Bacteremia imatanthauzidwa ndi kukhalapo kwa mabakiteriya m'magazi. Zitha kukhala zotsatira za machitidwe wamba monga kutsuka mano, chithandizo chamankhwala kapena njira zamankhwala, kapena zitha kuyambitsidwa ndi matenda monga chibayo kapena matenda a mkodzo. Nthawi zambiri, bacteremia samatsagana ndi zizindikiro zilizonse, koma nthawi zina mabakiteriya amadziunjikira m'magulu ena kapena ziwalo ndipo amakhala ndi matenda oopsa. Anthu omwe ali pachiwopsezo chachikulu cha zovuta zobwera chifukwa cha bacteria amathandizidwa ndi maantibayotiki musanayambe mankhwala ena a mano ndi njira zachipatala. Ngati bacteria akuganiziridwa, ma epirical makonzedwe a maantibayotiki akulimbikitsidwa. Mankhwalawa amasinthidwa malinga ndi zotsatira za mayesero a chikhalidwe ndi chidziwitso.

Bacteremia imatanthauzidwa ndi kukhalapo kwa mabakiteriya m'magazi. Magazi ndi madzimadzi osadziwika bwino. Kuzindikira kwa mabakiteriya m'magazi ndiko a priori zachilendo. Bacteremia amadziwika ndi chikhalidwe cha magazi, ndiko kuti kulima magazi ozungulira.

Avereji ya zaka za odwala omwe ali ndi bacteremia ndi zaka 68. Mabakiteriya ambiri ndi mono-microbial (94%), ndiko kuti chifukwa cha kukhalapo kwa mtundu umodzi wa mabakiteriya. Otsala 6% ndi polymicrobial. Majeremusi akuluakulu olekanitsidwa, pakachitika bacteremia, ndi Escherichia coli (31%) ndi Staphylococcus aureus (15%), ndipo 52% ya bacteremia ndi chiyambi cha nosocomial (enterobacteria, Staphylococcus aureus).

Bacteremia ingayambidwe ndi chinthu chopanda vuto monga kutsuka mano mwamphamvu kapena matenda oopsa.

Non-pathological bacteremia

Amafanana ndi kutulutsa kwachidule kwa mabakiteriya m'magazi omwe amawonedwa chifukwa cha zochitika wamba mwa anthu athanzi:

• pa chimbudzi mabakiteriya akhoza kulowa m'magazi kuchokera m'matumbo;
• pambuyo potsuka mano mwamphamvu, pamene mabakiteriya okhala m'kamwa "amakankhira" m'magazi;
• pambuyo pa mankhwala ena monga kuchotsa dzino kapena kukulitsa, pamene mabakiteriya omwe amapezeka m'kamwa amatha kuchotsedwa ndikulowa m'magazi;
• pambuyo endoscopy m'mimba;
• mutayika katheta mu genitourinary kapena catheter. Ngakhale njira za aseptic zimagwiritsidwa ntchito, njirazi zimatha kusamutsa mabakiteriya m'magazi;
• mutatha kubaya mankhwala osangalatsa, chifukwa singano zomwe zimagwiritsidwa ntchito nthawi zambiri zimakhala ndi mabakiteriya, ndipo ogwiritsa ntchito nthawi zambiri sayeretsa khungu lawo bwino.

Pathological bacteria

Amafanana ndi matenda amtundu uliwonse omwe amadziwika ndi kutuluka kwakukulu kwa mabakiteriya m'magazi kuchokera pamalo oyamba opatsirana, kutsatira chibayo, chilonda kapena matenda amkodzo. Mwachitsanzo, kuchiza zilonda zopatsirana, zithupsa zimene zimatanthauza kuunjikana kwa mafinya, ndi zilonda za m’mabedi, zimatha kuchotsa mabakiteriya omwe ali pamalo okhudzidwawo ndi kuyambitsa bacteremia. 

Kutengera ndi njira za pathophysiological, bacteremia imatha kukhala:

• intermitten kwa thromboembolic ndi endocarditic bacteremia: kumaliseche ndi osasamba ndi mobwerezabwereza;
• mosalekeza kwa bacteria wa mitsempha yodutsitsa madzi chiyambi monga brucellosis kapena typhoid fever.

