Cov kab mob Clostridium difficile

Cov kab mob Clostridium difficile inhabits hauv lub cev ntawm ib tug neeg. Nws muaj ib tug ib txwm mus rau intensive yug me nyuam rau, vim hais tias cov neeg uas nws yuav tej vim hais tias acquires pathogenic zog thiab ua rau ib tug tej yam kab mob. Nws yog hais txog obligate anaerobes thiab tej zaum yuav muaj nyob tsis muaj oxygen. Nws yog kev koom tes nyob rau hauv ib qho tseem ceeb dab xws li cleavage ntawm cov nqaijrog, stimulation thiab nruj ntawm lub plab hnyuv phab ntsa.

Yuav ua li cas yog Clostridium difficile?

Lo lus "Clostridium" yog txhais mus rau hauv Lavxias teb sab txhais tau tias "ntxaiv". Xws li ib tug lub npe rau lub feature ntawm lub microbes tau txais mus rau swell nyob rau hauv nruab nrab thaum sporulation. Ntau cov kab mob yuav tau siv sij hawm rau hauv daim ntawv ntawm ib tug ntxaiv. Muab faib ua plaub hom yog:

• Clostridium Kab mob Botulinum, yog lub causative tus neeg saib xyuas ntawm botulism;
• Clostridium tetanum, muaj txhawb rau tetanus;
• Clostridium perfringens, muaj feem xyuam rau qhov tshwm sim ntawm co kab mob;
• Clostridium difficile ua pseudomembranous mob plab.

Clostridium yog pas nrig-zoo li tus. Nws yuav muab tso nyob rau hauv officers thiab chains. Txaus muaj. Nyob rau hauv lub tiav tsis tuaj kawm ntawv ntawm cov pa pib mus muab sai heev. Lub microbes tsim spores, uas ua rau lawv resistant rau tshuaj tua kab mob, cov cua kub thiab ntau yam kev npaj kom tuaj tua kab. Lub hauv paus sib cav yog ntxaiv-zoo li tus, thiab ib tug uas yog davhlau ya nyob twg, - tus duab ntawm drumsticks.

Clostridium difficile ua raws plab los ntawm tshuaj tua kab mob. Feem ntau nws phem nyob rau hauv lub plab hnyuv ib puag ncig. Nrog zoo noj qab haus huv pab micro-kab inhibit txoj kev loj hlob ntawm cov kab mob. Tom qab txoj kev siv cov tshuaj tua kab mob pab tau cov kab mob yuav me me, thiab tus naj npawb ntawm Clostridium nce, uas yuav ua rau cov tsos ntawm plab, ua rau txoj kev loj hlob mob tus kab mob thiab tuag taus thiab ntawm tus neeg. Tshwj xeeb tshaj yog nws kev txhawj xeeb cov neeg laus thiab debilitated cov neeg mob tus kab mob.

Tag nrho cov hom ntawm Clostridia tsim toxins uas ua cov tsos ntawm ib lub pathology. Raws li ib tug tshwm sim ntawm nws txoj kev npaug ua tau ib lub taug A thiab B ntawm Clostridium difficile. Tus thawj yog hu ua enterotoxin, thiab lub thib ob - ib tug cytotoxin. Lawv muaj peev xwm ua ib tug ua ntawm raws plab thiab mob plab nyob rau hauv muaj coob tus neeg.

ntawm kab mob

Clostridium difficile feem ntau nyob rau hauv cov tsev kho mob thiab tsev laus. Nws yuav ua tau nyob qhov twg: hauv pem teb, Qhov rai, bedside lub rooj, nyob rau hauv lub txaj thiab lub chaw tso. Cov noob kab mob ntawm lub microorganism dawb do tau rau koj ob txhais tes nyob rau hauv kev sib cuag nrog lub kab mob nto. Advantageously kis los ntawm cov fecal-oral lawv.

