Ukutheleleka kwe-C. diff (Clostridioides difficile): Ake sazi kahle ukuthi lokhu buhlungu besisu kumayelana nani.

Ingabe ngezinye izikhathi uphathwa yisisu noma isifo sohudo esihlala izinsuku ezimbalwa? Sivame ukucabanga, 'O, lokhu kudla kumelwe ukuthi bekunobuthi kancane' noma 'Kumelwe ukuthi kuyigciwane lomkhuhlane.' Kodwa ngezinye izikhathi lezi zimpawu zingabangelwa ukutheleleka okungathi sína kwebhaktheriya okungalimaza amathumbu ethu. Enye yalezi zifo yi-C. diff (Clostridioides difficile).

Kuyini i-C. diff (Clostridioides difficile)?

Kalula nje, i-C. diff uhlobo lwebhaktheriya. Igama eliqondile lithi `(Clostridioides difficile)`. La mabhaktheriya angabangela ukutheleleka emathunjini akho amakhulu, okungukuthi, `(colon)`. Yilapho kuvela khona izimpawu ezingakhululekile ezifana nesifo sohudo. Manje, ake sibone, kuvamile ukuthi amathumbu ethu amakhulu athole ukutheleleka kwamagciwane. Iningi lawo alilibi kangako. Kodwa lokhu kutheleleka kwe-C. diff kuyingozi kakhulu. Isizathu ukuthi la mabhaktheriya `(Clostridioides difficile)` akhiqiza ubuthi. Lawa ma-toxin alimaza amaseli angaphakathi kwamathumbu ethu. Lokhu kubangela ukuvuvukala kolwelwesi lwamathumbu kanye namathumbu amakhulu, okungukuthi, ukuvuvukala (i-colitis). Ukuthi uthola izimpawu nokuthi zimbi kangakanani kuncike ebangeni lomonakalo odalwe yilawa ma-toxin. Ngezinye izikhathi lesi simo singaba yingozi ngisho nokuphila. La mabhaktheriya ayebizwa ngokuthi `(Clostridium difficile)` ngaphambilini. Manje igama elisha lithi `(Clostridioides difficile)`.

Kuvame kangakanani ukutheleleka kwe-C. diff?

Ukutheleleka kwe-C. diff, noma i-CDI, kuyinkinga yezempilo yomhlaba wonke. Kodwa-ke, azikho izibalo eziqondile zokuthi kusakazeke kangakanani emhlabeni. E-United States, kulinganiselwa ukuthi kunezifo ezingaba ngu-500,000 ngonyaka, kanye nokufa okungaba ngu-15,000. Ngakho-ke lokhu akuyona into okufanele ithathwe kalula.

Ziyini izimpawu zokutheleleka kwe-C. diff?

Uphawu lokuqala noluvame kakhulu uhudo olunamanzi. Ezimweni ezincane, uhudo luvela kathathu ngosuku, futhi kungase kube nokuqaqamba kwesisu. Njengoba ukutheleleka kwe-C. diff kuqhubeka, ukuvama kohudo kuyanda. Kungavela izikhathi ezifika kweziyi-10-15 ngosuku. Ungase futhi uqaphele igazi esitulweni sakho. Ezinye izimpawu zifaka:

• Ukuba nobuhlungu besisu obungapheli
• Isisu sigcwele futhi sivuvukele.
• Isicanucanu nokuhlanza
• Isifiso sokudla
• Imfiva
• Ukwanda kwesilinganiso senhliziyo

Ekuqaleni, izimpawu ze-C. diff zingase zizwakale njengokudla okunobuthi noma umkhuhlane wesisu. Uma uthatha ama-antibiotic, ungase uphambanise uhudo nomphumela omubi womuthi.

Kodwa khumbula, ngezinye izikhathi ukutheleleka kwe-C. diff kungenzeka ngaphandle kohudo .

Indle ibukeka kanjani uma une-C. diff? Inuka kanjani?

