Zamkatimu
17.03.2017
enterococcus ndi tizilombo tating'onoting'ono tokhala ngati chowulungika chomwe ndi gawo la microflora yamatumbo amunthu (omwe kale anali tizilombo toyambitsa matenda ngati gulu D streptococci).
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Kuchita ndi zochitika za chithandizo
Kuyang'ana patsogolo pang'ono, tikuwona kuti akonzi akudziwa bwino kuti owerenga akufunafuna zambiri za mmene kuchiza enterococcus. Pachifukwa ichi, choyamba tikukupatsani zambiri za Forum yathu, komwe kuli zokambirana zogwira mtima pamutu wa chithandizo cha matenda a bakiteriya a enterococcal mwa amuna. Nayi mitu yodziwika bwino yomwe imakhala ndi zambiri zothandizidwa ndi machitidwe:
Enterococcus faecalis - Mutu womwe uli ndi kafukufuku wokhudza zotsatira za mankhwala Enterococcus wamwalira! Ndipo sindinadziwebe - Chithandizo chamankhwala Kodi matumbo a prostate amachokera kuti - Muyenera kudziwa izi.
Tikuitana aliyense kuti alowe nawo pazokambirana! Msonkhanowu wakhala ukuyenda kuyambira 2006. Malo osungiramo chidziwitso chothandiza pazaumoyo wa amuna.
Komabe, chidziŵitso chothandiza sichimathetsa kufunika kwa chidziwitso cha njira. Ndiye tiyeni tipitilize…
Mitundu ya enterococci. Zomwe zimayambitsa matenda
Enterococci chiwerengero oposa 16 mitundu, ena a iwo angayambitse matenda a genitourinary dongosolo, endocarditis, etc. Ambiri ndi Enterococcus faecalis (fecal enterococcus) ndi Enterococcus faecium. Ngakhale kuti malo abwino a enterococci ndi matumbo, pafupifupi 25 peresenti ya amuna athanzi, Enterococcus faecalis amapezeka kumtunda wa mkodzo. Ndicho chifukwa chake enterococci amatchulidwa ngati mwayi (wosakhalitsa) microflora ya ziwalo za genitourinary. Komanso, Enterococcus faecium imayambitsa matenda ambiri a vancomycin omwe amalimbana ndi enterococcal. Kusamva kwa mabakiteriya ku maantibayotiki ndi vuto lalikulu lamankhwala amakono.
Enterococci onse awo, chifukwa cha dongosolo lapadera, ndipo anapeza mankhwala kukana. Izi zimapereka chithandizo chachikulu cha mabakiteriyawa pakukula kwa matenda a nosocomial komanso kuchepetsa mphamvu ya madokotala pokhudzana ndi mbali yofunika kwambiri monga chithandizo cha enterococcus.
Enterococcus mwa amuna (nthawi zambiri - Enterococcus faecalis) imatha kuyambitsa matenda a ziwalo za urogenital thirakiti, makamaka mwa anthu omwe adayesedwa koyenera komanso / kapena kumwa maantibayotiki:
• prostatitis; • balanoposthitis; • urethritis; • epididymitis/orchoepididymitis; • cystitis, etc.
Njira zopatsirana:
• Kugonana (makamaka kusinthana kwa maliseche ndi maliseche); • ukhondo wosayenera mukamagwiritsa ntchito chimbudzi; • kupatsirana kuchokera kwa mayi kupita kwa wobadwa kumene; • kawirikawiri - poika ziwalo.
Polowa mu ziwalo za genitourinary, enterococci imatha kukhala mwa iwo kuyambira maola angapo mpaka masabata, potsirizira pake ikuwonongedwa ndi njira zotetezera. Derali limatchedwa mayendedwe osakhalitsa. Pamenepa, wonyamulirayo amatha kupatsira tizilombo toyambitsa matenda kwa ogonana naye. Kuzindikira kwa enterococcus ndikunyamula kwakanthawi kumatheka ndi njira zolondola kwambiri (mwachitsanzo, PCR).
Komanso, enterococci pang'ono akhoza kukhala mu genitourinary ziwalo (kulimbikira galimoto). Kukula kwawo kumalepheretsedwa ndi njira zomwezo zotetezera komanso microflora yachibadwa. Ndi kuchepa kwa tizilombo tating'onoting'ono komanso / kapena kuphwanya chitetezo cha enterococci, amayamba kuchulukirachulukira, kutupa kumayamba. Kunyamula kosalekeza nthawi zambiri kumakhala kopanda zizindikiro, kupatula nthawi yowonjezereka, kuzindikira kwa enterococcus ndizotheka ndi PCR, njira ya chikhalidwe cha kafukufuku. Pankhaniyi, palinso kuthekera kwa matenda okondedwa.
