Igciwane lesifo zeClostridium difficile

Igciwane zeClostridium difficile uhlale umzimba lomntu ngamnye. Kuye notyekelo yokuzalela okunzulu, ngenxa leyo iba yingozi kuba irhweba iipropati ebangela isifo kwaye ebangela isifo esithile. Libhekisela uyawabophelela anaerobes kwaye khona ingekho i-oksijini. Ibandakanya kwiinkqubo ezibalulekileyo ezifana cleavage of iiprothini, uvuselelo kunye ukulungiswa eludongeni emathunjini.

Yintoni zeClostridium difficile?

Igama elithi "zeClostridium" iguqulelwe lithetha Russian "yokuluka". Loo igama Upohawu amagciwane zaba ukudumba phakathi xa sporulation. amagciwane bakwazi ukuthatha indlela osimelela ngentonga. Zohlulwa ngokwendidi ezine:

• ZeClostridium botulinum, yi-arhente causative sifo;
• ZeClostridium tetanum, kwenza ngqi;
• ZeClostridium perfringens, ichaphazela kukuvela izifo anaerobic;
• ZeClostridium difficile kubangela wenze pseudomembranous.

ZeClostridium intonga-emise. Kokuba zibekwe ngababini nezidanga. ukuhamba ezoneleyo. Xa engekho epheleleyo ioksijini uqalisa phinda ngokukhawuleza. Amagciwane ukuvelisa imbewu, nto leyo ebenza ukumelana nemithi, ukufudumeza kunye namalungiselelo ezahlukeneyo kweentsholongwane. Le ngxoxo engundlunkulu yokuluka emile, yaye lowo terminal, - ubume drumsticks.

ZeClostridium difficile ebangela isifo sorhudo evela antibiotics. oko Ngokuqhelekileyo uhlala kwindawo emathunjini. Xa impilo entle luncedo micro-eziphilayo zinqanda ukukhula iintsholongwane. Emva kokuba nokusebenzisa imithi iintsholongwane kuluncedo kuba ezincinane, yaye inani zeClostridium ukunyuka, esinokubangela ukubonakala yokudumba, ukuba uphuhliso sifo kakhulu kwaye nkqu nokufa umntu. Ingakumbi kumayelana esi sifo izigulane abadala ephelile.

Zonke iintlobo Clostridia ukwenza ityhefu engabangela inkangeleko ngezifo ethile. Ngenxa phindo wayo uvelisa ityhefu A and B zeClostridium difficile. Eyokuqala kuthiwa enterotoxin, kwaye eyesibini - a cytotoxin. Banako ukuba imzisele urhudo kunye nokudumba kubantu abaninzi.

ezifo

ZeClostridium difficile kudla ubomi ezibhedlele kumakhaya abalupheleyo. Kunokuba naphi; emgangathweni, Ungqameko window, itheyibhile kwebhedi, ebhedini kunye zangasese. Imbewu le silwanyana ukuze ngokukhululekileyo ezandleni zenu wadibana kumphezulu ingcolisekile. Advantageously twa yi indlela ilindle-ngomlomo.

Xa imbewu sele eyangena emzimbeni, kulula ukuba kudlula eliphakathi esiswini kuze ahlale emathunjini. Ku imvelo emathunjini amancinci eziguqulelwe kwi ifomu kwezityalo kwaye ngokubonakalayo baqale phinda. Iibhaktheriya ikholoni efakwe kwi isondo amathumbu kunye neqalayo ukuba abulale A no-B, ebangela umtshiso kakhulu yokusingqongileyo isisu, nto leyo ebangela ukubana kobutyobo kunye yencindi yomlomo. Ukwenziwa pseudomembranous. A tyhefu iqalisa ukuba nomtsalane iiseli ezimhlophe zegazi, ngelixa yoluvo B othatha inxaxheba kugwayimbo etshabalalisayo iiseli epithelial. Ezi nkqubo Siyayikhweletisa na ukudumba imbonakalo, utyatyazo alilayo imbonakalo pseudomembranous.

