Utachiona Clostridium difficile

Utachiona Clostridium difficile anogara muviri mumwe munhu. It ane muitiro ndichibvunza maberekero, nemhaka iyo inova ngozi nekuti anowana pathogenic zvivako uye kunokonzera chimwe chirwere. Rinoreva unosungira anaerobes uye angawanika pasina oxygen. It rinobatanidzwa dzinonetsa pezvakaitwa akadai cleavage kwemapurotini, kurudziro uye toning pamusoro intestinal rusvingo.

Chii Clostridium difficile?

Shoko "Clostridium" rinoshandurwa mu rinoreva Russian "chokurukisa". Kwakadaro zita nokuda chepfungwa utachiona akanzwa kuzvimba pakati apo sporulation. More bacteria vanokwanisa kutora chimiro chokurukisa. Rakakamurwa nezvemarudzi mana:

• Clostridium botulinum, ndiye causative nomumiririri zvanga zvine utachiona uhu;
• Clostridium tetanum, hunoita kuti tetenasi;
• Clostridium perfringens, kunokanganisa panowanikwa anaerobic zvirwere;
• Clostridium difficile kunokonzera pseudomembranous colitis.

Clostridium ndiyo tsvimbo serin'i. Rinogona kuiswa vaviri vaviri uye ngetani. Yakakwana mufambo. Pasina okisijeni yakakwana anotanga kuwanda nokukurumidza. Utachiona kubereka spores, unoita kuti nemishonga inouraya mabhakitiriya, kudziyisa uye kugadzirira siyana nokuda disinfection. The nechepakati nharo iri chokurukisa serin'i, uye pane chinouraya, - chimiro drumsticks.

Clostridium difficile kunokonzera manyoka kubva nemishonga. Yemanyorero izvozvo anogara intestinal zvakatipoteredza. With utano hwakanaka kubatsira Micro-zvinenge tunodzivisa kukura mabhakitiriya. Pashure kushandiswa kwemishonga inorwisa mabhakitiriya anobatsira utachiona yava duku, uye uwandu Clostridium kunowedzera, izvo zvinogona kukonzera nechitarisiko colitis, kukonzera kukura chirwere chakakomba uye kunyange rufu munhu. Kunyanya nezvezvitadzo vakwegura uye zvamuremadza varwere chirwere.

Miti yose Clostridia anoumba muchetura kuti chirwise nechitarisiko kuchiitirwa zvokurwara. Somugumisiro kwayo chokuwanziridza pave toxin A uye B Clostridium difficile. Yokutanga inonzi enterotoxin, uye wechipiri - a cytotoxin. Vanogona kuva chinokonzera manyoka uye colitis vanhu vazhinji.

chirwere

Clostridium difficile kazhinji anogara muzvipatara uye mumisha inotarisira vakwegura. Zvinogona pose: pasi, hwindo Sills, tafura parutivi pomubhedha, pamubhedha uye zvimbudzi. Spores of microorganism kuti takasununguka kuwana maoko enyu neVadzidzi utachiona pamusoro. Advantageously chakapinzwa fecal-nomumukanwa nzira.

Pakangotanga spores kunge rakapinda mumuviri, vanogona nyore kupfuura svikiro mudumbu uye kuramba vari ura. In nharaunda yacho ura duku dziri mudzoke kunyika vegetative chimiro uye kushingaira dzinotanga kuwanda. The muura Mabhakitiriya iiswe intestinal pazvirugu uye rinotanga kubudisa tsvina A uye B, zvichiguma kwazvo kuzvimba intestinal kwezvakatipoteredza, izvo zvinokonzera misha marara uye madzihwa. Paumbwe pseudomembranous. A toxin anotanga kukwezva ropa masero machena, apo toxin B rinobatanidzwa risa masero epithelial. azvaiitwa kutsamwisa chitarisiko colitis, mvura manyoka uye pseudomembranous chitarisiko.

