Bakiteriya Clostridium difficile

Mabakiteriya Clostridium zovuta moyo mu thupi la munthu aliyense. Ali ndi chizoloŵezi cha kubalana kwambiri, chifukwa cha zomwe zimakhala zoopsa, chifukwa zimapeza mavitamini ndipo zimayambitsa matenda ena. Akufuna kukakamiza anaerobes ndipo akhoza kukhala popanda oxygen. Zimakhudzidwa ndi ntchito ya njira zofunika kwambiri, monga mapuloteni ogawanika, kukondoletsa ndi kutulutsa matumbo.

Kodi Clostridium Difficile N'chiyani?

Mawu akuti "clostridium" mu Chirasha amatanthawuza "kusungunula". Dzina lofanana ndi tizilombo toyambitsa matenda linatengedwa chifukwa cha kutupa kwapakatikati pakati pa mapangidwe a spore. Mabakiteriya ambiri amatha kukhala ndi mawonekedwe a fosholo. Iwo agawidwa mu mitundu inayi:

• Clostridium botulinum, ndi wothandizira causulism;
• Clostridium tetanum, imathandizira maonekedwe a tetanasi;
• Clostridium perfrigence, imakhudza kuchitika kwa anaerobic matenda;
• Clostridium diffifile, amachititsa pseudomembrane colitis.

Clostridium ili ndi mawonekedwe ofanana ndi ndodo. Zingakonzedwe mu unyolo ndi pawiri. Ndikokwanira. Pomwe pali mpweya wokwanira, umayamba kuchulukitsa. Tizilombo toyambitsa matenda timapanga tizilombo toyambitsa matenda, zomwe zimapangitsa kuti azipewa mankhwala osokoneza bongo, kutenthetsa ndi mankhwala osiyanasiyana ophera tizilombo toyambitsa matenda. Mtsutso waukulu uli ngati mawonekedwe, ndipo malo omwe ali pomwepo ndi mawonekedwe a ng'anjo.

Clostridium imayambitsa matenda otsekula m'mimba kuchokera ku maantibayotiki. Kawirikawiri amakhala m'mimba ya m'mimba. Ndi thanzi labwino, tizilombo toyambitsa matenda timathandizira kukula kwa bakiteriya. Pambuyo pogwiritsira ntchito maantibayotiki, mabakiteriya opindulitsa amakhala ochepa, ndipo chiwerengero cha Clostridium chimakula, chomwe chingayambitse maonekedwe a colitis, chifukwa cha matenda aakulu komanso imfa ya munthu. Izi ndizo makamaka makamaka okalamba ndi ofooka odwala.

Mitundu yonse ya clostridia imaoneka ngati poizoni yomwe imayambitsa maonekedwe ena. Chifukwa cha kubereka kwake, zimapanga poizoni wa A ndi B Clostridium. Choyamba chimatchedwa enterotoxin, ndipo chachiwiri chimatchedwa cytotoxin. Ndizo zimayambitsa kutsekula m'mimba komanso kutupa pakati pa anthu ambiri.

Matenda opatsirana

Nthawi zambiri maselo a clostridium amakhala m'mzipatala komanso m'mabanja oyamwitsa. Zitha kukhala paliponse: pansi, zenera, magome a pambali, pabedi ndi zipinda. Mikangano ya tizilombo toyambitsa matenda imagwera mmanja mosavuta tikakhudzana ndi malo owonongeka. Amafalikira kwambiri ndi njira yachinsinsi.

Momwe spores zalowa mu thupi, zimadutsa m'mimba ndikukhala m'matumbo. Pakati pa matumbo aang'ono amasandulika mawonekedwe a zamasamba ndikuyamba kuchulukana. M'matumbo akuluakulu, mabakiteriya amakhala m'matumbo ndipo amayamba kutulutsa poizoni A ndi B, zomwe zimapangitsa kutupa kwambiri kwa m'mimba, zomwe zimayambitsa kusokonezeka kwa zinthu zomwe zimawonongeka ndi ntchentche. Kupangidwa kwa pseudomembranes kumachitika. Toxin A imayamba kukopa lekocyte, pamene poizoni B imakhudzidwa ndi zotsatira zowononga za maselo a epithelial. Njirazi zimapangitsa maonekedwe a colitis, madzi komanso maonekedwe a pseudomembrane.