Ngokusisiseko, zonke ezimbi ezibandakanya zeClostridium difficile kwenzeka emva unyango isibulala-zintsholongwane, kwakunye emva kotyando. Ingakumbi abakhuselekanga kwala magciwane abantu abadala abangaphezulu kweminyaka engama-60 ubudala yaye abantu kunyango ixesha elide esibhedlele, kwakunye izigulane bathabatha iziyobisi immunosuppressive.

ZeClostridium difficile zivusa lurhudo buthathaka okanye eliphakathi kunye amahlaba esiswini ezingephi. Nangona kunjalo, kwiimeko ezizodwa, esi sifo iba kakhulu lwe ngakumbi sikabhobhosi. Yintoni ebangela iimpawu ezifana:

• indle zamanzi;
• iintlungu esiswini;
• ayanda;
• umkhuhlane;
• emzimbeni;
• isicaphucaphu.

Ngowe-3% ezigulane ube uhlobo kakhulu kwesi sifo. Kwezi, 30-85% kufa. Ngowe-20-25% yezigulane esi sifo kungenzeka kwakhona. Sisifo zezifo ngenxa iintsholongwane eseleyo Amathumbu amakhulu emva konyango, okanye ngenxa difficile olutsha usulelo zeClostridium. Isifo kungachaphazela abantwana, ingakumbi buthathaka.

Izifo ezibangelwa igciwane

ZeClostridium difficile kwenye yesithathu amatyala kudale urhudo ezinxulumene ngokungenisa antibiotics. Kwezinye iimeko, imbonakalo sifo lichatshazelwe ezinye iintsholongwane. Isikakhulu sifo lwenzeka ezibhedlele. Abantwana awehlelwa ngexesha elifanayo

sorhudo Anitibiotiko-ezinxulumene (izilungiselelo) ukuze izigaba ezahlukileyo zophuhliso, ukususela ukuphazamiseka abanomoya amathumbu akhe ukuya enterocolitis kakhulu, nto leyo kuthiwa wenze pseudomembranous. Unobangela wale sifo sisifo okubangelwa zeClostridium difficile, ebonakala kwezinye iimeko ngenxa yokusetyenziswa unyango isibulala-zintsholongwane.

Angabangela ukurhuda okanye ukudumba okwenziwa sisilonda pseudomembranous uyakwazi ukufumana nokuba zintsholongwane olunye ukuba spectrum ezibanzi amanyathelo. Ngaphezu koko, sabonakala isibetho akuxhomekekanga kwi idosi indlela yolawulo.

ZeClostridium difficile: iimpawu zosulelo

Klostridioz ezibangelwa zeClostridium difficile, ungakwazi ukuthatha indawo kule fom zilandelayo:

• usuleleko nazimpawu;
• sorhudo mnene;
• uhlobo kakhulu zesi sifo, ipasiswe wenze pseudomembranous.

Izilungiselelo livela kwizigulane abaye unenzondelelo unyango ixesha elide - elingaphezu kweeveki ezine esibhedlele. Clostridia kwi wamathumbu medium afumane ukuxhathisa amachiza ezithile. Xa olu leengxaki ekhoyo kwingingqi yosana bomzimba, apho kamva echaphazela yonke isisu. izigulane nguSihlalo uba rhoqo ngakumbi, kodwa imvakalelo iyonke kuhlala ngokwanelisayo.

ukudumba okwenziwa sisilonda Pseudomembranous ezibangelwa difficile zeClostridium, uneempawu kakhulu ngakumbi. Izigulane zibonakala goiter, kunye nemisebenzi kugquba zeClostridium difficile. Igciwane colonizes na isifo wamathumbu kwaye bavelisa enterotoxin kunye cytotoxin. inkqubo yokukrala iqala lokusekwa mucosal pseudomembrane. Xa engekho unyango ngexesha elililo, isifo siqhubela phambili kwaye anike iingxaki ezinkulu kakhulu. Oku kwenzeka perforation kodonga isisu, ebangela peritonitis. Kwezinye iimeko, esi sifo kukhokelela ekufeni.

izifo ezifanayo sifo ukuba izigulane ezinomhlaza, abadala kunye iziguli uqhaqho. Uphuhliso sifo ihamba ifiva, iintlungu esiswini kunye nentloko, flatulence, belching, ukugabha. Kukho nezinye iimpawu kunxilwe. Izigulane ukunciphisa umzimba, abanye kuvela ukudla, ukudandatheka yokuziphatha, ukudakumba kwenzeka. Kwaphawuleka cachexia, amalinge, tenesmus, urhudo ivumba elinukayo kunye fibrin uzaleke kangangezihlandlo ezingama-20 ngosuku.

