Contents
17.03.2017
enterococcus ƙananan ƙwayoyin cuta ne mai siffar oval wanda ke cikin microflora na hanji na yau da kullun na ɗan adam (a da ana rarraba irin waɗannan ƙwayoyin cuta a matsayin rukunin D streptococci).
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Kwarewa da ƙwarewar jiyya
Duban gaba kadan, mun lura cewa masu gyara suna sane da cewa masu karatu suna neman ƙarin bayani game da yadda za a magance enterococcus. A saboda wannan dalili, mun fara ba ku bayanai game da Dandalin mu, inda ake tattaunawa mai mahimmanci akan batun maganin kamuwa da kwayar cutar enterococcal a cikin maza. Anan ga wasu shahararrun batutuwa waɗanda suka ƙunshi galibin bayanai waɗanda aka tallafawa ta hanyar aiki:
Enterococcus faecalis - Taken tare da bincike game da sakamakon jiyya Enterococcus ya mutu! Kuma har yanzu ban samu ba – Kwarewar jiyya A ina ne furen hanji a cikin prostate ya fito – Kuna buƙatar sanin wannan
Muna gayyatar kowa da kowa don shiga tattaunawar! Dandalin yana gudana tun 2006. Ma'ajiyar ilimi mai amfani a fannin lafiyar maza.
Duk da haka, ilimi mai amfani ba zai soke amfanin bayanan hanya ba. Don haka mu ci gaba…
Nau'in enterococci. Dalilan kamuwa da cuta
Yawan Enterococci fiye da nau'in 16, wasu daga cikinsu na iya haifar da cututtuka na tsarin genitourinary, endocarditis, da dai sauransu. Mafi yawan su ne Enterococcus faecalis (fecal enterococcus) da Enterococcus faecium. Ko da yake mazaunin enterococci na al'ada shine hanji, a kusan kashi 25% na maza masu lafiya, Enterococcus faecalis yana cikin ɓangaren gaba na urethra. Wannan shine dalilin da ya sa ake rarraba enterococci a matsayin microflora mai dacewa (mai wucewa) na gabobin genitourinary. Hakanan, Enterococcus faecium yana da alhakin yawancin cututtukan enterococcal na vancomycin. Rashin kula da ƙwayoyin cuta ga maganin rigakafi babbar matsala ce ta magungunan zamani.
Enterococci suna da nasu duka, saboda tsari na musamman, kuma sun sami juriya na ƙwayoyin cuta. Wannan yana ba da gudummawa mai mahimmanci na waɗannan ƙwayoyin cuta don haɓaka cututtukan cututtuka na nosocomial kuma yana iyakance ikon likitoci dangane da irin wannan muhimmin al'amari kamar maganin enterococcus.
Enterococcus a cikin maza (mafi sau da yawa - Enterococcus faecalis) na iya haifar da cututtuka na gabobin urogenital, musamman a cikin mutanen da suka yi gwajin kayan aiki masu dacewa da / ko shan maganin rigakafi:
• prostatitis; • balanoposthitis; • urethritis; • epididymitis / orchoepididymitis; • cystitis, da dai sauransu.
Hanyoyin kamuwa da cuta:
• jima'i (musamman canjin al'aurar al'aura da al'aura); • rashin tsafta bayan amfani da bayan gida; • watsa daga uwa zuwa jariri; • da wuya – a cikin dashen gabobi.
Lokacin shigar da gabobin genitourinary, enterococci na iya zama a cikinsu daga sa'o'i da yawa zuwa makonni, a ƙarshe ana lalata su ta hanyar hanyoyin kariya. Ana kiran wannan jihar karusar wucin gadi ko wucewa. A wannan yanayin, mai ɗaukar hoto zai iya watsa kwayar cutar zuwa abokin jima'i. Ganewar cututtuka na enterococcus tare da jigilar wucin gadi yana yiwuwa tare da ingantattun hanyoyin (misali, PCR).
Har ila yau, enterococci a cikin ƙananan adadin zai iya kasancewa a cikin gabobin genitourinary (jigon karusa). Ci gaban su yana hana su ta hanyar hanyoyin kariya iri ɗaya da microflora na al'ada. Tare da raguwa a cikin adadin ƙwayoyin cuta na al'ada da / ko cin zarafi na kariyar enterococci, sun fara haɓaka da sauri, tsarin kumburi yana tasowa. Karusa na yau da kullun yawanci asymptomatic ne, sai dai lokacin tashin hankali, gano cutar enterococcus yana yiwuwa ta PCR, hanyar al'adu ta bincike. A wannan yanayin, akwai kuma yiwuwar kamuwa da cuta na abokin tarayya.