Kwenikweni, matenda onse a Clostridium difffile amayamba pambuyo pochizidwa ndi maantibayotiki, komanso pambuyo pa opaleshoni. Anthu okalamba ali ndi zaka makumi asanu ndi awiri ndi makumi asanu ndi awiri (60) komanso omwe ali ndi chithandizo chamakono nthawi yayitali amadziwika ndi tizilombo toyambitsa matenda, komanso odwala omwe amatenga mankhwala osokoneza bongo.

Clostridium difficile amachititsa kutsegula m'mimba mofatsa kapena mopitirira malire ndi mitsempha ya m'mimba. Koma m'zochitika zapadera, matendawa amakhala mtundu woopsa wa colitis. Nchiyani chimayambitsa zizindikiro monga:

• Mitsuko yamadzi;
• Ululu m'mimba;
• Kumanga;
• Kuwonjezeka kwa kutentha kwa thupi;
• Kutaya madzi m'thupi;
• Nausea.

Pazigawo zitatu, odwala amakhala ndi matenda aakulu. Mwa awa, 30-85% amafa. Mu 20-25% mwa odwala, matendawa amatha kuchitika mobwerezabwereza. Matendawa amayamba chifukwa cha mabakiteriya omwe anatsalira m'matumbo akuluakulu atatha mankhwala kapena chifukwa cha matenda atsopano a Clostridium Zovuta. Matenda angakhudze ana, makamaka omwe afooka.

Matenda oyambitsa mabakiteriya

Clostridium difficile pa milandu imodzi mwa atatu amachititsa kutsekula m'mimba pogwiritsa ntchito mankhwala opha tizilombo. Nthawi zina, maonekedwe a matendawa amachititsidwa ndi mabakiteriya ena. Kawirikawiri matendawa amapezeka kuchipatala. Ana samavutika nthawi yomweyo

Mankhwala oteteza kumadzi a antibiotic (AMA) akhoza kukhala ndi magawo osiyanasiyana a chitukuko, kuchokera ku matenda opweteka m'mimba mpaka mtundu wovuta wa enterocolitis, womwe umatchedwa pseudomembranous colitis. Chifukwa cha matendawa ndi matenda omwe amabwera chifukwa cha Clostridium difficile, yomwe imawonekera m'magulu angapo chifukwa cha kugwiritsa ntchito mankhwala oletsa maantibayotiki.

Kuchepetsa kutsekula m'mimba kapena pseudomembranous colitis kumatha ngakhale kuyendetsa limodzi kwa antibiotic yomwe ili ndi zochita zambiri. Komanso, maonekedwe a matendawa sadalira momwe mungayendetsere mankhwalawa.

Clostridium Zovuta: Zizindikiro za Matenda

Clostridiosis yowonongeka ndi Clostridium difficile ingachitike m'mawonekedwe otsatirawa:

• Matenda a Asymptomatic;
• Kutsekula m'mimba;
• Mtundu wambiri wa matenda omwe wakhala pseudomembranitis colitis.

AMA imachitika kwa odwala amene adalandira mankhwala a nthawi yaitali - milungu iwiri kuchipatala. Clostridia m'mimba amatha kupeza kukana mankhwala osokoneza bongo. Pamene matendawa amapezeka, pamakhala chiwopsezo m'dera la peri-pooch, lomwe limakhudza kwambiri mimba yonse. Mpando wa wodwalayo umakhala wopitilira, koma chikhalidwe chonse cha thanzi chimakhala chokhutiritsa.

Pseudomembranous colitis chifukwa cha clostridium difficile, zizindikirozo ndizoopsa kwambiri. Dysbacteriosis imawoneka mwa odwala, ndipo Clostridium difficile imayambitsa. Bakiteriya amachititsa m'mimba mucosa ndipo amachititsa cytotoxin komanso mankhwala. Njira yotupa ya mucous membrane imayamba ndi mapangidwe a pseudomembranes. Ngati palibe chithandizo cham'tsogolo, matendawa amapitirira ndipo amapereka mavuto aakulu. Pali perforation ya m'mimba khoma, zomwe zimayambitsa peritonitis. Nthawi zina, matendawa amatsogolera ku imfa.

Matenda ofanana ndi omwe amawopsa kwambiri, okalamba komanso odwala omwe anachitidwa opaleshoni. Kukula kwa matenda kumaphatikizapo malungo, ululu pamimba ndi mutu, flatulence, eructation, kusanza. Palinso zizindikiro zina za kuledzera kwa thupi. Odwala amataya thupi, ena amakhala ndi anorexia, kuvutika maganizo, kuvutika maganizo. Palinso chachexia, kuyesayesa, tenesmus, kutsegula m'mimba ndi mafuta onunkhira komanso fibrin yophimbidwa mpaka 20 pa tsiku.