I-C. diff diarrhea ivame ukuba nokuvumelana okufana ne-paste, hhayi amanzi ngokuphelele. Ngezinye izikhathi ingaba luhlaza, kodwa lokhu kungenzeka nakwezinye izifo ezibangelwa amagciwane. Akuvamile, igazi, amafinyila, noma ubomvu kungabonakala endle. Abantu abaningi babika ukuthi i-C. diff diarrhea inephunga elihlukile . Bathi inamandla angavamile futhi inokunambitheka okumnandi ngendlela exakile. Lokhu kungenzeka ngoba i-C. diff inyusa amazinga e-bile acid endle.

Yini ebangela ukutheleleka kwe-C. diff?

Ngokuvamile, umuntu onesimiso somzimba sokuzivikela esinempilo ugcina amabhaktheriya e-C. diff elawulwa emathunjini akhe, ukuze angabangeli ukutheleleka. Inkinga iwukuthi lapho la mabhaktheriya eqala ukukhula kakhulu ngaphandle kokulawulwa okunjalo. Isizathu salokhu ukuthi ibhalansi phakathi kwamabhaktheriya "amahle" namabhaktheriya "amabi" emathunjini ethu iyalahleka. Wonke umuntu unebhaktheriya emathunjini akhe. Lawa mabhaktheriya amahle asiza ukugcina amanye amabhaktheriya afana ne-C. elawulwa. Isizathu esiyinhloko sokutheleleka kwe-C. diff ukusetshenziswa kwe-`(antibiotics)`. Lapho kusetshenziswa ama-antibiotic, ibhalansi phakathi kwamabhaktheriya amahle namabi emathunjini ethu (`(gut microbiome)` iyaphazamiseka. Khona-ke amabhaktheriya e-C. diff angaba namandla futhi akhule ngokweqile.

I-C. diff idluliselwa kanjani?

I-Clostridium difficile isakazwa ngokukhulula ama-spores. Lawa ma-spores mancane kakhulu futhi angatholakala esikhumbeni sethu, ezintweni ezisizungezile, nasezindaweni ezifana namatafula nezihlalo. Lokhu kusho ukuthi uma uthinta into enala ma-spores kuyo, bese udla ngayo noma uthinta umlomo wakho, ungathola i-C. diff.

Kungani i-C. diff isakazeka ngokushesha kangaka?

Ngaphandle kwemizimba yethu, amabhaktheriya e-C. diff akha ama-spores. Lawa ma-spores kunzima kakhulu ukuwabulala, ngaphakathi nangaphandle kwamathumbu. Amelana nokushisa, i-asidi, ama-antibiotic amaningi, kanye nezibulala-magciwane. Angaphila futhi ezindaweni izinyanga eziningi. Abacwaningi balinganisela ukuthi cishe u-5% wabantu banamabhaktheriya e-C. diff emathunjini abo ngaphandle kokubangela izimpawu. Lokhu kusho ukuthi noma ngabe une-C. diff elawulwayo, usengayisakaza kwabanye.

Ungakwazi yini ukuchitha isikhathi nomuntu one-C. diff?

Yebo, ungakwazi. Kodwa kuphela uma ulandela izinyathelo zokuphepha. Ukuze unciphise ukusabalala kokutheleleka, kufanele wenze okulandelayo:

• Geza izandla zakho kahle ngensipho njalo.
• Gwema ukuthinta ikhala lakho, umlomo, namehlo.
• Hlanza izindawo ezizungezile ngama-virus.
• Amagilavu, imaski yobusoSebenzisa izinto zokuzivikela, njengezingubo zokugqoka (ikakhulukazi uma unakekela isiguli).

Ubani osengozini enkulu yokuthola i-C. diff?

Kunezinye izimo zezokwelapha ezinganciphisa ukuzivikela komzimba wakho ekuthelelekeni nge-C. diff. Lezi zifaka:

• Isifo Samathumbu Esivuvukalayo ( IBD ): Izifo zamathumbu ezivuvukalayo ezingamahlalakhona, njengesifo sikaCrohn kanye nesifo sofuba esibangela ukuvuvukala, zenza amathumbu abe buthaka ngokuhamba kwesikhathi. Lezi zilimaza i-mucosa, ulwelwesi lwamathumbu, futhi zinciphise ukuzivikela kwamathumbu.
• Isimiso somzimba sokuzivikela esibuthakathaka: Uma unesifo sokuntuleka kwamasosha omzimba noma esinye isimo esingamahlalakhona esithinta isimiso somzimba wakho sokuzivikela, njengomdlavuza, i-HIV , isifo sezinso, noma isifo sikashukela, isimiso sakho somzimba sokuzivikela singase sibe buthaka, hhayi amathumbu akho kuphela. Lokhu kuyiqiniso ikakhulukazi uma uthatha imithi yokucindezela amasosha omzimba.

