I difficile igciwane Clostridium

Igciwane Clostridium difficile uhlala emzimbeni umuntu ngamunye. It has a ukuthambekela zizalela olunzulu, ngoba lapho kubonakala khona enobungozi ngoba ethola izakhiwo pathogenic futhi ibangela isifo esithile. Libhekisela baphoqwe anaerobes futhi angase aziphilele ngaphandle oksijini. It ehilelekile izinqubo esibucayi ezifana cleavage amaprotheni, ukukhuthazwa kanye toning odongeni emathunjini.

Kuyini Clostridium difficile?

Igama elithi "Clostridium" ihunyushwa izindlela Russian "uthi lokuphotha." igama okunjalo ngesici amagciwane ithole zigcwala phakathi lapho sporulation. amagciwane angeziwe bayakwazi ukuthatha ngesimo uthi lokuphotha. Uhlukaniswa kane izinhlobo yilezi:

• Clostridium botulinum, iyona ejenti causative of botulism;
• Clostridium tetanum, kunomthelela ngqi;
• Clostridium perfringens, kuthinta okuvela anaerobic izifo;
• Clostridium difficile kubangela nesifo pseudomembranous.

Clostridium kuyinto induku okwenyanga. It zingafakwa ngababili namaketanga. ukuhamba eyanele. In the engekho ephelele-mpilo uqala ande ngokushesha. Amagciwane akhiqiza ezinhlamvu, okubenza babe anenkani, Ukushisa kanye amalungiselelo ahlukahlukene magciwane. I-agumenti esimaphakathi othini lokuphotha emise, futhi nguye esibulalayo, - ukuma drumsticks.

Clostridium difficile kubangela isifo sohudo kusuka antibiotic. Ngokuvamile-ke uhlala imvelo emathunjini. Bephile sáka nenzuzo amagciwane zivimbela ukukhula kwamagciwane. Ngemva nokusetshenziswa kwamaphilisi bacterium awusizo kuba ezincane, bese inani Clostridium inyuka, okungase kubangele ukubukeka nesifo, kubangele ukuthuthukiswa isifo obukhulu ngisho nokubabulala lomuntu. Ikakhulukazi kumayelana nasebekhulile buthakathaka iziguli isifo.

Zonke izinhlobo Clostridia yakha ubuthi ezibanga ukubukeka zokugula ethize. Ngenxa yalokho zokuphindaphinda yayo ukhiqiza ubuthi A no B Clostridium difficile. Eyokuqala libizwa enterotoxin, kanti eyesibili - a cytotoxin. Abakwazi ibe imbangela sohudo nesifo kubantu abaningi.

ukutheleleka

Clostridium difficile ngokuvamile uhlala izibhedlela makhaya. Kungaba kuphi: phansi, ifasitela Sills, etafuleni eliseceleni kombhede, embhedeni kanye nezindlu zangasese. Ezinhlamvu of ukuba lesi silwanyana sikwazi ukuthola ngokukhululekile ezandleni zakho nabo enamagciwane. Advantageously asakazwa umzila fecal-ngomlomo.

Uma ezinhlamvu ukungena emzimbeni they qeda kalula kusetshenziswa esiswini futhi ahlale emathunjini. In imvelo emathunjini amancane aguqulwa efomini vegetative futhi ngenkuthalo aqale ukuphindaphindeka. I-bacterium ikholoni imali emaphaketheni emathunjini bese siqala ukukhiqiza ubuthi A no-B, kuphumele ukuvuvukala okunzima imvelo emathunjini, elibangela displacement doti ne isikhwehlela. Ukwakheka pseudomembranous. A ushevu iqala ukuheha amangqamuzana amhlophe egazi, kuyilapho ushevu B ehilelekile isenzo elimazayo kwamaseli EPITHELIAL. Lezi zinqubo ukuyithukuthelisa nesifo ukubukeka, uhudo ombozwe ukubukeka pseudomembranous.

Empeleni, zonke pathologies ezihilela Clostridium difficile zenzeka emva kokwelashwa ngemithi elwa namagciwane, kanye nangemva kokuhlinzwa. Ikakhulukazi wadalula nezilwanyana ezincane abantu abadala engaphezu kuka-60 ubudala futhi abantu abelashwayo eside esibhedlela, kanye iziguli ukuthatha imithi immunosuppressive.