Thupi likasiya kuletsa kukula kwa enterococci, mawonetseredwe a matendawa amapezeka. Zomwe zimayambitsa matenda a enterococcal:
• kukhalapo kwa matenda aakulu; • matenda am'mbuyomu a gonococcal/chlamydial; • kuphwanya njira zotetezera ziwalo zoberekera (njira zoterezi zimaphatikizapo malo osalowerera / ofooka amchere mu urethra, prostate antimicrobial factor, mechanical, local immunological protection) prostate antimicrobial factor - zinc-peptide complex); • mankhwala opha tizilombo; • kugwiritsa ntchito mankhwala osokoneza bongo a m'deralo, zomwe zimayambitsa kutentha kwa mkodzo; • catheterization wa mkodzo thirakiti kapena zida kufufuza, amene angayambitse zoopsa kwa mucous zimagwira ntchito zosiyanasiyana; • ukalamba, etc.
Zizindikiro za matenda a Enterococcal
Palibe zizindikiro zenizeni za kuwonongeka kwa genitourinary system ndi enterococcus. Ndi chitukuko cha pathological ndondomeko, odwala kupereka madandaulo khalidwe la mtundu wina wa matenda (malingana ndi kumasulira kwa kutupa).
Urethritis imatsagana ndi:
• kuchuluka pafupipafupi, zowawa mawonetseredwe pa pokodza; • kutulutsa mkodzo; • redness, kukwiya, kusapeza bwino mu mkodzo.
Prostatitis imadziwika ndi:
• syndrome mu mawonekedwe a ululu ndi kusapeza mu perineum, kupweteka kwa machende, kukokana / kupweteka kwa mkodzo, kuyaka pambuyo pogonana; • matenda a mkodzo (kuwonjezeka, kumverera kwa kutaya kosakwanira, mtsinje wofooka / wapakati); • kuphwanya mkamwa, kutulutsa umuna (kuwawa, kuvala kwa orgasm, kutulutsa umuna msanga kapena kugonana kwanthawi yayitali); • pamodzi ndi matenda a urethritis - kutuluka kwa mucopurulent.
Ndi balanitis / balanoposthitis, odwala amadandaula ndi ululu ndi redness m'dera la glans mbolo, redness (kukokoloka, zilonda, ming'alu), zolengeza, kutupa, kumaliseche. Orchiepididymitis ndi kuphatikiza kwa kutupa kwa testicle (orchitis) ndi epididymis yomalizayo (epididymitis). Mu matenda owopsa, kupweteka koopsa kwa scrotum, kukulitsa / kuuma kwa testicle imodzi kapena zonse ziwiri, hyperemia ya khungu la scrotum, kukulitsa / kuuma kwa epididymis ndi ululu wowawa kwambiri. Ululu umachepetsedwa mu scrotum pamene ikukwera. Matenda aakulu amadziwika ndi zizindikiro zosaoneka bwino, nthawi zina maonekedwe a magazi mu umuna.
Njira zodziwira
Kuzindikira kwa enterococcus mu ziwalo za urogenital thirakiti kumaphatikizapo:
• Kufufuzidwa ndi katswiri; • kuyezetsa mkodzo ndi magazi; • polymerase chain reaction (amalola kuzindikira tizilombo toyambitsa matenda ngakhale ndi asymptomatic carriage); • maphunziro a chikhalidwe (apo ayi bacteriological inoculation) ndi kutsimikiza kwa maantibayotiki tilinazo; • ma laboratory ena, monga RIF, ELISA, smear microscopy, etc., komanso zida (ultrasound, urethroscopy, MRI, CT) maphunziro kuti asachotse zifukwa zina za matendawa (matenda omwe si a enterococcal genital, zotupa, etc.) Zitsanzo za mkodzo zimawunikidwa mu labotale, umuna, katulutsidwe ka prostate, kutulutsa mkodzo.
Pamaso pa mawonetseredwe oipa a thirakiti urogenital, nkofunika kumvetsa kuti enterococcus kawirikawiri chifukwa cha mavuto amenewa. Ngati mayeserowo sanasonyeze kukhalapo kwa tizilombo toyambitsa matenda, zingakhale zofunikira kuti mufufuzenso (nthawi zina ngakhale mu labotale ina). Pokhapokha atasiya ena zotheka tizilombo toyambitsa matenda (Trichomonas, gonococci, mauka, etc.) ndi munthu achire Inde zotchulidwa kuthetsa enterococci.
Njira zochizira Enterococcus
Kuzindikira mwangozi kwa enterococcus pakuwunika kwanthawi zonse, chithandizo chimalimbikitsidwa pokhapokha ngati pali madandaulo, kukonza njira zopangira opaleshoni pazigawo za genitourinary thirakiti (nthawi zina, dokotala angalimbikitse chithandizo choyenera pokonzekera kutenga pakati). Izi ndichifukwa choti tizilombo totere timapezeka mwa amuna athanzi.
Mitundu ya Enterococcus ya dongosolo la 1 * 10 mu digiri ya 6 imatengedwa kuti ndi yofunika kwambiri (popanda mawonetseredwe azachipatala). Nthawi yomweyo, asymptomatic bacteriuria (kuzindikira kwa enterococcus mumkodzo) kungafunike kuyang'aniridwa ndi dokotala ndipo, ngati kuli kotheka, kuyezetsa nthawi ndi nthawi: mbewu zobwerezabwereza. Anyamata opanda zizindikiro za matenda mkodzo thirakiti, chizolowezi labotale kudziwika enterococcus ali osavomerezeka.