Zvikurukuru, vose pathologies chokuita Clostridium difficile kuitika mushure asingaurayiwi kurapwa, uyewo pashure kuvhiyiwa. Zvikurukuru pachena kuti zvigare vanhu vakwegura makore 60 okukura uye vanhu vari kurapwa kwenguva refu muchipatara, uyewo varwere vari kushandisa zvinodhaka immunosuppressive.

Clostridium difficile kunomutsa simba kana mwero manyoka uye zviduku dumbu chinyamunhari chinorwadza. Zvisinei, muna aakatipa zviitiko, chirwere anova zvikuru mhando colitis. Chii chinoita zviratidzo zvakadai:

• mvura-mvura zvituru;
• marwadzo mudumbu;
• bundu;
• fivhiri;
• kupera muviri;
• svoto.

Muna 3% wevarwere vane kwazvo chimiro chirwere. Izvi, 30-85% kufa. Muna 20-25% wevarwere chirwere zvingaitika zvakare. Recurrences zvirwere zvinokonzerwa kwemabhakitiriya yakasara guru ura pashure kurapwa, kana nokuda itsva utachiwana Clostridium difficile. The chirwere ingachinja vana, kunyanya simba.

Zvirwere zvinokonzerwa ne utachiona

Clostridium difficile muna chimwe muzvitatu Muzviitiko chinokurwadzai manyoka chokuita pakutora mishonga inorwisa mabhakitiriya. Mune mamwe mamiriro ezvinhu, pakuonekwa chirwere iri sei nemamwe utachiona. Most kazhinji chirwere kunoitika muzvipatara. Vana hakurevi kutambura panguva imwe chete

Anitibiotiko-akabatanidza manyoka (aad) vangava mumatanho akasiyana okukura, kubva nyoro intestinal zvinetso kusvikira zvikuru enterocolitis, unonzi pseudomembranous colitis. Chinokonzera chirwere ichi chiri chirwere anokonzerwa Clostridium difficile, izvo rinowanikwa dzimwe nguva yakafanira pakushandisa asingaurayiwi mishonga.

Manyoka kana pseudomembranous colitis anokwanisa kugamuchira kunyange chimwe mushonga ane chakarondedzera chiito. Uyezve, pakuonekwa chirwere hakubvi pamusoro chipimo chemushonga uye nzira chourongwa.

Clostridium difficile: zviratidzo chirwere

Klostridioz anokonzerwa Clostridium difficile, anogona kutora nzvimbo zvinotevera siyana:

• asymptomatic chirwere;
• munyoro manyoka;
• wakaomarara chimiro hosha, akapfuura pseudomembranous colitis.

Aad rinowanikwa mune varwere vanenge inini kurapwa kwenguva refu - kwevhiki dzinopfuura mana muchipatara. Clostridia ari intestinal svikiro kuwana kuramba zvimwe zvinodhaka. Kana zvokurwara iri aripo soreness achiine rukuvhute nharaunda, vakazochinja kunokanganisa yose dumbu. Chair varwere kwava kakawanda, asi zvinonyatsorehwa kunzwa anoramba inogutsa.

Pseudomembranous colitis anokonzerwa Clostridium difficile, ane zviratidzo zvikuru. Varwere kuonekwa goiter, mabasa inotongwa Clostridium difficile. Utachiona colonizes ari intestinal mucosa uye kubudisa enterotoxin uye cytotoxin. Kushoma kunotanga nokuumbwa mucosal pseudomembrane. Pasina nenguva kurapwa, chirwere mberi uye anopa zvakawanda kwazvo matambudziko. It anowanikwa perforation pamusoro intestinal rusvingo, zvichikonzera peritonitis. Mune zvimwe zviitiko, chirwere chinourayisa.

zvirwere Similar ndivo zvikuru kubatwa kenza varwere, vakwegura uye varwere achirapwa kuvhiyiwa. Kukura hosha achiperekedzwa fivha, marwadzo mudumbu uye musoro, flatulence, belching, kurutsa. Pane zvimwe zviratidzo kudhaka. Varwere, uremu, vamwe kuonekwa neanorexia, mwoyo tsika, mwoyo kunoitika. More anozivikanwa cachexia, kuedza, tenesmus, manyoka chinonyangadza kunhuwa uye fibrin kuifukidza kusvika ka20 pazuva.