Thaum cov noob tau penetrated rau hauv lub cev, lawv tau yooj yim kis los ntawm tej qhov nruab nrab ntawm lub plab thiab cov nyob twj ywm nyob rau hauv cov hnyuv. Nyob rau hauv lub cheeb tsam ntawm cov hnyuv yog hloov dua siab tshiab rau hauv lub vegetative daim ntawv thiab nquag pib muab. Cov nyuv kab mob tso rau hauv cov hnyuv folds thiab pib tsim toxins A thiab B, uas ua nyob rau hauv ib tug loj heev o ntawm lub plab hnyuv ib puag ncig, uas ua rau xaav ntawm cov khib nyiab thiab hnoos qeev. Cov tsim ntawm pseudomembranous. Ib tug taug pib nyiam cov ntshav dawb, thaum taug B yog muab kev koom tes nyob rau hauv cov tug kev txiav txim ntawm epithelial hlwb. Cov dab ntxias cov tsos mob plab, dej raws plab thiab pseudomembranous tsos.

Yeej, tag nrho cov pathologies uas Clostridium difficile tshwm sim tom qab cov tshuaj tua kab kev kho mob, raws li tau zoo raws li tom qab phais. Tshwj xeeb yog raug kab mob cov neeg laus tshaj 60 xyoo ntawm lub hnub nyoog thiab cov neeg uas yog nyob rau hauv ntev-lub sij hawm kev kho mob nyob rau hauv tsev kho mob, raws li tau zoo raws li cov neeg mob uas noj immunosuppressive tshuaj.

Clostridium difficile nkoos tsis muaj zog los yog muaj mob loj tsawv raws plab thiab me plab ntswj. Txawm li cas los, nyob rau hauv exceptional mob, tus kab mob no yuav mob hnyav dua daim ntawv ntawm plab. Dab tsi ua rau cov tsos mob xws li:

• dej quav;
• mob nyob rau hauv lub plab mog;
• o;
• kub taub hau;
• lub cev qhuav dej;
• xeev siab.

Nyob rau hauv 3% ntawm cov neeg mob muaj ib tug loj heev hauv daim ntawv ntawm tus kab mob no. Ntawm no, 30-85% tuag. Nyob rau hauv 20-25% ntawm cov neeg mob tus kab mob no tej zaum yuav tshwm sim dua. Recurrences ntawm tus kab mob yog vim cov kab mob uas nyob twj ywm nyob rau hauv txoj hnyuv loj tom qab kev kho mob, los yog vim hais tias ntawm ib tug tshiab kab mob Clostridium difficile. Tus kab mob tej zaum yuav muaj kev cuam tshuam cov me nyuam, tshwj xeeb tshaj yog tsis muaj zog txaus.

Cov kab mob tshwm sim los ntawm ib tug kab mob

Clostridium difficile nyob rau hauv ib feem peb ntawm tus neeg mob provokes raws plab txuam nrog kev noj tshuaj tua kab mob. Nyob rau hauv lwm yam teeb meem, cov tsos ntawm cov kab mob no yog cuam tshuam los ntawm lwm yam kab mob. Feem ntau cov feem ntau cov kab mob no tshwm sim nyob rau hauv cov tsev kho mob. Cov me nyuam tsis raug kev txom nyem nyob rau tib lub sij hawm

Anitibiotiko-txuam raws plab (Aad) tej zaum yuav muaj ntau theem ntawm kev loj hlob, los ntawm me me plab hnyuv mob li mus rau mob hnyav enterocolitis, uas yog hu ua pseudomembranous mob plab. Qhov ua rau ntawm tus kab mob no yog ib tug kab mob tshwm sim los ntawm Clostridium difficile, uas zoo nkaus li nyob rau hauv tej rooj plaub vim rau kev siv ntawm tshuaj tua kab mob.

Ua rau raws plab los yog pseudomembranous mob plab muaj peev xwm sawv tau txais txawm tias ib tug tib tshuaj tua kab mob muaj ib tug broad spectrum ntawm kev txiav txim. Ntxiv mus, cov tsos ntawm cov kab mob tsis yog nyob ntawm seb ntau npaum thiab hom ntawv.

Clostridium difficile: cov tsos mob ntawm kab mob

Klostridioz tshwm sim los ntawm Clostridium difficile, yuav muab qhov chaw nyob rau hauv cov nram no cov ntaub ntawv:

• asymptomatic kab mob;
• me ntsis raws plab;
• ib tug loj heev hauv daim ntawv ntawm tus kab mob no, dhau nyob rau hauv pseudomembranous mob plab.