Clostridium difficile kuvusa uhudo ababuthakathaka noma okusesilinganisweni nezincane amajaqamba esiswini. Nokho, ezimweni ezehlukile, lesi sifo siba ifomu kakhulu yesifo. Yini ebangela izimpawu ezifana:

• izigqiki lwamanzi;
• ubuhlungu esiswini;
• ukuvuvukala;
• umkhuhlane;
• amanzi emzimbeni;
• isicanucanu.

Ngo 3% eziguli ube nohlobo ezinzima zalesi sifo. Kulawa, 30-85% afe. Ngo-20-25% of iziguli lesi sifo kungenzeka futhi. Recurrences zezifo ngenxa bacterium ahlala emathunjini ezinkulu emva kokwelashwa, noma ngenxa entsha ukutheleleka Clostridium difficile. Lesi sifo kungase kuthinte izingane, ikakhulukazi buthaka.

Izifo esibangelwa igciwane

Clostridium difficile kwelinye wesithathu amacala kuphakamisa sohudo elihlobene ne ukuphuza imithi elwa namagciwane. Kwezinye izimo, ukubukeka kwalesi sifo kuthintwa nezinye amagciwane. Ngokuvamile lesi sifo kwenzeka ezibhedlela. Izingane akusho ahlupheke ngesikhathi esifanayo

uhudo Anitibiotiko-ezihambisana (Aad) Kungase kudingeke zokukhula ezihlukene, kusuka imnene iziyaluyalu emathunjini kuze kube enterocolitis ezinzima, okuthiwa nesifo pseudomembranous. Imbangela yalesi sifo amagciwane kubangelwa Clostridium difficile, okubonakala kwezinye izimo ngenxa ukusetshenziswa ukwelashwa ngemithi elwa namagciwane.

Kubangele isifo sohudo noma nesifo pseudomembranous uyakwazi ukwamukela ngisho imithi elwa namagciwane olulodwa kokuba spectrum ezibanzi yesenzo. Ngaphezu kwalokho, ukubukeka kwalesi sifo akuxhomekile umthamo kanye imodi yokuphathwa.

Clostridium difficile: izimpawu ukutheleleka

Klostridioz kubangelwa Clostridium difficile, kungathatha indawo amafomu alandelayo:

• ukutheleleka asymptomatic;
• uhudo omnene;
• ifomu ezinzima kakhulu lesi sifo, ophasiswe nesifo pseudomembranous.

Aad kwenzeka ezigulini eziye zabhekana ukwelashwa eside - amasonto engaphezu kwemine esibhedlela. Clostridia e medium emathunjini ukuthola amandla okumelana nemithi ethile. Uma lokhu zokugula elikhona soreness endaweni enkabeni, kamuva kuthinta wonke esiswini. iziguli Chair kuba njalo, kodwa umuzwa jikelele uhlala egculisayo.

nesifo Pseudomembranous kubangelwa difficile Clostridium, inezimpawu ngaphezulu ezinzima. Iziguli avele goiter, nemisebenzi ubuswa Clostridium difficile. Igciwane colonizes le mucosa emathunjini bese ukukhiqiza enterotoxin futhi cytotoxin. ukuvuvukala iqala ukwakheka mucosal pseudomembrane. In the ukungabikho ukwelashwa esifike ngesikhathi, isifo siqhubeka futhi inika yezinkinga ezimbi kakhulu. Kwenzeka perforation odongeni emathunjini, okubangela peritonitis. Kwezinye izimo, lesi sifo siholela ekufeni.

izifo ezifanayo Lesi sifo siphatha kakhulu ukuba abathile abanomdlavuza, asebekhulile kanye neziguli othola ukuhlinzwa. Ukuthuthukiswa sifo kuhambisana imfiva, ubuhlungu esiswini kanye ekhanda, ukubuyisa, ukubhodla, ukuhlanza. Zikhona nezinye izimpawu zokudakwa. Iziguli ulahlekelwe isisindo, abanye bavele sokuzincisha ukudla, ukucindezeleka zokuziphatha, ukucindezeleka kwenzeka. Okuningi imakwe cachexia, imizamo, tenesmus, uhudo nephunga Putrid futhi fibrin Imbondela izikhathi 20 ngosuku.