Kana Kusvibisa ne tsvina inogona kuva necrotic enteritis. Panyaya iyi, masvingo muura vari vakaumba erosions uye maronda, necrosis. Inosimudzira muviri tembiricha. Pane hwava kuderera. Pane fufune, chetsoka anova emura, zvakavhenganiswa neropa. Chirwere hepatosplenomegaly, paresis pamusoro bowel, achiperekedzwa bloating. Pangava gastrointestinal ropa, perforation ari maronda, uyewo venules uye arterioles thrombosis.

Kazhinji zvinokonzera chikafu chepfu clostridia, kusanganisira Clostridium difficile. Clinical zviratidzo zviri chirwere anozviratidza muchimiro nomuchetura. Kazhinji, ndizvo fivha, kurwadziwa mudumbu, manyoka, kurasikirwa kudya, fufune. In chirwere ichi kuratidza kwose kudhaka uye dyspeptic zviratidzo. Varwere vave tsamwa, lethargic uye kudzikama. Negative zviratidzo rinovapo anenge 4 Mazuva, uye zvishoma nezvishoma aserera.

The chikuru chepfungwa utachiona vari idzokororo, anoonekwa muna 25% nyaya. Chikonzero chiitiko dzavo ndidzo pfungwa dziri intestinal zvakatipoteredza. Hatigoni siya nyaya kunenge hweHIV. Kazhinji, pakarepo pashure kurapwa kupora kunoitika, asi maawa 2-28 zvingamuka dzokororo, zvakafanana zviratidzo dzavo kutanga nokuratidzwa chirwere.

zvinokonzera

Pamusoro kuziva miedzo Clostridium difficile ari kurapwa muviri vanofanira kutanga pakarepo. The zvinokonzera chirwere ichi vari zvinhu zvinotevera:

• murombo ezvinhu;
• Stress mwoyo, neurosis;
• refu kurapa pamwe hormone inorwisa mabhakitiriya;
• immunodeficiency;
• atadze kushanda zvakanaka Central tsinga;
• Prematurity muvana;
• kushaya hope, akapfuura mune chirwere muchimiro kukura;
• zvirwere zvokufema;
• Utachiona kurarama madziro muchipatara;
• Kuvhiya.

Izvi zvinokonzera zinyekenyeke muviri uye pave kuwanda Clostridium difficile. kurapwa chirwere zvinofanira kuitika chete pashure kumbonyatsoongorora chirwere murwere.

Diagnostics

Chirwere chirwere anobva kuziva zvirwere zviratidzo uye ayo dzenharo. History inocherechedzwa nhoroondo, uyewo epidemiological zvinhu. Nyatsoteerera kuti kurapwa zvinoratidza chirwere. Nokuti chirwere kushandisa richishanda uye mumarabhoritari nzira.

Ko fecal Clostridium difficile. Ezvokunambira kunze kwomuviri waamai tsanangura tsvimbo giremu-akanaka uye dzavo spores. Nemaziso kuongorora inoculated biomaterial uye zvakananga, zvikaonekwa yakavakirwa yaitongwa utachiona. Special kugadzirira hurukuro yakadaro kuongorora hakusi zvakakodzera. Kuwanda clostridia kuona zodzera giremu. Pashure mabhakitiriya mhando ichi chinozivikanwa. Mutsvina yadzo pasi Clostridium difficile akanga munyaya imwe bacteriological murabhoritari.

Kana chirwere yomuzvarirwo mharidzo rinoitwa pasi mbeva chena, iyo inorondedzera danho kudhaka, rinotaura toxin uye anobatsira kutsanangura nzira kurapa chirwere. In nechirwere chirwere kuti zvakananga antigen bvunzo mu immunological mumarabhoritari.

In rinokosha nguva dzakatarwa taura Diagnostics kubatsira kuziva pamberi toxin mu mutsvina yadzo. Biopsy pamusoro intestinal nhengo kuti unobvumira kuziva nzvimbo foci pakati kuzvimba.