Pamene poizoni ali poizoni, matenda osokoneza ubongo angayambe. Pachifukwa ichi, kutentha ndi zilonda zam'mimba zimapangika pamakoma a matumbo. Kutentha kwa thupi kumatuluka. Pali zovuta. Dyspepsia amaonedwa, chopondapo chimakhala chamadzi, ndi kusakaniza magazi. Matenda a hepatosplenomegaly, a paresis a m'matumbo, pamodzi ndi bloating. Kuchepa kwa m'mimba kumatheka, kupweteka kwa zilonda, komanso thrombosis ya mitsempha ndi arterioles.

Kawirikawiri amachititsa kuti zakudya zisawonongeke za clostridia, kuphatikizapo Clostridium difftyle. Zizindikiro za matendawa zimadziwonetsera okha ngati ma poizoni. Kawirikawiri, chimfine, ululu m'mimba , kutsegula m'mimba, kusowa kwa kudya, kudziletsa. Ndi matendawa mitundu yonse ya dyspeptic ndi zakumwa zoledzeretsa zimawonetseredwa. Odwala amakhala okwiya, othawa komanso osasamala. Zizindikiro zolakwika zimatha masiku 4 ndipo pang'onopang'ono zimasiya.

Chinthu chachikulu cha matendawa chimabwereranso, chomwe chikuwonetseredwa mu 25% mwa milandu. Chifukwa cha zochitika zawo ndi spores zomwe zili m'mimba mwa m'mimba. N'zosatheka kuchotsa milandu ya matenda opatsirana mobwerezabwereza. Monga lamulo, atangotha mankhwalawa amachira, koma pa tsiku lachiwiri la 28 kubwezeretsa, zofanana ndi zizindikiro za matendawa, zingayambe.

Zimayambitsa

Ngati Clostridium diffusile imawoneka m'thupi, chithandizo chiyenera kuyambitsidwa mwamsanga. Zomwe zimayambitsa matendawa ndi izi:

• Zovuta zamoyo;
• Kusokonezeka maganizo, kupanikizika, neurosis;
• Kuchiza kwa nthawi yaitali ndi mahomoni ndi maantibayotiki;
• Imodzi;
• Kulephera kwa dongosolo lalikulu la mitsempha;
• Kusamvana kwa ana;
• Kugonjetsedwa, kusandulika kukhala mtundu wosatha wa chitukuko;
• Matenda opuma;
• Amayambitsa matenda opatsirana omwe amakhala m'chipatala;
• Ntchito zopangira opaleshoni.

Izi zimafooketsa thupi ndikulimbikitsa kuti Clostridium ikhale yosiyana. Chithandizo cha matenda chiyenera kuchitika pokhapokha ngati wodwalayo akudziŵa bwinobwino.

Zofufuza

Kuzindikira matendawa kumadalira kudziwika kwa zizindikiro za matenda ndi zifukwa zake. Anamnesis amalingaliridwa, komanso zifukwa za matenda. Samalani mawonetseredwe a chipatala cha matendawa. Kukhazikitsa njira yogwiritsira ntchito matenda ndi ma laboratory.

Kufufuza zakumwa zochokera ku klostridium zosiyana zimapangidwa. Mu labotale, ndodo zabwino za Gram ndi spores zawo zatsimikiza. Poganizira zochepa kwambiri, zomerazi zimabzalidwa mwachindunji ndipo mothandizidwa ndi izi, magulu a tizilombo toyambitsa matenda ali otsimikizika. Kukonzekera kwapadera kwa kubwereza kusanthula koteroko sikukufunika. Chiwerengero cha clostridia chimatsimikiziridwa ndi gram smear. Pambuyo pake, mitundu ya bacterium imadziwika. Cal pa Clostridium difficile imafufuzidwa mu labotoriya labotale.

Mukapeza kuti matendawa, amayesedwa pa nyemba zoyera, zomwe zimayambitsa ndondomeko ya kuledzera kwa thupi, zimayang'ana poizoni ndipo zimathandizira njira zothandizira matendawa. Mukapeza kuti matendawa, mayeso a antigen amachitika muzipangizo zamakono zamagetsi.