Ezinye izinto eziyingozi ezihlobene nokutheleleka kwe-C. diff zifaka:

• Ubudala: Abantu abangaphezu kweminyaka engama-65 basengozini enkulu yokuthola i-C. diff. Lokhu kungaba ngenxa yokuthi banesimiso somzimba esibuthakathaka, bathatha imithi eminingi ngesikhathi esisodwa, noma bahlala ezibhedlela noma emakhaya asebekhulile. Izingane ezincane nazo zingaba ne-C. diff.
• Ukulaliswa esibhedlela noma ezindaweni ezinabantu abaningi (isb., emajele): I-C. diff isakazeka kalula ezindaweni ezinabantu abaningi. Ama-spores angaphila izinyanga ezindaweni ezivamile. Angasakazeka kusuka komunye umuntu kuya komunye ngezindawo ezihlanganyelwe, njengezindlu zangasese.

Kodwa ngezinye izikhathi asikho isizathu esicacile sokutheleleka kwe-C. diff. Nakuba kunezici eziningi ezingathinta amasosha omzimba wakho, kubalulekile ukwazi ukuthi ungayithola le gciwane ngisho nangaphandle kwezinto eziyingozi .

Yiziphi izinkinga ezingaba khona ngenxa yokutheleleka kwe-C. diff?

Izinkinga zingavela ngokutheleleka okukhulu kakhulu. Ukuthi ukutheleleka kwakho kubi kangakanani kuncike ezintweni eziningana, okuhlanganisa uhlobo lwamagciwane otheleleke ngawo, kanye namandla esimiso sakho somzimba sokuzivikela. Abantu abanezici eziyingozi zokutheleleka yi-C. diff basengozini enkulu yokuthola ukutheleleka okukhulu noma ukutheleleka okuphindaphindiwe. Lokhu kungabangela umonakalo omkhulu ngokuhamba kwesikhathi. Izinkinga ezivamile zifaka:

• Ukutheleleka okuphindaphindiwe: Cishe abantu abangu-20% baphinde bahlaselwe yilesi sifo zingakapheli amasonto amabili kuya kwayisishiyagalombili ngemva kokuqeda ukwelashwa. Ngemva kwalokho, abanye abangu-40% bangase bahlaselwe yiso futhi.
• Ukuphelelwa amanzi emzimbeni kanye nokulahlekelwa ama-electrolyte:Uma ulahlekelwa uketshezi nama-electrolyte emzimbeni wakho ngokushesha kunalokho ongakufaka esikhundleni sako, ungaba nemiphumela emibi eyingozi njengomthamo wegazi ophansi, umfutho wegazi ophansi, ngisho nokwehluleka kwezinso ezimweni ezimbi kakhulu.
• I-Pseudomembranous colitis: Lolu uhlobo olubi kakhulu lwe-colitis. Lungabangela ukwakheka koqweqwe olukhulu nolunamaqhubu olwelwesini lwekholoni lakho.

Njengoba umonakalo obangelwa ubuthi emathunjini ukhula, kungase kube nezinkinga ezengeziwe:

• Ukuvuza koketshezi: Uketshezi lungase luqale ukuvuza lusuka ku-colon yakho luye emgodini wesisu sakho (lokhu kubizwa ngokuthi i-ascites), okubangela ukuthi isisu sakho sivuvuke. Ungase futhi ulahlekelwe yiprotheni evela ku-colon yakho, okubangela ukuthi amazinga akho e-albhamuin ehle. Lokhu kungabangela izimpawu ezifana nokuvuvukala nokukhathala.
• I-Reactive arthritis: Ukutheleleka okukhulu kungabangela isimo esibizwa ngokuthi "i-reactive arthritis." Lokhu kungabangela ukuvuvukala, ukuvuvukala, kanye nobuhlungu emalungeni akho nakwezinye izingxenye zomzimba wakho.
• I-megacolon enobuthi: I-megacolon enobuthi iyisimo esingavamile kodwa esiyingozi kakhulu. Lokhu kwenzeka lapho ukuvuvukala okubangelwa ukuvuvukala kuba kubi kakhulu kangangokuthi ikholoni iba yinto engasebenzi kahle. Lokhu kungagcina kuholele ku-sepsis (ubuthi egazini).