Serodiagnosis rinozivisa pamberi toxin iri IHA. Zvikaonekwa pavanoparidza antibody diagnosticum. Cherechedza maitiro kuti kunoitika somugumisiro yemabhuku immunoelectrophoresis.

Diagnostics - haasi chinhu asi radiography pakati intestinal nhengo, iyo anobvumira kuziva apo gasi yaungana munyama womunhu muviri.

Zvinonzi vaiona yakarurama uye edoskopicheskoe zvikuru tomographic kuzviongorora. Zvinoratidza kuzvimba uye paumbwe pseudomembranous.

Vakawedzera basa clostridia mu vacheche kunoratidza kuvapo dysbiosis. In bloating mucheche zvinogona kuonekwa zvokurwara ichi, ungaderedza kudya, kurutsa. Dzimwe nguva ungave hope vachivavhiringidza uye kutadza bowel. Kuwanda utachiona vari vacheche havafaniri kupfuura 103-104 cfu / g. Zvakawandisa chakarurama kunoonekwa sechinhu zvokurwara kuti inofanira kubatwa.

Kana zviri clostridia zvakajairika panguva ongororo iri dysbacteriosis, ichi zvinoreva kuti muura vari mudanga. Treatment yaifanira ura nokuwedzera uwandu pathogenic mabhakitiriya.

Zvinokwanisika kuita kudzidza pamusoro Clostridium difficile mu "Invitro". Zvinofanira kuva Kuongororwa vanenge 1200 rubles. On ayo hwaro, kazhinji mishonga anodiwa kurapwa.

Sei chirwere kuvana?

Utachiona Clostridium difficile kashoma inobata vana vachangoberekwa uye mafufu gore upenyu rokutanga. Izvi imhaka yokuti mukaka waamai rine chaizvo antibodies kuti zvinobatsira pamusoro Clostridium.

In zvinoitirwawo mushonga-akabatanidza manyoka muvana kuitika zvose zviratidzo zvimwechete vakura. Enterocolitis uye colitis muvana uye lightweight unobuda pasina intonsikatsii uye fivha. Varwere vanogona kunokanganisa marwadzo mudumbu, panguva imwe palpation nzira munzvimbo iyi kuonekwa.

Dzimwe nguva pane kakawanda zvituru kuti chinokurwadzai manyoka, izvo inotungamirira nokuvhiringidzirwa mvura uye electrolyte mumuviri.

Utachiona anogona kukonzera idzokororo relapsing siyana klostridioza achiperekedzwa colitis. Izvi zvinoitika kana hosha haina vakaporeswa kusvikira pakuguma. Muchiitiko chino, klostridioz kunoitika pashure pemazuva 7-14 pashure discontinuation kurapwa.

Pseudomembranous colitis sezvo mwana ikabuda kusachengeteka kukuru muchimiro. In kuchava kutanga kwekupwanyiwa dzichiri chirwere hapana havi. Pane nefivha, belching uye dumbu chinyamunhari chinorwadza. Pane kudhaka, manyoka uye bloating. On palpation mudumbu vakachengeta soreness. Chair unoraramisa. Rinooneka ropa uye madzihwa. Pangava nezvidimbu fibrinous overlaps. Kana manyoka rinogara, pane exsicosis achiperekedzwa kweropa akundikana. Mune zvisingawanzoitiki Muzviitiko, paiva kuparara.

Kugadzirwa pseudomembranous colitis dzimwe nguva kuwedzera nokuti vabereki perforation, ropa uye panowanikwa peritonitis. Muzviitiko zvakadaro, mwana anofanira kuchengetwa kwete chete wevana asi chiremba.

The chirwere anokonzerwa Clostridium difficile: Kurapwa

Klostridioz kubatwa chete muchipatara. Kana ane kudhaka uye dyspeptic zvirwere ushandiswe gastric lavage ndokunatsawo kushandisa bowel enema. Pazuva rokutanga rakarumbidza mvura-nzara zvokudya.