Xa etheni ubuthi angaphuhlisa enteritis necrotic. Kulo mzekelo, iindonga amathumbu akhiwa erosions kunye nezilonda, necrosis. iqondo lobushushu emzimbeni Ukwandiswa. Kukho obandayo. Kukho ukuqunjelwa, isitulo uba elulwelo, ixutywe igazi. Kwafunyaniswa ukuba hepatosplenomegaly, paresis kwamathumbu, kunye ukuqumba. Kusenokubakho ukopha zesisu, perforation ye nangezilonda, kwakunye venules kunye arterioles thrombosis.

Amaxesha amaninzi ukuba ukutya Ityhefu clostridia, kuquka zeClostridium difficile. Iimpawu kwezonyango sifo azibonakalisa ngohlobo yityhefu. Ngokuqhelekileyo, oko ifiva, iintlungu esiswini, urhudo, ukungabi namdla, ukungacoleki kokutya. Kule sifo uyakuvelisa zonke iintlobo ukunxila kunye neempawu dyspeptic. Izigulane nochuku, ecubhukile kunye noko amnye ebantwini. Iimpawu ezimbi ithatha malunga 4 iintsuku, yaye ngokuthe ngcembe kudambe.

Eyona iphambili izifo nezolo, ezivelayo-25% yamatyala. Isizathu sokuba ukwenzeka yabo wempikiswano afumaneka kwi-bume emathunjini. Asikwazi ngaphandle amatyala kwakhona losuleleko-. Njengomgaqo, ngoko nangoko emva kokuvela nokufunyanwa unyango, kodwa iiyure 2-28 inokuphuhlisa ukwenzeka, efanayo iimpawu zazo ngokubonakala zokuqala zesi sifo.

oonobangela

Xa efumanise zeClostridium difficile kwi unyango umzimba kufuneka uqale ngoko nangoko. Izinto ezibangela le zokugula ezi zinto zilandelayo:

• indawo amahlwempu;
• Ntshikilelo, ukudakumba, neurosis;
• unyango elide kunye hormone nemithi;
• immunodeficiency;
• sibangelwa inkqubo Central luvo;
• prematurity kubantwana;
• ubuthongo, badlula ngendlela ezingapheliyo zophuhliso;
• izifo zemiphunga;
• amagciwane abahlala iindonga esibhedlele;
• uqhaqho.

Ezi oonobangela buthathaka umzimba nokukhuthaza ukwanda zeClostridium difficile. unyango sifo kufuneka kwenzeka kuphela emva kokuba uxilongo ngokucokisekileyo isigulane.

ekuxilongweni

Lokufunyaniswa kwesifo isekelwe ngokuchonga iimpawu zesifo noonobangela balo. Imbali kuthathelwa ingqalelo, ngokunjalo izinto epidemiological. Nikelani ingqalelo wabonakala kwezonyango sifo. Moshilongo sebenzisa iindlela negalelo kunye elabhoratri.

Ngaba gciwane zeClostridium difficile. -In vitro ukuchaza iintonga Igram-HIV kunye sikuyo zabo. iimviwo ngemikroskopu biomaterial zitofwe yaye ngokukodwa, iya kumiselwa ngokusekelwe ngamagciwane koloni. ukulungiselela ezizodwa sokuphuculwa kohanjiso ye azihlole ayikho imfuneko. Inani clostridia ukuqinisekisa Igram smear. Emva kolu hlobo iintsholongwane kuchongwa. Endleni on zeClostridium difficile uye kuvavanywa kwiilebhu bacteriological.

Xa ekuxilongweni isifo isampuli yendalo olwenziwe neempuku ezimhlophe, nto leyo ichaza inyathelo kunxilwe, chonga yoluvo kwaye inceda uchaze iindlela zokunyanga izifo. Xa lokufunyaniswa kwesifo enze esithile uvavanyo iantigens kwiilebhu ngumzimba.