Lapho ushevu owadalwa ubuthi ingaqala enteritis necrotic. Kulokhu, ezindongeni amathumbu akhiwa erosions kanye nezilonda, necrosis. Ukwandiswa nezinga lokushisa komzimba. Kukhona obandayo. Kukhona ukuqunjelwa, sezinyawo iba ketshezi kuxutshaniswe negazi. Uma sisheshe satholakala hepatosplenomegaly, paresis wamathumbu, ephelezelwa ukuvuvukala. Kungase kube ukopha emathunjini, perforation we izilonda, kanye ama-venule futhi arteriole thrombosis.

Ngokuvamile abangele ubuthi ekudleni clostridia, kuhlanganise Clostridium difficile. izimpawu zokwelashwa lesi sifo azibonakalisa ifomu ubuthi. Njengomthetho, kuba imfiva, ubuhlungu esiswini, uhudo, ukungakuthandi ukudla, ukuqunjelwa. Kulesi isifo sibonakalise zonke izinhlobo adakwe izimpawu dyspeptic. Iziguli ucasukelane, ucobekile futhi ukubuyisa. izimpawu Negative sihlala 4 izinsuku, futhi kancane kancane luyaphela.

Isici esiyinhloko ukuthi izifo yansukuzonke, okuyinto avele 25% amacala. Isizathu sokuba nesenzakalo yabo kukhona agumenti ezitholakala imvelo emathunjini. Asikwazi ukubeka eceleni amacala kabusha ukutheleleka. Njengomthetho, ngokushesha ngemva yokutakula ukwelashwa kwenzeka, kodwa amahora 2-28 angagcina Ukuphinda, ezifanayo izimpawu zabo ukubonakaliswa kokuqala kwalesi sifo.

izimbangela

Phezu ukuthola Clostridium difficile ekwelapheni umzimba kumele kuqale ngokushesha. Izimbangela lokhu ukutheleleka kuyizimbangela elandelayo:

• imvelo abampofu;
• Ukucindezeleka, ukucindezeleka, neurosis;
• ukwelashwa isikhathi eside nge-hormone nemithi elwa namagciwane okufakwa;
• immunodeficiency;
• ukungasebenzi Central nervous system;
• prematurity ezinganeni;
• ukuqwasha, lidlule efomini ezingamahlalakhona nezinga lokukhula kwengane;
• nezifo zokuphefumula;
• Amagciwane abahlala izindonga esibhedlela;
• ukuhlinzwa.

Lezi izimbangela buthaka emzimbeni futhi ukukhuthaza ukwanda Clostridium difficile. ukuphathwa isifo okufanele kwenzeke kuphela ngemva kokutshelwa ngokukhubazeka kwengane ngokuphelele nesineke.

ukuhlola

Sitholakele isifo kusekelwe ukuhlonza izimpawu isifo nezimbangela zayo. Umlando kunakwe, kanye izici epidemiological. Nakani ukubonakaliswa emitholampilo ye isifo. Ukuze uphethwe sebenzisa izindlela wezinsimbi futhi laboratory.

Ingabe fecal Clostridium difficile. Ngaphandle kwesibeletho ichaze izinduku Gram-HIV kanye ezinhlamvu yabo. luhlolo ezincane of biomaterial inoculated futhi ngokuqondile, kunqunywa esekelwe koloni Amagciwane. ukulungiselela okubalulekile ukulethwa azihlole akudingekile. Isibalo clostridia ukunquma Gram smear. Ngemva lolu hlobo amagciwane uchazwa. Indle ku Clostridium difficile ukuthi bahlola endaweni yokugeza bacteriological.

Lapho kuhlolwa isampula isifo begazi kwenziwa amagundane amhlophe, esichaza isinyathelo zokudakwa, ikhomba ushevu futhi usiza ichaze izindlela kokuphatha isifo. Esikhathini sitholakele isifo ukwenza ethize antigen test laboratories immunological.

Ezimweni ekhethekile, esimisiwe ukuhlahlwa express ukuze lisize khona ushevu endleni. Biopsy isitho emathunjini evumela ukuba ukwazi indawo foci ukuvuvukala.