Aad tshwm sim nyob rau hauv cov neeg mob uas tau undergone ntev-lub sij hawm kev kho mob - ntau tshaj plaub lub lis piam nyob rau hauv lub tsev kho mob. Clostridia nyob rau hauv lub plab hnyuv nruab nrab tau kuj mus yam tshuaj. Thaum zoo li no pathology yog tam sim no nyob rau hauv ce hlab cheeb tsam, uas tom qab muaj feem xyuam rau tag nrho cov plab. Lub rooj zaum cov neeg mob yuav ntau heev, tab sis lub zuag qhia tag nrho lawm tseem fee.

Pseudomembranous mob plab tshwm sim los ntawm Clostridium difficile, muaj cov tsos mob loj dua. Cov neeg mob yuav tshwm sim goiter, nrog kev ua ub no yeej los ntawm Clostridium difficile. Cov kab mob colonizes lub plab hnyuv mucosa thiab tsim enterotoxin thiab cytotoxin. Inflammatory txheej txheem yuav pib nrog lub tsim ntawm mucosal pseudomembrane. Nyob rau hauv lub qhaj ntawv ntawm raws sij hawm kev kho mob, tus kab mob loj zuj zus thiab muab ib tug ntau mob. Nws tshwm sim perforation ntawm lub plab hnyuv phab ntsa, yuav ua peritonitis. Nyob rau hauv tej rooj plaub, tus kab mob ua rau yus tuag.

Zoo li cov kab mob no feem ntau raug rau cov neeg mob cancer, cov neeg laus thiab cov neeg mob niaj phais. Txoj kev loj hlob ntawm tus kab mob yog nrog kub taub hau, mob nyob rau hauv lub plab mog thiab lub taub hau, flatulence, belching, ntuav. Muaj lwm yam kev mob ntawm intoxication. Cov neeg mob poob phaus, ib txhia yuav tshwm sim anorexia, ncaj ncees kev nyuaj siab, kev nyuaj siab tshwm sim. Ntau cim cachexia, cov me nyuam, tenesmus, raws plab putrid tsis hnov tsw thiab fibrin overlay mus rau 20 lub sij hawm ib hnub.

Thaum lom los ntawm toxins muaj peev xwm tsim necrotic enteritis. Nyob rau hauv cov ntaub ntawv no, cov phab ntsa hauv cov hnyuv yog tsim erosions thiab ulcers, necrosis. Nce lub cev kub. Muaj yog ib tug txias. Muaj yog kem plab, quav yuav ua kua, tov nrog cov ntshav. Thiaj paub hais tias hepatosplenomegaly, paresis ntawm lub plob tsis so tswj, nrog tsam plab. Tej zaum yuav muaj hnyuv los ntshav, perforation ntawm lub ulcers, raws li zoo raws li venules thiab arterioles thrombosis.

Feem ntau ua rau cov zaub mov lom clostridia, xws li Clostridium difficile. Soj ntsuam cov tsos mob ntawm tus kab mob manifest lawv tus kheej nyob rau hauv daim ntawv ntawm cov tshuaj lom. Raws li ib tug txoj cai, nws yog kub taub hau, mob nyob rau hauv lub plab mog, plab, tsis qab los noj mov, kem plab. Nyob rau hauv no kab mob tshwm sim tag nrho cov ntaub ntawv ntawm cov intoxication thiab dyspeptic cov tsos mob. Cov neeg mob ua chim siab, lethargic thiab nyob tsis tswm. Tsis zoo mob li hais txog 4 hnub, thiab maj daim.

Lub ntsiab feature ntawm lub mob no recurrent, uas yuav tshwm sim nyob rau hauv 25% ntawm cov neeg. Yog vim li cas rau lawv tshwm sim yog cov nqe lus nyob rau hauv lub plab hnyuv ib puag ncig. Peb yuav tsis cais tus neeg mob ntawm re-kab mob. Raws li ib tug txoj cai, tam sim ntawd tom qab qhov kev kho mob rov qab tshwm sim, tab sis 2-28 teev tej zaum yuav tsim tsis tshua mob heev, zoo ib yam li nyob rau hauv lawv cov tsos mob nrog rau thawj zaug manifestation ntawm tus kab mob.

