Uyalwazi lolu hlobo lwebhaktheriya olubi? (Ama-Enterobacteriale Amelana Ne-Carbapenem - CREs) Ake sixoxe!

Cishe uke wezwa ukuthi imithi enikezwa odokotela yezifo ezithile, okungukuthi, `(ama-antibiotic)` ngezinye izikhathi ayisebenzi. Leso ngesinye sezimo eziyingozi neziphathelene esizokhuluma ngazo namuhla, ukutheleleka kwamagciwane okuthi `(Carbapenem-Resistant Enterobacteriales)` noma `(CREs)`. Lokhu kungase kungaphenduli kwezinye ze-`(ama-antibiotic)` ezinamandla ezivame ukunikezwa. Ngakho-ke, yize lokhu kuyindaba engathi sína, kubaluleke kakhulu kithi sonke ukuqaphela lokhu. Ake siqonde nje ukuthi kwenzekani.

Ziyini `(Carbapenem-Resistant Enterobacteriales)` noma `(CREs)`?

Kalula nje, `(Enterobacteriales)` yiqembu lamabhaktheriya ahlobene, njengomndeni ofanayo. Lawa mabhaktheriya angabangela izifo ezahlukahlukene emizimbeni yethu. Manje, la mabhaktheriya `(Enterobacteriales)` ngezinye izikhathi abonisa ukumelana ne-`(antibiotic)` ekhethekile, enamandla ebizwa ngokuthi `(Carbapenems). Lawo mabhaktheriya `(Enterobacteriales)` amelana ne-`(Carbapenems)` yilokho esikubiza ngokuthi `(Carbapenem-Resistant Enterobacteriales)` noma `(CREs)`.

Cabanga ngakho, odokotela basebenzisa `(ama-antibiotic)` ukwelapha izifo ezibangelwa amagciwane. Kodwa, lawa magciwane ahlakaniphile kakhulu. Uma ehlala evezwa `(ama-antibiotic)` (ikakhulukazi esibhedlela noma ekhaya labagugile), athola izindlela zokusinda nokusinda ngokumelene nalawo `(ama-antibiotic). Yilokhu esikubiza ngokuthi `(ukumelana) . Ngakho `(ama-CRE)` angamabhaktheriya aseye amelana nesigaba `(i-Carbapenem)` se`(ama-antibiotic)`.

Kunezinhlobo eziningana zemithi engaphansi kwalolu hlobo lwama-antibiotic abizwa ngokuthi "i-Carbapenems":

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

Lawa ngama-antibiotic anamandla avame ukunikezwa ezifweni ezinkulu. Ngakho-ke uma igciwane liba namandla okumelana nalokhu, kusho ukuthi ukutheleleka kuba nzima ukukwelapha.

Yiziphi izinhlobo zamagciwane (ama-Enterobacteriales)?

Abanye abantu basebenzisa isifinyezo esithi `(CRE)` ukusho `(Carbapenem-resistant Enterobacteriaceae)`, kanti abanye basebenzisa `(Carbapenem-resistant Enterobacteriaceae)`. `(Enterobacteriale)` uhlobo olukhulu oluqukethe izinhlobo eziningi ezahlukene zamagciwane. Lunemindeni emithathu, noma ama-suborder. Elinye lala ma-suborder yi-`(Enterobacteriaceae).` Leli qembu elithi `(Enterobacteriaceae)` yilapho amabhaktheriya esivame ukuzwa ngawo etholakala khona:

• `I-Escherichia` (eyaziwa kakhulu kithi ngokuthi `i-E. coli`)
• `Klebsiella`
• `I-Salmonella`
• `I-Shigella`

Ama-CRE avame kakhulu izinhlobo ze-Klebsiella pneumoniae kanye ne-E. coli ezingamelani namagciwane. Kubalulekile ukukhumbula ukuthi ngenxa yokuthi unesifo i-Klebsiella noma i-E. coli, akusho ukuthi ayimelani namagciwane.

Yiziphi izifo ezibangelwa yi-`(CREs)`?

La mabhaktheriya "(ama-CRE)" angabangela ukutheleleka ezingxenyeni eziningi ezahlukene zomzimba wakho. Lokhu kutheleleka kuvame ukubonakala ku:

• Egazini(Ukutheleleka kwegazi)
• Ukutheleleka komgudu womchamo (UTI)
• Emaphashini (i-pneumonia)
• Isisu (ithumba elingaphakathi kwesisu)

Kusezindaweni ezinjengalezi lapho la magciwane angafihla khona kalula angabangela khona izifo.