Serodiagnosis wembula khona we ubuthi e-IHA. Okunqumayo ngokuhlanganyela diagnosticum omzimba. Abheke ukusabela ukuthi kwenzeka ngenxa esiphikisayo immunoelectrophoresis.

Ukuxilonga - lutho kodwa esimweni isitho emathunjini, okuvumela ukucacisa lapho igesi emisipheni yomzimba womuntu.

Kuthathwa inembe kakhulu futhi edoskopicheskoe luhlolo tomographic. Ibonisa ukuvuvukala kanye kumiswa pseudomembranous.

Ukwandisa of clostridia ezinsaneni kubonisa khona dysbiosis. Ngo ukuvuvukala usana kungabonakala nasemkhakheni lokhu zokugula, kwehle esesuthi, ukuhlanza. Ngezinye izikhathi engakuphazamisi thuthuva ubuthongo futhi wamathumbu okungajwayelekile. Inani lama-bacterium awusizo ezinsaneni akufanele bube ngaphezu kuka-103-104 CFU / g. inkomba okweqile kuthathwa njengesibikezelo esiyiso zokugula ukuthi kufanele baphathwe.

Uma okuqukethwe clostridia evamile ngesikhathi ukuhlaziywa kwi dysbacteriosis, lokhu kusho ukuthi amathumbu izinze. Ukwelashwa okufanele wenziwe amathumbu ngokwandisa inani namagciwane abangela izifo.

Kungenzeka ukuba afeze yocwaningo Clostridium difficile e "Invitro". Kufanele kube ekuhlaziyweni ruble mayelana 1200. On osekelwe kuyo, avame libeke izinqubo zokwelapha kunesidingo.

Kanjani ukugula ezinganeni?

Igciwane Clostridium difficile akuvamile kuthinta izinsana kanye imvuthu konyaka wokuqala wokuphila. Lokhu kungenxa yokuthi ubisi lukamama luqukethe amasosha omzimba ethize aphumelela ngokumelene Clostridium.

Esimeni sohudo-antibiotic-ezihambisana ezinganeni zingakenzeki zonke izimpawu ezifanayo njengoba abadala. Enterocolitis kanye nesifo ezinganeni ukuqhutshwa engasindi ngaphandle intonsikatsii nomkhuhlane. Iziguli ungase uphazamise ubuhlungu esiswini, lapho zivele indlela palpation kule ndawo.

Ngezinye izikhathi kukhona indle njalo ukuthi wenza uhudo, okuholela ukuphazamiseka kwamanzi kanye electrolyte emzimbeni.

Igciwane kungabangela relapsing amafomu yansukuzonke klostridioza ephelezelwa nesifo. Lokhu kwenzeka uma lesi sifo hhayi belashwa kuze kube sekupheleni. Kulokhu, klostridioz kwenzeka emva kwezinsuku 7-14 emva ukuqedwa ukwelashwa.

nesifo Pseudomembranous njengoba ingane eba ifomu oyingozi. Ngo esigabeni sokuqala ekuthuthukiseni lesi sifo kungekho iphango. Kukhona imfiva, nokubhamuka futhi amajaqamba esiswini. Kukhona ukudakwa, isifo sohudo kanye ukuvuvukala. On palpation esiswini waphawula soreness. Chair ophilisayo. Kubonakala igazi isikhwehlela. Kungase kube izingcezu ukweqelana fibrinous. Uma uhudo kaningi, kukhona exsicosis ephelezelwa ukwehluleka kwegazi. Ezimweni ezingavamile, kwakukhona wokugoqa.

Kutfutfukiswa nesifo pseudomembranous ngezinye izikhathi zaba zimbi ngu perforation, ukopha futhi okuvela peritonitis. Ezimweni ezinjalo, ingane kufanele libukwe hhayi kuphela isazi sezifo zezingane kodwa udokotela ohlinzayo.

Ukugula okubangelwa Clostridium difficile: Ukwelashwa

Klostridioz iphathwa kuphela esibhedlela. Lapho i adakwe dyspeptic iziyaluyalu ebekiwe lavage esiswini waliphothula usebenzisa wamathumbu enema. Ngosuku lokuqala Kunconywa amanzi yokulamba Ukudla.