ua rau

Thaum nrhiav kom tau ntawm Clostridium difficile nyob rau hauv lub cev kev kho mob yuav tsum tau pib tam sim ntawd. Cov ua rau kab mob no yog cov nram qab no yam:

• cov neeg pluag ib puag ncig;
• Kev nyuaj siab, kev nyuaj siab, neurosis;
• heev kho nrog cov tshuaj hormones thiab tshuaj tua kab mob;
• immunodeficiency;
• malfunction Central tshee system;
• prematurity nyob rau hauv cov me nyuam;
• insomnia, dhau nyob rau hauv lub mob hauv daim ntawv ntawm txoj kev loj hlob;
• ua pa kab mob;
• pathogens nyob rau hauv lub phab ntsa ntawm lub tsev kho mob;
• phais.

Cov ua tsis muaj zog hauv lub cev thiab txhawb loj hlob Clostridium difficile. kab mob kev kho mob yuav tsum muab qhov chaw tsuas yog tom qab ib tug meej mob ntawm tus neeg mob.

diagnostics

Mob ntawm tus kab mob no yog raws li nyob rau hauv cov cim ntawm tus kab mob cov tsos mob thiab nws ua. Keeb kwm yog muab rau tus account, raws li zoo raws li epidemiological yam. Them mloog mus rau cov kev soj ntsuam kom paub txog tus kab mob no. Rau mob siv instrumental thiab cov kev ua sim.

Yog quav Clostridium difficile. Nyob rau hauv vitro txhais Gram-zoo rods thiab lawv muaj cov noob. Me me kev soj ntsuam ntawm inoculated biomaterial thiab hais, nws yog txiav txim raws li pawg pathogens. Tshwj xeeb npaj rau tus me nyuam xws li ib tug tsom xam yog tsis tsim nyog. Tus nab npawb ntawm clostridia txiav txim smear Gram. Tom qab qhov no zoo ntawm cov kab mob yog qhia tau. Quav rau Clostridium difficile twb soj ntsuam nyob rau hauv ib tug bacteriological laboratory.

Thaum diagnosing kab mob lom qauv yog nqa tawm nyob rau hauv dawb nas, uas txhais tau tias cov kauj ruam ntawm intoxication, qhia taug thiab pab txhais rau txoj kev kho tus kab mob. Nyob rau hauv lub mob ntawm tus kab mob no ua rau tej antigen xeem nyob rau hauv immunological laboratories.

Nyob rau hauv tshwj xeeb no, lub koomhaum nthuav qhia diagnostics kom paub lub xub ntiag ntawm taug nyob rau hauv cov quav. Me ntawm lub plab hnyuv hloov khoom nruab nrog uas tso cai rau kom paub qhov chaw ntawm foci ntawm o.

Serodiagnosis qhia lub xub ntiag ntawm cov taug nyob hauv lub IHA. Nws yog txiav txim nyob rau hauv nrog cov antibody diagnosticum. Soj ntsuam cov tshuaj tiv thaiv uas tshwm sim raws li ib tug tshwm sim ntawm counter immunoelectrophoresis.

Diagnostics - yog tsis muaj dab tsi tab sis ib tug radiography ntawm lub plab hnyuv hloov khoom nruab nrog, uas tso cai rau los mus txiav txim qhov twg cov roj sau nyob rau hauv cov ntaub so ntswg ntawm tib neeg lub cev.

Nws yog suav hais tias yog feem ntau muaj tseeb thiab edoskopicheskoe tomographic xeem. Nws qhia tau hais tias muaj mob thiab lub tsim ntawm pseudomembranous.

Nce kev ua ntawm clostridia nyob rau hauv cov me nyuam mos qhia lub xub ntiag ntawm dysbiosis. Nyob rau hauv me nyuam mos liab tsam plab tau cai nyob rau hauv no pathology, tsis qab los noj mov, ntuav. Tej zaum disturbs pw tsaug zog teeb thiab lus plob tsis so tswj. Tus nab npawb ntawm cov kab mob nyob rau hauv cov me nyuam mos yuav tsum tsis txhob yuav ntau tshaj 103-104 CFU / g. Tshaj qhia yog suav tias yog ib tug pathology uas yuav tsum tau kho.