Zivame kangakanani izifo ze-`(CRE)`?

Uma ubheka izibalo zezwe elifana ne-United States, kubikwa izifo ezingaba ngu-13,000 minyaka yonke ngenxa ye-"(CREs).`` Cishe eziyi-1,100 zazo ziyafa. Odokotela baseSri Lanka nabo bayasinaka lesi simo. Ngoba amagciwane anjalo amelana namagciwane aba yinkinga emhlabeni wonke.

Ziyini izimpawu zokutheleleka kwe-`(CRE)`?

Izimpawu ze-`(Carbapenem-resistant Enterobacteriales)` ziyahlukahluka kuye ngokuthi unesifo sini. Ezinye izimpawu ezivamile zingafaka:

• Imfiva
• Ukugodola
• Ubunzima bokuphefumula
• Ukukhwehlela
• Ubuhlungu besisu
• Ubuhlungu lapho uchama
• Ubomvu, ukuvuvukala, kanye nokulunywa endaweni yokuhlinzwa noma inxeba

Okubalulekile: Lezi zimpawu azigcini nje ekuthelelekeni kwe-`(CRE)`. Ezinye izifo ezibangelwa amagciwane nazo zingadala lezi zimpawu. Ngakho-ke, uma uhlangabezana nanoma yiziphi zalezi zimpawu, kungcono ukubona udokotela.

Yiziphi izimbangela zokutheleleka kwe-`(CRE)`?

Kalula nje, ukutheleleka kwe-`(CRE)` kubangelwa amagciwane amelana ne-`(antibiotics)` ebizwa ngokuthi `(Carbapenem)`. Kunezizathu ezahlukahlukene ezenza amagciwane athuthukise lokhu kumelana ne-`(antibiotic)`. Esinye yindlela aguquke ngayo ukuze ahlale ndawonye nezinye izinto eziphilayo emvelweni.

Ezibhedlela nakwezinye izindawo zokunakekelwa kwempilo, amabhaktheriya ahlala evezwa kuma-antibiotic. Ikakhulukazi njengoba ama-antibiotic anamandla njenge-carbapenems esetshenziselwa ukwelapha izifo ezingathi sína, amabhaktheriya anethuba lokuthuthukisa izindlela zokumelana nawo. Lawa mabhaktheriya anekhono elimangalisayo lokudlulisela izakhi zofuzo zawo zokumelana kwamanye amabhaktheriya . Lokhu kubizwa ngokuthi ukudluliselwa kwezakhi zofuzo okuvundlile. Njengokutshela umngane imfihlo, lawa mabhaktheriya abelana ngokumelana kwawo nabanye. Ngaphandle kwalokho, amabhaktheriya asinda kuma-antibiotic angadlulisela izakhi zofuzo zawo zokumelana, adale amabhaktheriya amaningi amelana nawo.

Enye yezindlela eziyinhloko amabhaktheriya amelana ngazo ne-`(CRE)` ukukhiqiza i-enzyme ebizwa ngokuthi `(Carbapenemase)`. Le enzyme iyabhidliza futhi ibhubhise `(ama-antibiotic e-Carbapenem)`. Le enzyme yenza umsebenzi ofanayo nokusika umuthi ngesikele esincane. Ngemuva kwalokho umuthi awusebenzi.

Ama-CRE adluliselwa kanjani?

Ama-bacterium e-Enterobacteriales amelana ne-carbapenem angaphila esikhumbeni sakho noma emgudwini wakho wesisu (amathumbu) ngaphandle kokukugulisa. Lokhu kubizwa ngokuthi i-colonization.Ama-CRE angadluliselwa kumuntu ogulayo onegciwane le-CRE, noma kumuntu ohlala naleli gciwane ngaphandle kwezimpawu.

Usengozini enkulu yokuthola ukutheleleka nge-`(CRE)` esibhedlela noma kwenye indawo yokunakekelwa kwempilo. Lokhu kungenxa yokuthi amagciwane ahlala ngokwemvelo esikhumbeni sethu nasemizimbeni yethu angaba namandla okumelana nama-antibiotic ngokuwachayeka kuwo. Ungathola ukutheleleka nge-`(CRE)` ngezindlela ezilandelayo:

• Ngokuthinta umuntu onegciwane esikhumbeni sakhe (isibonelo, uma lowo muntu engagezanga izandla zakhe kahle).
• Ukusuka ezindaweni ezingcolile , ikakhulukazi amasinki nezindlu zangasese.
• Kusukela emishinini yezokwelapha engcolile kanye namadivayisi ezokwelapha afakwe emzimbeni wakho (isb., umugqa ophakathi wemithambo yegazi, ipayipi lokuphefumula).