Kukhala ndi prosthesis kapena prosthesis, kapena kukhala ndi vuto ndi ma valve a mtima, kumawonjezera chiopsezo cha bacteremia yosalekeza kapena chiopsezo chakuti ndizomwe zimayambitsa mavuto. .

Nthawi zambiri, mabakiteriya omwe amayamba chifukwa cha zochitika wamba, monga chithandizo cha mano, sakhala oyambitsa matenda, chifukwa ndi mabakiteriya ochepa chabe omwe amapezeka ndipo amachotsedwa mwachangu ndi thupi lokha. , chifukwa cha phagocytes-mononuclear system (chiwindi, ndulu, mafupa a mafupa), kapena mwa kuyankhula kwina, chifukwa cha chitetezo chathu cha mthupi.

Mabakiteriyawa nthawi zambiri amakhala osakhalitsa ndipo samatsagana ndi zizindikiro zilizonse. Mabakiteriyawa, popanda zotsatira za anthu ambiri, amatha kukhala ndi chiopsezo pakachitika matenda a valvular kapena kuponderezedwa kwambiri kwa chitetezo chamthupi. Ngati mabakiteriya alipo motalika mokwanira komanso okwanira, makamaka kwa odwala omwe ali ndi chitetezo chamthupi chofooka, bacteremia amatha kuyambitsa matenda ena ndipo nthawi zina amayambitsa kuyankha kwakukulu kapena sepsis.

Bacteremia woyambitsa matenda ena angayambitse kutentha thupi. Ngati munthu yemwe ali ndi bacteremia ali ndi zizindikiro zotsatirazi, mwina akudwala sepsis kapena septic shock:

• malungo osalekeza;
• kuchuluka kugunda kwa mtima;
• kuzizira;
• kutsika kwa magazi kapena hypotension;
• zizindikiro za m'mimba monga kupweteka kwa m'mimba, nseru, kusanza ndi kutsekula m'mimba;
• kupuma mofulumira kapena tachypnée;
• kusokonezeka kwa chidziwitso, mwina akudwala sepsis kapena septic shock.

Septic mantha akufotokozera 25 mpaka 40% ya odwala kwambiri bakiteriya. Mabakiteriya omwe sanachotsedwe ndi chitetezo chamthupi amatha kudziunjikira m'malo osiyanasiyana amthupi, zomwe zimayambitsa matenda mu:

• minofu yomwe imaphimba ubongo (meningitis);
• envelopu yakunja ya mtima (pericarditis);
• maselo ozungulira ma valve a mtima (endocarditis);
• mafupa a mafupa (osteomyelitis);
• matenda a nyamakazi (arthritis).
  

Prevention

Anthu ena monga otsatirawa ali pachiwopsezo chachikulu chotenga matenda a bacteraemia:

• anthu omwe ali ndi ma valve a mtima opangira;
• anthu omwe ali ndi ma prostheses olowa;
• anthu omwe ali ndi ma valve a mtima osakhazikika.

Izi nthawi zambiri zimathandizidwa ndi maantibayotiki pamaso pa ndondomeko iliyonse yomwe ingakhale ndi udindo wa bacteria monga chisamaliro cha mano, njira zamankhwala, opaleshoni ya mabala omwe ali ndi kachilombo etc. Maantibayotiki amatha kuteteza bacteria ndipo motero kukulitsa matenda ndi sepsis.

chithandizo

Pankhani ya kukayikira bacteremia, tikulimbikitsidwa kupereka mankhwala empirically, ndiko kunena popanda kuyembekezera chizindikiritso cha tizilombo tating'onoting'ono mu funso, pambuyo anatenga zitsanzo za chikhalidwe cha malo chiyambi. kuthekera. Mankhwala ena onse ndi awa:

• sinthani maantibayotiki potengera zotsatira za zikhalidwe komanso kuyezetsa kuti mulingalire;
• kukhetsa abscesses opaleshoni, ngati pali abscess;
• chotsani zida zonse zamkati zomwe zikuganiziridwa kuti zayambitsa mabakiteriya.