Yog hais tias cov ntsiab lus ntawm clostridia qub thaum lub sij hawm ntawm kev tsom xam rau ib tug dysbacteriosis, qhov no txhais tau tias cov hnyuv yog ruaj khov. Kev kho mob yuav tsum tau nqa hnyuv los ntawm kev ua tus nqi ntawm cov pathogenic cov kab mob.

Nws yog ua tau mus nqa tawm ib txoj kev tshawb rau Clostridium difficile nyob rau hauv "Invitro". Nws yuav tsum yog ib qho kev ntsuam ntawm txog 1200 rubles. Nyob rau nws cov hauv paus, feem ntau muab cov kev tsim nyog kho mob.

Yuav ua li cas puas muaj tus mob nyob rau hauv cov me nyuam?

Cov kab mob Clostridium difficile tsis tshua muaj feem xyuam rau me nyuam mos cov me nyuam mos thiab cov khoom noj ntawm cov thawj xyoo ntawm lub neej. Qhov no yog vim lub fact tias cov niam cov kua mis muaj kev tshuaj uas yog zoo tiv thaiv Clostridium.

Nyob rau hauv cov kev tshwm sim ntawm cov tshuaj tua kab mob raws plab nyob rau hauv cov me nyuam tshwm sim tag nrho cov mob ib yam nkaus li cov neeg laus. Enterocolitis thiab mob plab nyob rau hauv cov me nyuam thiab khaub-ncaws nyias tau nyaij tsis intonsikatsii thiab kub ib ce. Cov neeg mob yuav cuam tshuam mob nyob rau hauv lub plab mog, uas yuav tshwm sim ntawm ib tug palpation txoj kev nyob rau hauv cov cheeb tsam no.

Tej zaum muaj ntau qhov tso quav heev uas provokes raws plab, uas ua rau yus muaj kev cuam tshuam ntawm cov dej electrolyte nyob rau hauv lub cev.

Cov kab mob yuav ua rau recurrent relapsing ntaub ntawv klostridioza nrog mob plab. Qhov no tshwm sim thaum tus kab mob no yog tsis kho txog rau thaum xaus. Nyob rau hauv cov ntaub ntawv no, klostridioz tshwm sim tom qab 7-14 hnub tom qab discontinuation ntawm kev kho mob.

Pseudomembranous mob plab raws li ib tug me nyuam muaj nyob rau hauv ib tug mob daim ntawv. Nyob rau hauv thawj zaug rau theem ntawm kev tsim muaj tus kab mob tsis muaj qab los noj mov. Muaj yog kub taub hau, belching thiab lub plab ntswj. Muaj intoxication, raws plab thiab tsam plab. Nyob rau palpation lub plab mog cai ce. Lub rooj zaum quickens. Nws zoo nkaus li ntshav thiab hnoos qeev. Tej zaum yuav muaj tej daim ntawm fibrinous overlaps. Yog hais tias qhov uas raws plab yog heev, yog ib tug exsicosis nrog lub plawv failures. Nyob rau hauv tsawg zaus, muaj ib tug cev qhuav dej.

Kev loj hlob ntawm pseudomembranous mob plab yog tej zaum exacerbated los ntawm perforation, los ntshav thiab qhov tshwm sim ntawm peritonitis. Nyob rau hauv xws li mob, tus me nyuam yuav tsum muaj cai tsis tau tsuas yog ib tug cov menyuam yaus, tiam sis ib tug kws phais neeg.

Tus mob tshwm sim los ntawm Clostridium difficile: kev kho mob

Klostridioz kho xwb nyob rau hauv lub tsev kho mob. Thaum ib tug intoxication thiab dyspeptic mob tshuaj pais plab lavage thiab kev dawb huv siv plob tsis so tswj enema. Nyob rau hauv thawj hnub pom zoo dej-starvation noj cov zaub mov.