Ubani osengozini enkulu yokutheleleka nge-`(CRE)`?

Ungase ube sengozini enkulu yokuthola ukutheleleka kwe-`(CRE)` uma:

• Uma unomugqa ophakathi wemithambo yegazi (ithubhu elifakwe emthanjeni oyinhloko), ithubhu lokuphefumula, ithubhu lokuphakela, noma elinye ithubhu noma idivayisi efakwe emzimbeni wakho, ama-CRE angangena emzimbeni wakho evela ngaphandle ngalezi zinto.
• Uma usuthathe ama-antibiotic isikhathi eside noma uma uwathatha njalo, kungenzeka ukuthi amabhaktheriya azokhula ukumelana nawo ngokuhamba kwesikhathi. Lokhu kungabulala amabhaktheriya "amahle" (angenabungozi) emathunjini ethu, okuvumela amanye amabhaktheriya ukuba akhule ngokungalawuleki futhi abangele ukutheleleka.
• Uma unesifo esingaqondakali esibangela ubuthakathaka bamasosha omzimba wakho . Isibonelo, uma une-HIV, umdlavuza wegazi, isifo sikashukela, noma uke wafakelwa isitho noma wafakelwa i-stem cell, usengozini enkulu. Lokhu kungenxa yokuthi kunzima ngomzimba ukulwa nezifo ngaphansi kwalezi zimo.
• Uma udinga usizo ngemisebenzi yansuku zonke, njengokugeza nokusebenzisa indlu yangasese , ungase ube sengozini enkulu yokuthintana nendle (namagciwane avela endleleni yokugaya ukudla), angasakaza ama-CRE.
• Uma usuhlale esibhedlela isikhathi eside , ikakhulukazi uma ubusesibhedlela esingaphandle kwe-United States ezinyangeni eziyisithupha ezedlule. Nakuba ama-CRE anda e-United States, avame kakhulu ngaphandle kwezwe.

Yiziphi izinkinga ezingaba khona ze-`(CREs)`?

Uma odokotela bengakwazi ukulawula ukutheleleka ngamagciwane ngama-antibiotic, kungasakazeka emzimbeni wonke futhi kubangele izinkinga ezibulalayo njengokwehluleka kwezitho zomzimba. Lena ingozi enkulu yokutheleleka nge-CRE.

Ungayibona kanjani igciwane elithi `(CRE)`?

Uma unezimpawu zokutheleleka ngamagciwane futhi kungaqedi ngama-antibiotic, udokotela wakho angase acabange ukuthi unesifo se-CRE. Uzobe esethatha amasampula emzimbeni wakho ukuze ahlole amagciwane. Lawa masampula angafaka:

• Igazi
• Umchamo
• Isihlalo
• Uketshezi noma izicubu ezivela esilondeni

Ilabhorethri inganquma ukuthi amabhaktheriya akulezi zibonelo angama-"CREs". Ungakhohlwa ukutshela udokotela wakho nganoma yimaphi amadivayisi ezokwelapha owafakile emzimbeni wakho noma uma usanda kulaliswa esibhedlela.

Iphathwa kanjani i-CRE?

Ukwelapha ama-CRE kungaba nzima ngoba ama-antibiotic ovame ukuwasebenzisa awasebenzi. Ngakho-ke, udokotela wakho angakunika i-antibiotic ehlukile. Noma, angakunika i-antibiotiki ye-carbapenem kanye nomunye umuthi ovimbela i-enzyme ye-carbapenemase yamagciwane. Ama-laboratories angahlola imithi ehlukene ukuze abone ukuthi yimiphi esebenza kuma-CRE.

Izinhlobo `(Ama-antibiotic)` asetshenziswa ukwelapha `(ama-CRE)`

Nazi ezinye izinhlobo zama-antibiotic odokotela abazisebenzisayo – zodwa noma zihlanganisiwe – ukwelapha ama-CRE:

• `I-Polymyxin/i-Colistin`
• `I-Tigecycline`
• `I-Fosfomycin`
• Ama-aminoglycosides (isib. i-gentamicin noma i-tobramycin)
• `I-Rifampin`
• `I-Carbapenem` (ene-inhibitor)

Le mithi ikhethwa ngokusekelwe esimweni sesiguli, uhlobo lokutheleleka, kanye nendlela yokumelana kwamagciwane.

Kuyingozi kangakanani ukutheleleka kwe-`(CRE)`?