Kwiimeko ezizodwa, le uxilongo okucacileyo amisiweyo ukunceda ukuchonga ubukho yoluvo endleni. Biopsy welungu wamathumbu evumela ukuba ukwazi indawo nakujoliso olutsha of komtshiso oko.

Serodiagnosis ityhila ubukho yoluvo kwi IHA. Oku kumiselwa kubanjiswene kunye diagnosticum omzimba. Qwalasela indlela oko kwenzeka ngenxa counter immunoelectrophoresis.

Uxilongo - akukho nto kodwa ray welungu isisu, nto leyo evumela ukuba ukujonga apho irhasi amaninzi nezihlunu umzimba womntu.

Kucingwa uviwo echanekileyo kunye edoskopicheskoe tomographic. Ibonisa nangokurhala, ukuyilwa pseudomembranous.

umsebenzi Ukwanda clostridia kwiintsana ibonisa phambi dysbiosis. Xa nokuqunjelwa usana ibonakala kule ngezifo, sinciphise ukutya, ukugabha. Ngamanye amaxesha kukuphazamisa kokulala namathumbu engagunyaziswanga. Inani iintsholongwane kwiintsana akufuneki sibe ngaphezulu kwe-103-104 cfu / g. Isalathisi kwemfuneko kugqalwa ngezifo ekufuneka ngayo.

Ukuba umxholo clostridia oqhelekileyo ngexesha uhlalutyo kwi dysbacteriosis, oku kuthetha ukuba amathumbu uzinzile. Unyango kufuneka kwenziwe emathunjini ngokwandisa isixa iintsholongwane izifo.

Kuyenzeka ukwenza uphando kwi zeClostridium difficile kwi "Invitro". Kufuneka ube uhlalutyo malunga 1200 engange. Kwi siseko wayo, amaxesha amaninzi amisele iinkqubo zonyango eziyimfuneko.

wenza njani yokugula ebantwaneni?

Igciwane zeClostridium difficile ayifane kuchaphazela kubelekwa kwiimvuthuluka kunyaka wabo wokuqala bezelwe. Oku kungenxa yokuba ubisi sikanina iqulethe omzimba athile ukuba phumelela zeClostridium.

Xa kuthe urhudo zintsholongwane enxulumene ebantwaneni zenzeke zonke iimpawu efanayo abadala. Enterocolitis kunye nokudumba ebantwaneni kunye inzuzo ayisindi ngaphandle intonsikatsii kunye nomkhuhlane. Izigulane uphazamise iintlungu esiswini, apho ukuvela kwi indlela Ngokucofa kule ndawo.

Ngamanye amaxesha kukho ilindle rhoqo ngakumbi oko kudale urhudo, nto leyo ekhokelela nokuphazanyiswa kwamanzi electrolyte emzimbeni.

Igciwane kungabangela iifom relapsing nezolo klostridioza kuhambisane sikabhobhosi. Oku kwenzeka xa sifo asipheli de kube sekupheleni. Kulo mzekelo, klostridioz kwenzeka emva kweentsuku 7-14 emva ukupheliswa unyango.

ukudumba okwenziwa sisilonda Pseudomembranous njengomntwana senzeka ngohlobo yayiyazi. Xa lokuqala inqanaba yokuphuhlisa sifo uthando. Kukho fever, belching kunye amahlaba esiswini. Kukho ukunxila, urhudo kunye ukuqunjelwa. Kwi Ngokucofa esiswini waphawula bomzimba. Isitulo ophilisayo. Kubonakala igazi kunye yencindi yomlomo. Kusenokubakho iingceba seqela fibrinous. Ukuba urhudo buninzi ke, kukho exsicosis kunye iintsilelo kwegazi. Kwiimeko ezinqabe kakhulu, kwakukho ukuwa.

Uphuhliso yokudumba pseudomembranous wambi mandundu yi perforation, ukopha kunye kukuvela peritonitis. Kwiimeko ezinjalo, umntwana kufuneka babonwe nje kuphela wabantwana kodwa kugqirha.

Le ukugula okubangelwa zeClostridium difficile: Kuxakekwe ngonyango

Klostridioz ngayo kuphela esibhedlele. Xa ukunxila kunye dyspeptic ukuphazamiseka emiselweyo lavage esiswini hlamba kusetyenziswa kwamathumbu enema. Ngosuku lokuqala ekucetyiswa amanzi-yindlala yokudla.