Kutholakala kanjani ukutheleleka kwe-C. diff?

Uma udokotela wakho esola ukuthi unegciwane le-C. diff ngokusekelwe ezimpawini zakho, uzothatha isampula yendle yakho ayithumele elebhu ukuze ahlole ubuthi be-C. diff. Uma imiphumela yokuhlolwa kwakho ikhombisa ukuthi unaleli gciwane, udokotela wakho angenza ezinye izivivinyo ukuthola ukuthi lingakanani. Lokhu kungafaka ukuhlolwa kwegazi kanye nokuhlolwa kwezithombe ukuze kubhekwe ngaphakathi kwekholoni lakho.

Ilashwa kanjani i-C. diff infection?

Ukutheleleka kwe-C. diff kwelashwa kuye ngokuthi kungakanani. Uma unesifo se-C. diff ngenkathi uthatha ama-antibiotic, udokotela wakho angase aqale ayeke ukuthatha imithi. Kwabanye abantu, yilokho kuphela okudingekayo. Isimiso sabo somzimba sokuzivikela esingokwemvelo sizoqala ukusebenza futhi silawule ukutheleleka. Uma kungenjalo, udokotela wakho angase akunikeze ezinye izinhlobo zama-antibiotic angavimba i-C. diff. Ezinye izinhlobo zama-antibiotic e-C. diff zifaka:

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

Uma unesifo esincane, ungaya ekhaya uyothatha imithi yakho. Iningi labantu liqala ukuba ngcono ezinsukwini ezimbalwa. Kodwa uma isifo sibi kakhulu, kuzodingeka uhlale esibhedlela. Esibhedlela, udokotela wakho uzokunikeza ama-antibiotic, mhlawumbe ngomthambo (IV - ngemithambo). Bazokunikeza nezinto ezifana nosawoti ukuvimbela ukuphelelwa amanzi emzimbeni. Kwezinye izimo, umuthi unganikezwa ngqo kumathumbu amakhulu njenge-enema.

Yini okufanele uyenze ngezifo eziyinkimbinkimbi ze-C. diff?

Uma unezinkinga ezinkulu, ungadinga ukwelashwa egunjini lokunakekelwa okujulile. Akuvamile kakhulu, odokotela bangase batuse ukuhlinzwa okuphuthumayo (i-colectomy) ukuze kususwe umthombo wokutheleleka emathunjini akho. Uma ululama kodwa uqhubeka nokuthola izifo eziphindaphindayo ngemva kokwelashwa, izinketho zakho yilezi:

• Ukwelashwa ngama-antibiotic futhi: Udokotela wakho angakunika umuthi ohlukile, noma umuthi ofanayo isikhathi eside. Ngemva kwama-antibiotic, udokotela wakho angancoma nokuthi uthathe ama-probiotics ukusiza ekubuyiseleni amagciwane emathunjini akho.
• Ukufakelwa Kwe-Fecal Microbiota (FMT): Le ndlela iboniswe ukuthi iyasebenza kakhulu ekuvimbeleni ukutheleleka kwe-C. diff okuphindaphindiwe ngemva kokuthi ukwelashwa okuphindaphindiwe ngama-antibiotic kuhlulekile. Kuhilela ukudlulisa isampula yendle kusuka kumuntu ophilile iye kumathumbu amakhulu agulayo. Le sampula isetshenziselwa ukulinganisa kabusha i-microbiome yamathumbu akho. Cabanga ngakho njengokufaka inhlabathi enhle engadini enezitshalo ezimbi nokutshala izitshalo ezinhle.

Yiziphi izinyathelo zokuphepha ezingathathwa ukuvimbela ukusabalala kwe-C. diff?