Ngati enterococcus amaganiziridwa kuti ndi chifukwa chokha cha mavuto munthu urogenital thirakiti (urethritis, prostatitis pyelonephritis, cystitis, etc.), okwanira mankhwala mankhwala ndi zofunika. Chifukwa cha kukana kwa tizilombo totere kuti tigwiritse ntchito mankhwala oletsa antibacterial, ndikofunikira kwambiri kudziwa kukhudzika koyenera musanayambe chithandizo (mwatsoka, izi ndizochitika zowononga nthawi ndipo sizingatheke kuchedwetsa kuyamba kwa chithandizo).
Nthawi zambiri matenda otupa a genitourinary system mwa amuna, chifukwa cha matendawa ndi fecal enterococcus (Enterococcus faecalis). Mtundu uwu wa enterococcus nthawi zambiri:
• kukhudzidwa ndi rifaximin, levofloxacin, nifuratel, zovuta zina - kwa doxycycline; • kusamala kwambiri ndi ciprofloxacin; • kukhudzidwa pang'ono (kwa mitundu yambiri) ku tetracycline; • mosakhudzidwa ndi lincomycin.
Ma penicillin, cephalosporins, fluoroquinolones oyambirira sagwira ntchito kapena sagwira ntchito motsutsana ndi enterococcus.
Kwa mankhwala, monga lamulo, mankhwala amodzi ndi okwanira; ngati sichikugwira ntchito, wina kapena kuphatikiza angapo akhoza kuperekedwa. Pambuyo pa maphunzirowa, matenda achiwiri a enterococcus amachitika. Kuchiza kwa ogonana nawo kumachitika malinga ndi malangizo a dokotala (nthawi zambiri pakukonzekera mimba). Pankhani ya matenda osakanikirana, mankhwala omwe amagwira ntchito pa tizilombo toyambitsa matenda amasankhidwa.
Mankhwala opha maantibayotiki nthawi zambiri amakhala okwanira kuchira kwathunthu. Komabe, nthawi zina, dokotala akhoza kuwonjezera:
• njira zosiyanasiyana physiotherapeutic; • njira ya kutikita minofu (nthawi zambiri amagwiritsidwa ntchito pa matenda otupa a prostate gland); • kukonzekera kwa enzyme; • mavitamini; • immunomodulating agents; • homeopathic mankhwala; • mankhwala achikhalidwe (kusamba kwa decoctions ndi infusions wa zitsamba mankhwala, kumwa madzi a kiranberi, etc.); • mankhwala am'deralo (infusions, otchedwa instillations, mu mkodzo wa njira zothetsera zosiyanasiyana mankhwala, monga antiseptics).
Kunyalanyaza malangizo achipatala, kudzikonda kwambiri ndi mankhwala owerengeka sikungangoyambitsa kuchira, komanso kumawonjezera kwambiri mkhalidwe wa wodwalayo. Mwachitsanzo, kugwiritsa ntchito molakwika kulowetsedwa kwa njira zophatikizira mu mkodzo nthawi zambiri kumayambitsa kuyaka kwa mucosal, komwe kumakhala ngati chinthu choyambitsa matenda a bakiteriya.
Mavuto
Ngati palibe chithandizo chokwanira cha matenda a enterococcal, zotsatirazi ndizotheka:
• kugawa njira ya kutupa kwa ziwalo zina ndi minofu; • kusintha kwa matendawa kukhala mawonekedwe aakulu; • kuwonongeka kwa ubwino wa umuna ndipo motero, kukula kwa kusabereka kwa amuna; • kuphwanya ntchito ya erectile, etc.
Prevention
Kupewa matenda a enterococcal ndi:
• kutsata malamulo okhudzana ndi kugonana kotetezedwa (kugwiritsa ntchito njira zotchingira chitetezo, bwenzi lokhalitsa); • kuzindikira panthawi yake ndi kuthetsa / kukonza matenda aakulu; • chithandizo choyenera cha matenda opatsirana pogonana (makamaka gonococcal, trichomonas); • kukhala ndi moyo wathanzi (kukhazikika kwaulamuliro wa ntchito ndi kupuma, chakudya chokwanira chokwanira, kuchita masewera olimbitsa thupi, kuchepetsa zovuta, etc.), ndi zina zotero.
Adakonzedwa ndikuwonjezedwa pa 14.03.2021/XNUMX/XNUMX.
Magwero ogwiritsidwa ntchito
1. Kufunika kwa mabakiteriya amtundu wa Enterococcus m'moyo wamunthu. Magazini yasayansi yamagetsi "Mavuto amakono a sayansi ndi maphunziro". Krasnaya Yu.V., Nesterov AS, Potaturkina-Nesterova NI FSBEI HPE “Ulyanovsk State University”. 2. Zotsatira za kafukufuku wambiri wa ma antibiotic susceptibility wa enterococci. Sidorenko SV, Rezvan SP, Grudinina SA, Krotova LA, Sterkhova GV State Research Center for Antibiotics, Moscow