Pakati mishonga inoshandiswa nemishonga inorwisa mabhakitiriya-makrolity. Kwavari nzwisisa clostridia. "Clarithromycin" uye "Azithromycin" chinonyanya anowanzoshandiswa pakati zvinodhaka izvi. Toxin Clostridium difficile mu (Zviratidzo uye kurapwa wakaiswa nomumwe chiremba inobva murwere nemamiriro) mushonga anogona kubvisa cephalosporins, pakati pavo - "Cefazolin" uye "Ceftriaxone". Kazhinji kurwisana pathogenic bacteria zvinosanganisira nemishonga kuti penicillin, ndiyo "Vancomycin" "Amoxiclav". Rinoshandiswawo "Metronidazole".

Kunotangazve microflora ari intestinal kwezvakatipoteredza, vanachiremba akarayira probiotics uye prebiotics. Kupfuura mukurumbira vari "Hilak forte", "Atsipol", "Laktofiltrum", "Bifiform", "Enterol", "Linex", "Enterol".

, Intravenous "Reopoligljukin" kubvisa toxicity. Kana zvakakodzera, akarayira antihistamine madhiragi uye corticosteroids.

Held symptomatic kurapwa enterosorbents, hepatoprotectors, mavhitaminzi, nootropics, cardiac glycosides, uyewo antipyretics.

Zvinonzi vaidavira kuti kuramba kurapwa unoshanda kana:

• ungaderedza chetsoka maitikiro;
• chetsoka kusachinja-chinja kunova mukobvu;
• mukuru wehurumende kuvandudza kunoitika;
• zvakanaka kuchinja kuchengetwa kurapwa uye murabhoritari inoongorora;
• hakuna kuchiita chirwere.

Kana zviratidzo izvi zvikaramba zviripo Clostridium difficile, akarurama kurapwa vari kushanda asingaurayiwi mishonga.

Dzimwe nguva colitis, kukonzerwa Clostridium difficile, vabatwe surgically. Izvi zvinowanzoitika kana perforation ari muura, uye kana pane kushoma pakati kukura chidzoke chepfu megacolon, uye intestinal mhingaidzo kunoitika. Operation rinoitwa kana mukana wakakwana kuchinja kurapwa pasina chete.

Pane mushonga Clostridium difficile?

Clostridium difficile chirwere kunoratidzwa pamwero yakasiyana-siyana zvakaoma. It ane mumwe hunhu aibuda uye mwero yematambudziko.

Kana hosha isina achimhanya uye ane runyoro kana svikiro zvakaoma kwazvo, chirwere anoporeswa pa 100%. Fever haazombotaurwi kwemaawa 1-2, uye manyoka anomiswa kwemazuva 4-7. Bowel mhingaidzo, itsvo kukundikana, uye pseudomembranous colitis ezvinhu kwakanyanya.

matanho

Kuongororwa Clostridium difficile anobvumira nguva kudzivirira kukura chirwere uye kubvisa hosha anotibatsira kuti nenguva matanho chokudzivirira, izvo richiratidzwa:

• kuchengetwa mitemo utsanana ;
• Washing zvinogadzirwa;
• kudziyisa kurapwa mishonga zvokudya;
• kuvandudzwa kutapata;
• Kudzikamiswa of intestinal microflora;
• mangwanani kuonekwa kuti utachiona vanhu;
• kushandisa mishonga inorwisa mabhakitiriya mishonga.

Utachiona husingakwanisi amoniya, asi vakaurayiwa yokuwana yavaibvisa hypochlorite etilenoksidsoderzhaschih zvinhu, uyewo alkaline kurapwa pamwe glutaraldehyde. Pamusoro chirwere, Clostridium difficile zvinofanira kucheneswa kwazvo vose hukawanika ose akati nzira, kuparadza kwemabhakitiriya spores yacho microbe. Utachiona havafi iri kubudiswa doro, asi ruoko-washing nesipo anokwanisa kudzivirira panowanikwa chirwere.