Lokacin da jiki ya daina hana ci gaban enterococci, bayyanar cutar yana faruwa. Abubuwan da ke haifar da ci gaban kamuwa da cutar enterococcal:
• kasancewar cututtuka masu tsanani; • cututtuka na gonococcal / chlamydial da suka wuce; • cin zarafi na hanyoyin kariya na gabobin al'aura (irin waɗannan hanyoyin sun haɗa da yanayin tsaka-tsaki / raunin alkaline a cikin urethra, prostate antimicrobial factor, inji, kariya na rigakafi na gida) prostate antimicrobial factor - zinc-peptide complex); • maganin rigakafi na dogon lokaci; • cin zarafi na maganin sa barci na gida, yana haifar da kunar urethra; • catheterization na urinary fili ko wasu kayan aiki na kayan aiki, wanda zai iya haifar da rauni ga mucous membranes; • tsufa, da sauransu.
Alamun kamuwa da cutar enterococcal
Babu takamaiman alamun lalacewa ga tsarin genitourinary ta hanyar enterococcus. Tare da ci gaban tsarin ilimin cututtuka, marasa lafiya suna gabatar da gunaguni game da wani nau'i na cututtuka (dangane da yanayin kumburi).
Urethritis yana tare da:
• ƙara yawan mita, bayyanar cututtuka a lokacin fitsari; • fitar da fitsari; • ja, haushi, rashin jin daɗi a cikin urethra.
Prostatitis yana da alamun bayyanar cututtuka:
• ciwo a cikin nau'i na ciwo da rashin jin daɗi a cikin perineum, jin zafi a cikin ƙwanƙwasa, ƙuƙwalwa / ciwo a cikin urethra, ƙonewa bayan jima'i; • ciwo na rashin fitsari (ƙara, jin rashin cikawa, rashin ƙarfi / rafi mai tsaka-tsaki); • cin zarafi na inzali, fitar maniyyi (ciwo, lalatawar inzali, fitar maniyyi da wuri ko tsawon jima'i); • a hade tare da na kullum urethritis - mucopurulent fitarwa.
Tare da balanitis / balanoposthitis, marasa lafiya suna koka da zafi da ja a cikin yanki na glans azzakari, ja (zazzagewa, raunuka, fasa), plaque, kumburi, fitarwa. Orchiepididymitis shine hadewar kumburin maniyyi (orchitis) da epididymis na karshen (epididymitis). A cikin m cuta, maras ban sha'awa mai tsanani zafi a cikin scrotum, girma / taurin daya ko duka biyu, hyperemia na fata na scrotum, karawa / hardening epididymis tare da ciwo mai tsanani. Ana rage zafi a cikin maƙarƙashiya lokacin da aka tashe shi. Cutar da ba ta daɗe tana da alamun bayyanar cututtuka, wani lokacin bayyanar jini a cikin maniyyi.
Hanyoyin bincike
Bincike na enterococcus a cikin gabobin urogenital na namiji ya ƙunshi:
• jarrabawar gwani; • gwaje-gwajen fitsari da jini na gaba ɗaya; • Halin sarkar polymerase (yana ba da damar gano ƙananan ƙwayoyin cuta ko da tare da jigilar asymptomatic); • nazarin al'adu (in ba haka ba ƙwayar cuta ta kwayoyin cuta) tare da ƙaddarar ƙwayoyin cuta; • sauran dakin gwaje-gwaje, irin su RIF, ELISA, smear microscopy, da dai sauransu, da kuma kayan aiki (ultrasound, urethroscopy, MRI, CT) nazarin don ware wasu abubuwan da ke haifar da cutar (cututtukan al'amuran al'ada ba tare da enterococcal ba, tsarin tumo, da dai sauransu). Ana bincika samfuran fitsari a cikin dakin gwaje-gwaje, maniyyi, fitar da prostate, fitar da fitsari.
A gaban mummunan bayyanar cututtuka daga urogenital fili, yana da muhimmanci a fahimci cewa enterococcus ne da wuya dalilin irin wadannan matsaloli. Idan gwaje-gwajen ba su nuna kasancewar sauran ƙwayoyin cuta ba, yana iya zama dole a sake bincikar cutar (wani lokaci ma a cikin dakin gwaje-gwaje daban). Sai kawai bayan ware wasu yiwu pathogens (Trichomonas, gonococci, chlamydia, da dai sauransu) ne wani mutum warkewa Hakika wajabta kawar da enterococci.