Ama-CRE angabangela izifo ezingathi sína, okunzima ukuzelapha. Abanye abantu bathola izifo ezisongela ukuphila. Uma uthola ukutheleleka kwe-CRE, uzolashwa esibhedlela lapho abasebenzi bezokwelapha bengakuqapha khona eduze.

Lingakanani izinga lokutakula kusuka ku-`(CRE)`?

Izifundo zibonisa ukuthi izinga lokufa kwama-CRE liyahlukahluka kuye ngokuthi ukutheleleka kwenzeka kuphi. Isibonelo, izinga lokufa kwama-UTI abangelwa yi-CRE licishe libe ngu-13%, kanti izinga lokufa kwama-CRE abangelwa yi-CRE lingaba ngu-50% noma ngaphezulu. Uma ubheka lezi zibalo, ungabona ukuthi lokhu kungaba yingozi kangakanani, akunjalo?

Ingabe ama-CRE angavinjelwa?

Abahlinzeki bezempilo, njengodokotela nabahlengikazi, balandela imithetho ekhethekile yokuphepha kanye nokubulala inzalo ukuvimbela "ukutheleleka okutholakala ekunakekelweni kwezempilo" njenge "CREs." Lokhu kufaka phakathi:

• Geza izandla zakho njalo.
• Ukubulala amagciwane ezindaweni.
• Qinisekisa ukuthi ama-antibiotic anikezwa abantu abanezifo ezibangelwa amagciwane kuphela. (Ama-antibiotic awasizi ekuthelelekeni ngegciwane.)
• Ukubulala amagciwane kwemishini yezokwelapha.

Ungasiza futhi ekuvimbeleni ukutheleleka kwe-CRE ngokuthi:

• Geza izandla zakho njalo nangokuphelele. Lokhu kubaluleke kakhulu uma unakekela umuntu onesimiso somzimba esibuthakathaka noma umuntu odinga usizo lokugeza noma ukusebenzisa indlu yangasese.
• Uma kudingeke ukuthi usebenzise amadivayisi ezokwelapha afakwa emzimbeni wakho, njenge-catheter , buza udokotela wakho ukuthi kufanele agcinwe isikhathi esingakanani endaweni yawo nokuthi yini okufanele uyenze ukuvimbela ukutheleleka ngenkathi idivayisi isendaweni yawo.

Kufanele ngimbone nini udokotela wami?

Uma unedivayisi yezokwelapha efakiwe noma uma amasosha omzimba wakho ebuthaka, buza udokotela wakho ukuthi yiziphi izimpawu zokutheleleka okufanele uziqaphele. Uma unezimpawu ezisolisayo, bona udokotela.

Ngisho noma usesibhedlela, kubalulekile ukugcina ukuxhumana okuhle nethimba lakho lezokwelapha. Uma uhlangabezana nanoma yiziphi izimpawu zokutheleleka, njengobuhlungu, ukushaya kwenhliziyo okusheshayo, ubuthakathaka, noma umkhuhlane, batshele ngokushesha.

Kufanele ngiye nini egumbini lezimo eziphuthumayo (ER)?

Uma unezimpawu zokugula okukhulu, iya ekamelweni eliphuthumayo. Izimpawu zifaka:

• Umkhuhlane ongaphezu kwama-degrees Celsius angu-40 (ama-degrees Celsius angu-103).
• Ubuhlungu obukhulu.
• Ukuquleka.
• Ukudideka noma ukudideka.
• Ukwehla okungazelelwe komfutho wegazi (izimpawu: ubuthakathaka, isiyezi, ukuquleka).

Yimiphi imibuzo okufanele ngiyibuze udokotela wami?

Kungaba usizo ukubuza udokotela wakho imibuzo efana nale:

• Yiziphi izindlela zokwelapha enginazo?
• Ngingalindela nini ukuthi ngilulame?
• Ngithole kanjani lokhu kutheleleka?
• Yini engingayenza ukuze ngivimbele lolu hlobo lokutheleleka esikhathini esizayo?

Okokugcina, izinto okufanele uzikhumbule (Umyalezo Wokuya Ekhaya)

Ama-Enterobacteriale (ama-CRE) angamelana ne-Carbapenem awuhlobo lwamagciwane angabangela ukutheleleka okukhulu okunzima ukwelapha. Yingakho abahlinzeki bakho bezempilo besebenza kanzima kangaka ukugcina izibhedlela nezindawo zokunakekelwa zesikhathi eside zihlanzekile futhi ziphephile. Odokotela nezikhulu zezempilo eSri Lanka nabo baqaphile ngalesi simo.