Nthawi zina, kufotokoza kumeneku kumaperekedwa, kumathandizira kudziwa komwe kulipo katemera. Chidutswa cha m'mimba zimatuluka, chomwe chimapangitsa kudziwa za malo omwe amatha kupweteka.

Serodiagnosis ikhoza kuzindikira kuti kulipo kwa poizoni mu RNGA. Zatsimikiziridwa pamodzi ndi matenda opatsirana pogonana. Onetsetsani zomwe zimachitika, zomwe zimachitika chifukwa cha anti immunoelectrophoresis.

Kufufuza kwa zipangizo zamagetsi sizowoneka ngati mafilimu a m'mimba, omwe amalola munthu kudziwa komwe gasi lapezeka m'magulu a thupi la munthu.

Chinthu cholondola kwambiri ndi kufufuza ndi kumapeto kwake. Zimasonyeza njira yotupa, komanso mapangidwe a pseudomembranes.

Ntchito yowonjezera ya clostridia kwa ana imasonyeza kukhalapo kwa dysbacteriosis. Mu khanda lomwe lili ndi matendawa, kupweteka, kuchepa kwa chilakolako, kubwezeretsedwa kumachitika. Nthaŵi zina kusokonezeka kwagona tulo ndi zidole zosadziwika. Chiwerengero cha mabakiteriya m'mabanja sayenera kukhala opitirira 103-104 cfu / g. Kupitirira kwa chizindikirocho kumatengedwa ngati matenda, omwe ayenera kuchiritsidwa.

Ngati zinthu za clostridium zimakhala zachilendo pofufuza za dysbiosis, zikutanthauza kuti matumbo amagwira bwino. Powonjezera chiwerengero cha tizilombo toyambitsa matenda tiyenera kuchizidwa m'matumbo.

Mukhoza kupanga phunziro pa Clostridium Difficile Invitro. Pali kusanthula kwa ma ruble 1200. Chifukwa chake, nthawi zambiri, njira zochiritsira zoyenera zimayikidwa.

Kodi matendawa amasonyeza bwanji ana?

Mabakiteriya Clostridium amasiyana kwambiri samakhudza ana amakhanda ndi zinyenyesero za chaka choyamba cha moyo. Izi ndi chifukwa chakuti mkaka wa amayi uli ndi ma antibodies apadera omwe ali othandiza polimbana ndi clostridia.

Pamene kutsegula m'mimba kumayambira ali mwana, zizindikiro zomwezo zimawoneka ngati akulu. Enterocolitis ndi kuchepa kwa ubongo kwa ana zimachitika popanda kudya ndi malungo. Odwala angadandaule ndi kupweteka m'mimba, kumene kumachitika ndi njira ya palpation m'deralo.

Nthawi zina pamakhala chonchi, chomwe chimayambitsa kutsekula m'mimba, komwe kumayambitsa matenda opatsirana ndi madzi m'thupi.

Bactamini ikhoza kuyambitsa mitundu yambiri yobwerezabwereza ya clostridiosis pamodzi ndi colitis. Izi zimachitika pamene matendawa sanachiritsidwe mpaka mapeto. Pankhani imeneyi, clostridiosis imachitika pambuyo pa masiku asanu ndi awiri ndi asanu ndi awiri (7-14) pambuyo pa kutha kwa mankhwala.

Nthenda yotsekemera imayamba kukula kwambiri mu ubwana. Pa chiyambi cha matendawa palibe chilakolako. Pali malungo, kumenyedwa ndi kupweteka m'mimba. Pali kuledzera kwa thupi, kutsegula m'mimba ndi kupuma. Pamene palpation ya pamimba imaonongeka. Mpando umakhala mobwerezabwereza. Magazi ndi ntchentche zimawonekera mmenemo. Pangakhale phokoso la nsonga za fibrinous. Ngati kutsekula m'mimba kumakhala kobwerezabwereza, ndiye kuti pali zotsatira zovuta kwambiri, kuphatikizapo kuchepa kwapakati. Kumadera akutali kunali kugwa.

Kukula kwa pseudomembranous colitis nthawi zina kumawonjezereka ndi kuperewera, kutuluka magazi, ndi kuyamba kwa peritonitis. Zikatero, ana sayenera kuyang'aniridwa ndi dokotala wa ana, koma ndi dokotala wa opaleshoni.

