelana ngokuchasana kwazo nabanye. Ngaphandle koko, iintsholongwane ezisindayo kwii-antibiotics zinokudlulisela ii-gene zazo zokuchasana, zidale iintsholongwane ezininzi ezichasanayo.

Enye yeendlela eziphambili zokuba iintsholongwane zikwazi ukumelana ne-`(CRE)` kukuvelisa i-enzyme ebizwa ngokuba yi-`(Carbapenemase)`. Le enzyme iyawaphula ize itshabalalise i-`(Carbapenem antibiotics)`. Le enzyme yenza umsebenzi ofanayo nowokusika iyeza ngesikere esincinci. Emva koko iyeza alisebenzi.

Zidluliselwa njani ii-CRE?

Iintsholongwane ze-Enterobacteriales ezingamelaniyo neCarbapenem zinokuphila eluswini lwakho okanye kwindlela yakho yokugaya ukutya (amathumbu) ngaphandle kokukugulisa. Oku kubizwa ngokuba yi-colonization.Ii-CRE zinokudluliselwa kumntu ogulayo onesifo se-CRE, okanye kumntu ohlala kwintsholongwane ngaphandle kweempawu.

Usengozini enkulu yokufumana usulelo lwe-`(CRE)` esibhedlele okanye kwenye indawo yokhathalelo lwempilo. Oku kungenxa yokuba iintsholongwane ezihlala eluswini lwethu nasemizimbeni yethu zinokuchasana nee-antibiotics ngokuziveza kuzo. Ungafumana usulelo lwe-`(CRE)` ngeendlela ezilandelayo:

• Ngokuchukumisa umntu onentsholongwane eluswini lwakhe (umzekelo, ukuba loo mntu akazihlambanga kakuhle izandla zakhe).
• Ukusuka kwiindawo ezimdaka , ingakumbi izinki kunye nezindlu zangasese.
• Kwizixhobo zonyango ezingcolileyo kunye nezixhobo zonyango ezifakwe emzimbeni wakho (umz., umgca ophakathi wemithambo yegazi, ityhubhu yokuphefumla).

Ngubani osengozini enkulu yosulelo lwe-`(CRE)`?

Usenokuba sengozini enkulu yosulelo lwe-`(CRE)` ukuba:

• Ukuba unomgca wemithambo ophakathi (ityhubhu efakwe kumthambo oyintloko), ityhubhu yokuphefumla, ityhubhu yokondla, okanye enye ityhubhu okanye isixhobo esifakwe emzimbeni wakho, ii-CRE zingangena emzimbeni wakho zivela ngaphandle ngezi zinto.
• Ukuba ubusoloko uthatha amayeza okubulala iintsholongwane okanye ukuba uwathatha rhoqo, kusenokwenzeka ukuba iintsholongwane ziya kukwazi ukumelana nawo ngokuhamba kwexesha. Oku kunokubulala iintsholongwane "ezilungileyo" (ezingeyongozi) emathunjini ethu, okuvumela ezinye iintsholongwane ukuba zikhule zingalawuleki kwaye zibangele usulelo.
• Ukuba unesifo esithile esibangela ukuba amasosha omzimba wakho abe buthathaka . Umzekelo, ukuba une-HIV, umhlaza wegazi, isifo seswekile, okanye ukhe wafakelwa amalungu omzimba okanye wafakelwa i-stem cell, usemngciphekweni omkhulu. Oku kungenxa yokuba kunzima emzimbeni ukulwa nosulelo phantsi kwezi meko.
• Ukuba ufuna uncedo ngemisebenzi yemihla ngemihla, efana nokuhlamba nokusebenzisa indlu yangasese , unokuba semngciphekweni omkhulu wokudibana nelindle (kunye neebhaktheriya ezivela kwindlela yokugaya ukutya), ezinokusasaza ii-CRE.
• Ukuba sele ulaliswe esibhedlele ixesha elide , ingakumbi ukuba ubusesibhedlele ngaphandle kwe-United States kwiinyanga ezintandathu ezidlulileyo. Nangona ii-CRE zisanda e-United States, zixhaphake kakhulu ngaphandle kwelizwe.

Ziziphi iingxaki ezinokubakho ze-`(CREs)`?

Ukuba oogqirha abakwazi ukulawula usulelo lwebhaktiriya ngee-antibiotics, lunokusasazeka emzimbeni wonke luze lubangele iingxaki ezibulalayo ezifana nokungasebenzi kakuhle kwamalungu omzimba. Le yeyona ngozi inkulu yosulelo lwe-CRE.

Ungayibona njani intsholongwane ethi `(CRE)`?

Ukuba uneempawu zosulelo lwebhaktiriya kwaye alupheli ngee-antibiotics, ugqirha wakho usenokucinga ukuba une-CRE infection. Emva koko baya kuthatha iisampulu emzimbeni wakho ukujonga iibhaktiriya. Ezi sampuli zingabandakanya:

• Igazi
• Umchamo
• Isitulo
• Ulwelo okanye izicubu ezivela enxebeni

Ilebhu inokufumanisa ukuba iintsholongwane ezikwezi sampuli zi-"CREs". Ungalibali ukuxelela ugqirha wakho ngazo naziphi na izixhobo zonyango ozifakileyo emzimbeni wakho okanye ukuba usandul' ukungena esibhedlele.

Ziphathwa njani ii-CRE?

Ukunyanga ii-CRE kunokuba nzima kuba ii-antibiotics ozisebenzisa rhoqo azisebenzi. Ngoko ke, ugqirha wakho unokukunika i-antibiotic eyahlukileyo. Okanye, banokukunika i-antibiotiki ye-carbapenem kunye nelinye iyeza elithintela i-enzyme ye-carbapenemase yebhaktheriya. Iilabhoratri zinokuvavanya amayeza ahlukeneyo ukuze zibone ukuba zeziphi ezisebenzayo kwi-CREs.