Ntawm cov tshuaj siv tshuaj tua kab mob-makrolity. Yuav kom lawv rhiab clostridia. "Clarithromycin" thiab "Azithromycin" yog feem ntau siv nrog cov tshuaj no. Taug Clostridium difficile nyob rau hauv (cov tsos mob thiab kev kho mob teem ib lub zuj zus tus kws kho mob raws li tus neeg mob tus mob) cov tshuaj yuav tshem tawm cephalosporins, ntawm lawv - "Cefazolin" thiab "Ceftriaxone". Feem ntau rau tshwj kom txhob pathogenic cov kab mob koom nrog tshuaj tua kab mob penicillin, nws yog "vancomycin" "Amoxiclav". Nws kuj yog siv "Metronidazole".

Yuav kom restore lub microflora ntawm lub plab hnyuv ib puag ncig, cov kws kho mob muab probiotics thiab prebiotics. Cov feem nrov yog "Hilak forte", "Atsipol", "Laktofiltrum", "Bifiform", "Enterol", "Linex", "Enterol".

, Tso dej "Reopoligljukin" kom tshem tawm cov tshuaj muaj taug. Yog hais tias tsim nyog, muab antihistamine tshuaj thiab corticosteroids.

Tuav symptomatic kev kho mob enterosorbents, hepatoprotectors, vitamins, nootropics, mob glycosides, raws li zoo raws li antipyretics.

Nws yog ntseeg hais tias kev kho yog zoo yog hais tias:

• tsis quav zaus;
• quav taub hau yuav thicker;
• lub xeev txoj kev txhim kho tshwm sim;
• zoo hloov cai nyob rau hauv kev soj ntsuam thiab kuaj ntsuam;
• muaj yog tsis muaj kev vam meej ntawm tus kab mob.

Yog hais tias cov tsos mob mob Clostridium difficile, yog kev kho mob hauv daim ntawv thov ntawm tshuaj tua kab mob.

Tej zaum mob plab, txhais los ntawm Clostridium difficile, yog kho surgically. Qhov no feem ntau tshwm sim thaum lub perforation ntawm cov nyuv, thiab thaum muaj ib tug inflammatory txheej txheem ntawm txoj kev loj hlob ntawm lub rov tshwm sim ntawm tshuaj lom megacolon, thiab hnyuv rhuav txhua tshwm sim. Lag luam yog ua tau tsuas yog hais tias ib tug txaus conservative kev kho mob los tsis muaj avail.

Yog muaj ib tug kho Clostridium difficile?

Clostridium difficile kab mob yog manifested nyob rau hauv ntau yam degrees ntawm heev. Nws muaj ib tug tej yam cim ntawm lub txaus thiab cov neeg kawm ntawv muaj teeb meem.

Thaum tus kab mob no yog tsis khiav thiab muaj ib tug me me los yog nruab nrab heev, tus kab mob no yog kho nyob rau ntawm 100%. Kub taub hau disappears rau 1-2 xuab moos, thiab raws plab yog nres rau 4-7 hnub. Plob tsis so tswj rhuav txhua, raum tsis ua hauj lwm, thiab pseudomembranous mob plab teeb meem hnyav zog.

tiv thaiv kev ntsuas

Analysis ntawm Clostridium difficile tso cai lub sij hawm los mus tiv thaiv cov kev loj hlob ntawm tus kab mob thiab tshem tawm tus kab mob no yuav pab kom raws sij hawm tiv thaiv kev ntsuas, uas yog manifested nyob rau hauv:

• observance ntawm cov kev cai ntawm tus kheej kev tu cev ;
• ntxuav cov khoom;
• sov kev kho mob ntawm cov khoom noj khoom;
• kev txhim kho kev tiv thaiv;
• stabilization ntawm lub plab hnyuv microflora;
• kom tau thaum ntxov ntawm kis tus kab mob tus neeg;
• kev siv cov tshuaj tua kab mob.

Pathogens resistant rau ammonia, tab sis tua los ntawm raug sodium hypochlorite etilenoksidsoderzhaschih tshuaj, raws li zoo raws li nyob rau hauv alkaline kev kho mob nrog glutaraldehyde. Thaum tus kab mob, Clostridium difficile yuav tsum tau kom huv si ntxuav tag nrho cov chaw ntawm hais tias txhais tau hais tias, yuav ua kom puas kab mob noob ntawm lub microbe. Tus kab mob tsis tuag nyob rau hauv lub ua cawv, tab sis txhais tes ntxuav nrog xab npum yog tau los mus tiv thaiv qhov tshwm sim ntawm tus kab mob.