Phakathi imithi antibiotics-makrolity. Kubo clostridia ezibuthathaka. "Clarithromycin" yaye "Azithromycin" ngoyena usetyenziswa rhoqo phakathi kula machiza. Yoluvo zeClostridium difficile in (iimpawu kunye nogqirha unyango ebekwe ngamnye ngokusekelwe kwi imeko yomguli) amayeza Ungasusa cephalosporins, phakathi kwabo - "Cefazolin" yaye "Ceftriaxone". Amaxesha amaninzi ukulwa iintsholongwane yayintsholongwane eyosulela zibandakanya antibiotics penicillin, kuba "Vancomycin" "Amoxiclav". Iyasetyenziswa "Metronidazole".

Ukubuyisela microflora lokusingqongileyo isisu, oogqirha amisele probiotics kunye prebiotics. Eyona ithandwayo "Hilak Forte", "Atsipol", "Laktofiltrum", "Bifiform", "Enterol", "Linex", "Enterol".

, Efakwa "Reopoligljukin" ukususa ubungozi. Ukuba kuyimfuneko, amisele iziyobisi antihistamine kunye corticosteroids.

Kubanjwe lingaze unyango enterosorbents, hepatoprotectors, iivithamini, nootropics, glycosides kwentliziyo, kwakunye antipyretics.

Kukholelwa ukuba nothomalaliso okuqhubekayo ngempumelelo xa:

• yehle esitulweni frequency;
• isitulo efanayo kuba mkhulu;
• ngcono nemeko ngokubanzi kwenzeka;
• nguqu zintle wazibona zekliniki laboratory hlaziya;
• akukho ukuqhubela phambili kwesifo.

Ukuba iimpawu phikelela zeClostridium difficile, unyango oluchanekileyo kwi sicelo unyango isibulala-zintsholongwane.

Maxa wambi besisu, senziwa zeClostridium difficile, baphathwa intsumpa. Oku kudla ngokwenzeka xa perforation ye ikholoni, yaye xa kukho inkqubo yokukrala yophuhliso ukuvela megacolon zinetyhefu, kunye emathunjini kwenzeka. Umsebenzi lwenziwa kuphela ukuba unyango eyaneleyo endala watsho phantsi.

Ingaba kukho difficile unyango zeClostridium?

usulelo zeClostridium difficile esibonakaliswa izidanga ezahlukeneyo ubungnqongqo. Kuye umlinganiswa othile ukuhamba kunye nezinga iingxaki.

Xa esi sifo awusebenzisi kwaye ubucaka qatha okanye aphakathi, esi sifo eso sinyangekile kwi-100%. Fever shwaka iiyure 1-2, nokurhuda iyakuvingca iintsuku 4-7. Kwesisu isithintelo, ukusilela kwezintso, kunye nemeko okwenziwa sisilonda pseudomembranous nzima.

amanyathelo othintelo

Uhlalutyo zeClostridium difficile kuvumela ixesha ukuthintela ukunwenwa kwesifo kunye ukuphelisa esi sifo hi pfuna ku amanyathelo othintelo ngexesha, nto leyo ziyabonakala:

• nokugcina imithetho ngococeko ;
• izinto zokuhlamba;
• ukufudumeza unyango iimveliso zokutya;
• ukuphucula amandla okukwazi;
• Ukuzinziswa microflora emathunjini;
• ukubhaqwa labantu abasuleleke;
• ukusetyenziswa unyango isibulala-zintsholongwane.

Iintsholongwane ukumelana ammonia, kodwa babulawa ukudibana nezinto etilenoksidsoderzhaschih sodium hayiphoklorayithi, ngokunjalo unyango obrak ne glutaraldehyde. Phezu usuleleko, zeClostridium difficile kufuneka ngocoselelo icocwe zonke iindawo yathi kuthetha, ukuze abatshabalalise zavuleka, iintsholongwane ye gciwane. Le ntsholongwane abafi ekusetyenzweni utywala, kodwa isandla-yokuhlamba anesepha uyakwazi ukuthintela ukwenzeka izifo.