Izisebenzi zezempilo zithatha izinyathelo zokuphepha ezikhethekile lapho zibhekene nokutheleleka kwe-C. diff ukusiza ekuvimbeleni ukusabalala kwalesi sifo esithelelanayo kakhulu. Ungalandela isibonelo sabo ukuze uvikele abanye:

• Ukuzihlukanisa: Uma unesifo, kungcono ukuzihlukanisa ekamelweni lakho. Noma ubani oza ekamelweni ukuzokunakekela kufanele agqoke amagilavu ​​​​angasetshenziswa, futhi kufanele awasuse lapho ephuma ekamelweni. Njengoba isifo sisakazeka ngendle yakho, kufanele ugweme ukwabelana ngezindlu zangasese nabanye abantu. Uma kufanele ngempela wabelane, hlanza isibambo, isihlalo sendlu yangasese, nendawo ezungezile ngesihlanzi esine-bleach ngemva kokuyisebenzisa.
• Ukugeza izandla: Ngenxa yokuthi i-C. diff ayithintwa yi-sanitizer yezandla, kubalulekile ukugeza izandla zakho njalo ngensipho namanzi ashisayo. Lokhu kubalulekile kuwo wonke umuntu ohlangana naye.
• Ukubulala amagciwane: Izibulali magciwane ezivame kakhulu azisebenzi ku-C. diff. Kodwa imikhiqizo equkethe i-bleach ingakwazi. Kubalulekile ukubulala amagciwane kunoma yiziphi izindawo ozithintayo, ikakhulukazi endlini yokugezela.
• Ukuthatha ama-antibiotic njengoba kuyalelwe: Ungathathi ama-antibiotic abanye abantu, futhi ungagcini ama-antibiotic ukuze uwasebenzise kamuva.

Yini ongayilindela uma uthola i-C. diff?

Iningi lezifo ze-C. diff lithambile futhi liyaphela ngokwelashwa. Kodwa-ke, izimo ezibangela ukutheleleka kwe-C. diff ngezinye izikhathi zingasakazeka ngokushesha okukhulu. Ukutheleleka kwe-C. diff kungavela ngokuzumayo futhi kube kubi kakhulu. Uma unezici eziyingozi zokutheleleka kwe-C. diff, kungenzeka ukuthi ube nokutheleleka okubi kakhulu, noma ungase ube nezifo eziphindaphindayo ezidinga ukwelashwa okwengeziwe.

Ingabe i-C. diff iyanyamalala yodwa?

Yebo, uma amabhaktheriya akho aphilile esiswini engabuyela esimweni esijwayelekile futhi alwe nawo, ungase ube ngcono ngokwakho. Lokhu kungenzeka kakhulu uma amabhaktheriya akho amathumbu ngokuvamile enamandla futhi ungenazo izinkinga zempilo zesikhathi eside eziwenza abe buthaka. Uma ukutheleleka kubangelwe ukuthatha ama-antibiotic, ungase ube ngcono uma uyeka ukuwathatha. Kodwa ungalindi isikhathi eside. Uma ungazizwa ungcono ezinsukwini ezimbalwa, bona udokotela ngokushesha.

Uma usuthole i-C. diff, ingabe ihlala ikhona?

Ngemva kokwelashwa, amanye amabhaktheriya angase asale. Kodwa ungahlala isikhathi esithile ngaphandle kokuthola ukutheleleka. Uma nje amabhaktheriya amahle asemathunjini ehlala, azosiza ukulawula iClostridium difficile. Uma uthola ukutheleleka okuphindaphindiwe, kungenxa yokuthi lawa amanye amabhaktheriya awakabuyeli esimweni esijwayelekile. Ukutheleleka okuphindaphindiwe kungaba ukuphinda kokutheleleka kokuqala, kodwa akunjalo ngaso sonke isikhathi. Ngezinye izikhathi kuba ukutheleleka okusha.

Ingabe zikhona izinkinga zesikhathi eside ngemva kokutheleleka nge-C. diff?