Phakathi imithi esetshenziswa ama-antibiotic-makrolity. Kubo clostridia ebucayi. "Clarithromycin" futhi "Azithromycin" ngokuvamile kakhulu esetshenziswa phakathi le mithi. Toxin Clostridium difficile e (izimpawu kanye nokwelashwa setha ngamunye udokotela esekelwe isimo lesiguli) imithi Ungasusa cephalosporins, phakathi kwawo - "Cefazolin" futhi "Ceftriaxone". Ngokuvamile ukuze ulwe namagciwane abangela izifo ukubandakanya imithi elwa namagciwane penicillin akuzange kusize, kuba "Vancomycin" "Amoxiclav". Iphinde isetshenziselwe "metronidazole".

Ukubuyisela microflora imvelo emathunjini, odokotela linqume probiotics futhi prebiotics. Ethandwa kakhulu kukhona "Hilak Forte", "Atsipol", "Laktofiltrum", "Bifiform", "Enterol", "Linex", "Enterol".

, I-intravenous "Reopoligljukin" ukususa ubuthi. Uma kudingeka, linqume antihistamine izidakamizwa corticosteroids.

Labetibambile lingaze ukwelashwa enterosorbents, hepatoprotectors, amavithamini, nootropics, glycosides inhliziyo, kanye antipyretics.

Kukholakala ukuthi imishanguzo okuqhubekayo ngempumelelo uma:

• kwehle sezinyawo imvamisa;
• sezinyawo ukungaguquguquki kuba mkhulu;
• jikelele isimo ngcono kwenzeka;
• Ngaphawula ushintsho oluhle ebonwe emitholampilo laboratory ihlaziya;
• akukho ukuqhubeka kwesifo.

Uma ziphikelela Clostridium difficile, impatho efanele ekusebenziseni indlela yokwelapha ngemithi elwa namagciwane.

Ngezinye izikhathi nesifo, senziwa Clostridium difficile, ziphathwa surgically. Lokhu kujwayele ukwenzeka uma perforation we ikholoni, futhi lapho kukhona ukuvuvukala ukuthuthukiswa ukuvela megacolon anobuthi, kanye ukuvimbela emathunjini kwenzeka. Umsebenzi wenziwa kuphela uma ukwelashwa ngoludala ezanele kwanhlanga zimuka nomoya.

Ingabe ikhona difficile ikhambi Clostridium?

Clostridium ukutheleleka difficile kubonakala degrees ezahlukene zaba namandla kakhulu. It has a uhlamvu oluthile ukugeleza kanye nezinga ukuxakeka.

Lapho lesi sifo hhayi egijima futhi kobukhulu okuncane noma ophansi, lesi sifo esesindile at 100%. Fever ubalekela for 1-2 amahora, Uhudo kuthiwa wayeka izinsuku 4-7. Wamathumbu isimiso, ukungasebenzi kwezinso, futhi nesifo pseudomembranous isimo esinzima ngokwengeziwe.

izinyathelo

Ukuhlaziya Clostridium difficile ivumela isikhathi ukuvimbela ukuthuthukiswa isifo, abaqede laba isifo uyasiza izinyathelo ngesikhathi esifanele ukukhalima, okuyinto ziyabonakala:

• ukugcinwa imithetho inhlanzeko yomuntu siqu ;
• imikhiqizo egeza;
• ukufudumeza ukwelashwa imikhiqizo ukudla;
• ekuthuthukiseni amasosha omzimba;
• sinjalo we microflora emathunjini;
• kusenesikhathi abantu abangenwe;
• ukusetshenziswa ukwelashwa ngemithi elwa namagciwane.

Amagciwane amelana ammonia, ibulala ukwenekwa sodium hypochlorite etilenoksidsoderzhaschih izinto, kanye nokwelashwa ane-alikhali nge glutaraldehyde. Lapho igciwane, Clostridium difficile kufanele kahle bahlanza zonke evele of wathi izindlela, ukubhubhisa ezinhlamvu webhaktheriya we bacterium. I-bacterium abafi e ukucutshungulwa utshwala, kodwa isandla-egeza ngensipho uyakwazi ukuvimbela okuvela kuyo isifo.