Matendawa chifukwa cha Clostridium difficile: njira zamankhwala

Clostridiosis amachiritsidwa m'chipatala. Mukakhala moledzeretsa, komanso matenda opatsirana, m'mimba mumatulutsa mankhwala ndipo matumbo amachotsedwa ndi enema. Pa tsiku loyamba, chakudya chosowa madzi chikulimbikitsidwa.

Zina mwa mankhwala ogwiritsa ntchito ndi mankhwala opha tizilombo. Clostridia amawaganizira. Mwa mankhwalawa, Clarithromycin ndi Azithromycin amagwiritsidwa ntchito kwambiri. Toxin Clostridium difficile (zizindikiro ndi chithandizo zimaperekedwa payekha ndi dokotala, kudalira mkhalidwe wa wodwalayo), mankhwala akhoza kuchotsa cephalosporins, mwa iwo ndi "Cefazolin" ndi "Ceftriaxone." Kaŵirikaŵiri maantibayotiki a mndandanda wa penicillin amagwiritsidwa ntchito polimbana ndi mabakiteriya a tizilombo, awa ndi "Vancomycin", "Amoxiclav". Metronidazole imagwiritsidwanso ntchito.

Pofuna kubwezeretsanso tizilombo toyambitsa matenda m'mimba, madokotala amapereka mankhwala opanga maantibiotiki ndi maantibiotiki. Odziwika kwambiri ndi Hilak forte, Acipol, Lactofiltrum, Bifiform, Enterol, Linex, Enterol.

Kuchotsa kuledzera, jekeseni intravenously "Reopoliglyukin." Ngati ndi kotheka, perekani antihistamines ndi corticosteroids.

Matendawa ndi mavitamini, hepatoprotectors, mavitamini, nootropics, glycosides a mtima, komanso antipyretic mankhwala.

Amakhulupirira kuti mankhwalawa ndi othandiza ngati:

• Nthawi zambiri kuchepa kwa sitolo kumachepetsa;
• Kusagwirizana kwa chinyumba kumakhala chowopsa;
• Pali kusintha kwa chikhalidwe chonse;
• Pali kusintha kwakukulu mu kafukufuku wamakono ndi labotale;
• Palibe chitukuko cha matendawa.

Ngati mankhwala oletsa tizilombo toyambitsa matenda sathana ndi zizindikiro za Clostridium Difficile, mankhwalawa amasinthidwa.

Nthawi zina matendawa amachititsa opaleshoni. Kawirikawiri izi zimachitika ndi kupweteka kwa koloni ndipo pamene pali kutupa ndi mawonekedwe a megacolon, ndipo palinso kutsekula kwa m'mimba. Opaleshoniyo imangotheka ngati mankhwala oyenera ochiritsirawo sakhala ndi zotsatira.

Kodi Clostridium difficile angachiritsidwe?

Clostridium matenda difficile akuwonetseredwa mu madigirii zosiyanasiyana mwamphamvu. Iwo ali khalidwe ena a otaya ndi digiri ya mavuto.

Pamene nthendayo osati akuthamanga ndi ali wofatsa kapena sing'anga mwamphamvu, nthendayo anachiritsa pa 100%. Malungo Mwamsanga kwa maola 1-2, ndi kutsekula m'mimba ndi anaima masiku 4-7. Matumbo kutsekeka, kulephera impso, ndi pseudomembranous matenda a m'matumbo zinthu ankawonjezereka.

zodzitetezera

Analysis wa Clostridium difficile amalola nthawi kupewa chitukuko cha matenda ndi kuthetsa matenda Kodi kuthandiza kuti miyeso yake njira, amene akuwonetseredwa mu:

• kusunga malamulo a ukhondo ;
• kutsuka katundu;
• kutenthetsa mankhwala mankhwala chakudya;
• kuwongolera chitetezo chokwanira;
• olimba a microflora ndi matumbo;
• oyambirira kudziwika anthu kachilombo;
• kugwiritsa ntchito mankhwala opha tizilombo.

Tizilombo toyambitsa matenda kugonjetsedwa amoniya, koma anaphedwa ndi kukhudzana ndi sodium hypochlorite etilenoksidsoderzhaschih zinthu, komanso mankhwala zamchere ndi glutaraldehyde. Pa matenda, Clostridium difficile ayenera bwinobwino ankakonza pamalo onse anati njira, kuwononga spores mabakiteriya tizilombo toyambitsa matenda a. mabakiteriya siumafa mu processing mowa, koma kusamba m'manja ndi sopo akhoza kuteteza zosayembekezereka wa matenda.