Inkinga evame kakhulu yesikhathi eside ukutheleleka okuqhubekayo noma okuphindaphindiwe nge-Clostridium difficile. Lokhu kwenzeka lapho ikholoni yakho inobunzima bokuphulukiswa ngokuphelele. Ikholoni yakho ingase yephuze ukuphulukiswa ngenxa yalezi zizathu:

• Uma unesifo esibi kakhulu esonakalisa ulwelwesi lwamathumbu akho.
• Uma kwadingeka uthathe ama-antibiotic isikhathi eside, noma uma kwadingeka uthathe ama-antibiotic e-C. diff ngemva kokuthatha amanye ama-antibiotic.
• Uma unesifo sempilo sesikhathi eside esithinta amathumbu akho noma amasosha omzimba.
• Uma uneminyaka engaphezu kwengu-65 ubudala.

Akuvamile ukuthi abanye abantu babe nezinkinga zokuzivikela komzimba ngemva kokutheleleka okukhulu. Lokhu kusho ukuthi amasosha omzimba abo aqhubeka nokusebenza sengathi kukhona ukutheleleka, ngisho nangemva kokuba ukutheleleka sekuphelile. Izinkinga zokuzivikela komzimba eziqala ngemva kokutheleleka kwe-C. diff zifaka phakathi i-IBS (i-irritable bowel syndrome) kanye ne-reactive arthritis.

Yimiphi imibuzo okufanele uyibuze udokotela wakho mayelana nokutheleleka kwe-C. diff?

Ungabuza imibuzo efana nale:

• Kubi kangakanani ukutheleleka kwami?
• Ingabe ngisengozini yezinkinga?
• Ngingazi kanjani ukuthi i-C. diff iyathuthuka?
• Kufanele ngikushayele nini ucingo? Kufanele ngiye nini egumbini lezimo eziphuthumayo?
• Ingabe ngidinga ukubona udokotela wezifo zamathumbu?
• Yiziphi izindlela zokwelapha izifo eziphindaphindayo?

I-Clostridium difficile yibhaktheriya evamile engahlala emathunjini akho ngaphandle kokubangela umonakalo. Kodwa uma iqala ukuba namandla kakhulu, ingaba yingozi kakhulu. Ungase uzizwe ukhathazekile ngokuba nesifo sohudo ngaso sonke isikhathi nokuthi sithinta kanjani impilo yakho. Ungase uzizwe unamahloni ukukhuluma ngesimo esithinta ukuhamba kwakho kwamathumbu. Kodwa ungavumeli leyo mizwa ikuvimbele ekufuneni usizo.Iningi labantu alibi nezinkinga ezivela ku-C. diff, futhi iphela ngokushesha nangokuphelele. Kodwa uma usengozini enkulu ngenxa yezici ezithile eziyingozi, ingaba nzima kakhulu. Iphinde ithelelane kakhulu, ingaqhubeka, futhi ingabuya kaninginingi. Uma unesifo sohudo ngemva kokuthatha ama-antibiotic, tshela udokotela wakho ngokushesha. Ungayithathi imithi evimba isifo sohudo, ngoba ngeke isize futhi ingase isenze sibe sibi nakakhulu. Uma usola ukuthi une-C. diff, bona udokotela ngokushesha.

Ngakho-ke, yiziphi izinto okufanele sizikhumbule kule ndaba?

I-C. diff iyibhaktheriya engabangela ukutheleleka emathunjini ethu amakhulu. Lokhu kubangela izimpawu ezifana nesifo sohudo kanye nobuhlungu besisu.

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Lokhu kuvame ukwenzeka lapho ama-antibiotic ebulala amabhaktheriya amahle emathunjini, okuvumela i-C. diff ukuba ikhule.

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Lokhu kuyathelelana kakhulu, ngakho-ke ukugeza izandla zakho nokunakekela inhlanzeko kubaluleke kakhulu.

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Abantu asebekhulile, labo abanezivikeli mzimba ezibuthakathaka, kanye nalabo abalaliswe esibhedlela banamathuba amaningi okuthola lokhu.

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Uma unezimpawu, funa iseluleko sezokwelapha ngokushesha. Ngoba, uma welashwa kahle, ungalulama kaningi. Kodwa-ke, uma ungelashwa, kungaba nezinkinga.

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Kubalulekile ukuthatha imithi yakho njengoba nje udokotela wakho ekuyalele futhi ngesikhathi.

Ngakho-ke, ngithemba ukuthi lolu lwazi luwusizo kuwe. Hlala uphilile!