Iintlobo ze-`(Antibiotics)` ezisetyenziselwa ukunyanga `(CREs)`

Nazi ezinye iintlobo zee-antibiotics ezisetyenziswa ngoogqirha - nokuba zodwa okanye zidityaniswe - ukunyanga ii-CRE:

• `I-Polymyxin/i-Colistin`
• `I-Tigecycline`
• `I-Fosfomycin`
• Ii-Aminoglycosides (umz. i-gentamicin okanye i-tobramycin)
• `I-Rifampin`
• `I-Carbapenem` (ene-inhibitor)

La mayeza akhethwa ngokusekwe kwimeko yesigulana, uhlobo losulelo, kunye nendlela yokuxhathisa kwebhaktheriya.

Ingaba ingakanani ingozi yosulelo lwe-`(CRE)`?

Ii-CRE zinokubangela izifo ezinzima nezinzima ukuzinyanga. Abanye abantu bafumana izifo ezisongela ubomi. Ukuba unesifo se-CRE, uya kunyangwa esibhedlele apho abasebenzi bezonyango banokukubeka esweni ngokusondeleyo.

Ingakanani izinga lokubuyiselwa kwemali kwi-`(CRE)`?

Izifundo zibonisa ukuba izinga lokufa kwabantu abane-CRE liyahluka ngokuxhomekeke kwindawo oluye lwasuleleka kuyo usulelo. Umzekelo, izinga lokufa kwabantu abane-UTIs elibangelwa yi-CRE limalunga ne-13%, ngelixa izinga lokufa kwabantu abane-CREs ​​linokuba yi-50% nangaphezulu. Ukujonga ezi zibalo, ungabona ukuba oku kunokuba yingozi kangakanani, akunjalo?

Ngaba ii-CRE zingathintelwa?

Ababoneleli beenkonzo zempilo, njengoogqirha nabahlengikazi, balandela imithetho ekhethekileyo yokhuseleko kunye nokubulala iintsholongwane ukuthintela "izifo ezifunyenwe kunyango lwempilo" ezifana "nee-CRE." Ezi ziquka:

• Hlamba izandla zakho rhoqo.
• Ukubulala iintsholongwane kumphezulu.
• Qinisekisa ukuba amayeza okubulala iintsholongwane anikwa abantu abaneentsholongwane kuphela. (Amayeza okubulala iintsholongwane awancedi kwiintsholongwane.)
• Ukubulala iintsholongwane kwizixhobo zonyango.

Unokunceda ekuthinteleni usulelo lwe-CRE ngokuthi:

• Hlamba izandla zakho rhoqo nangokucokisekileyo. Oku kubaluleke kakhulu ukuba unyamekela umntu onenkqubo yomzimba yokuzikhusela ebuthathaka okanye umntu ofuna uncedo lokuhlamba okanye ukusebenzisa indlu yangasese.
• Ukuba kuye kwafuneka usebenzise izixhobo zonyango ezifakwe emzimbeni wakho, ezifana nee-catheters , buza ugqirha wakho ukuba kufuneka zigcinwe ixesha elingakanani endaweni yazo kunye nento omawuyenze ukuthintela usulelo ngelixa isixhobo sisebenza.

Ndifanele ndimbone nini ugqirha wam?

Ukuba unesixhobo sonyango esifakelweyo okanye ukuba inkqubo yakho yokuzikhusela yomzimba ibuthathaka, buza ugqirha wakho ukuba zeziphi iimpawu zosulelo ekufuneka uziqaphele. Ukuba uneempawu ezikrokrisayo, bona ugqirha.

Nokuba usesibhedlele, kubalulekile ukuba uhlale unxibelelana kakuhle neqela lakho lezonyango. Ukuba ufumana naziphi na iimpawu zosulelo, ezinje ngentlungu, ukubetha kwentliziyo ngokukhawuleza, ubuthathaka, okanye umkhuhlane, baxelele ngoko nangoko.

Ndingaya nini kwigumbi likaxakeka (ER)?

Ukuba uneempawu zesifo esinzulu, yiya kwigumbi likaxakeka. Iimpawu ziquka:

• Umkhuhlane ongaphezulu kwama-degrees Celsius angama-40 (ii-degrees Celsius ezingama-103).
• Intlungu ebuhlungu.
• Ukuxhuzula.
• Ukudideka okanye ukudideka.
• Ukwehla ngequbuliso koxinzelelo lwegazi (iimpawu: ubuthathaka, isiyezi, ukuquleka).

Ndingayibuza yiphi imibuzo ugqirha wam?

Kunganceda ukubuza ugqirha wakho imibuzo efana nale:

• Ziziphi iindlela zonyango endinazo?
• Ndingalindela nini ukuba ndiphile?
• Ndiyifumene njani le ntsholongwane?
• Ndingenza ntoni ukuthintela olu hlobo losulelo kwixesha elizayo?

Okokugqibela, izinto ekufuneka uzikhumbule (Umyalezo Wokuya Ekhaya)

Ii-Enterobacteriales ezinganyangekiyo yiCarbapenem (ii-CRE) luhlobo lweebhaktheriya ezinokubangela usulelo olukhulu olunzima ukunyanga. Yiyo loo nto ababoneleli bakho bezempilo besebenza nzima kangaka ukugcina izibhedlele kunye neendawo zokhathalelo lwexesha elide zicocekile kwaye zikhuselekile. Oogqirha kunye namagosa ezempilo eSri Lanka nabo bakulungele oku.