Hanyoyin magani na Enterococcus
Idan akwai haɗarin kamuwa da cutar enterococcus a lokacin jarrabawar yau da kullun, ana ba da shawarar magani kawai idan akwai gunaguni na halaye, tsara shirye-shiryen tiyata akan gabobin genitourinary (a wasu yanayi, likita na iya ba da shawarar maganin da ya dace lokacin shirin ciki). Wannan shi ne saboda gaskiyar cewa ana iya samun irin wannan ƙananan ƙwayoyin cuta a cikin maza masu lafiya.
Enterococcus titers na oda na 1 * 10 a cikin digiri na 6 ana daukar su azaman diagnostically (idan babu bayyanar asibiti). A lokaci guda, asymptomatic bacteriuria (gano enterococcus a cikin fitsari) na iya buƙatar kulawar likita kawai kuma, idan ya cancanta, gwaje-gwaje na lokaci-lokaci: amfanin gona mai maimaita. A cikin yara maza da ba tare da alamun kamuwa da cutar urinary ba, ba a ba da shawarar binciken dakin gwaje-gwaje na yau da kullun na enterococcus ba.
Idan ana zargin enterococcus a matsayin kawai dalilin matsaloli a cikin mutum daga sashin urogenital (urethritis, prostatitis pyelonephritis, cystitis, da dai sauransu), isasshen maganin rigakafi ya zama dole. Ganin karuwar juriya na irin waɗannan ƙwayoyin cuta zuwa aikin ƙwayoyin cuta na ƙwayoyin cuta, yana da matuƙar kyawawa don sanin ƙimar da ta dace kafin fara jiyya (abin takaici, wannan motsa jiki ne mai ɗaukar lokaci kuma ba koyaushe zai yiwu a jinkirta farkon jiyya ba).
A mafi yawan lokuta na kumburi cututtuka na genitourinary tsarin a cikin maza, dalilin kamuwa da cuta ne fecal enterococcus (Enterococcus faecalis). Wannan nau'in enterococcus yawanci:
• kula da rifaximin, levofloxacin, nifuratel, wasu nau'i - zuwa doxycycline; • matsakaicin matsakaici ga ciprofloxacin; • dan kadan m (don yawancin nau'ikan) zuwa tetracycline; • a zahiri rashin jin daɗin lincomycin.
Penicillins, wasu cephalosporins, farkon fluoroquinolones ba su da aiki ko rauni a kan fecal enterococcus.
Don magani, a matsayin mai mulkin, daya magani ya isa; idan ba ta da tasiri, ana iya rubuta wani ko haɗin da yawa. Bayan ƙarshen karatun, ana gudanar da bincike na biyu na enterococcus. Ana gudanar da jiyya na abokin jima'i akan shawarar likita (sau da yawa a cikin yanayin shirin ciki). A cikin yanayin kamuwa da cuta mai gauraye, an zaɓi magungunan da ke aiki ga kowane ƙwayar cuta.
Hanya na maganin ƙwayoyin cuta yawanci ya isa don cikakken magani. Koyaya, a wasu lokuta, likita na iya kuma rubuta:
• daban-daban hanyoyin physiotherapeutic; • hanya ta tausa (sau da yawa ana amfani dashi don cututtukan cututtuka na prostate); • shirye-shiryen enzyme; • bitamin; • immunomodulating jamiái; • maganin homeopathic; • maganin gargajiya (wanka na decoctions da infusions na ganye na magani, shan ruwan 'ya'yan itace cranberry, da dai sauransu); • jiyya na gida (infusions, abin da ake kira instillations, a cikin urethra na mafita na abubuwa daban-daban na magani, irin su maganin antiseptics).
Yin watsi da shawarwarin likitanci, kulawa da kai fiye da kima da magungunan jama'a ba zai iya haifar da dawowa ba kawai, amma har ma yana daɗaɗa yanayin yanayin haƙuri. Alal misali, cin zarafi na jiko na maganin antiseptik a cikin urethra sau da yawa yakan haifar da ƙonewa na mucosal, wanda a cikin kanta yana aiki a matsayin wani abu mai ban sha'awa ga ci gaban kamuwa da cuta na kwayan cuta.
matsalolin
Idan babu isasshen magani don kamuwa da cutar enterococcal, masu zuwa suna yiwuwa:
• rarraba tsarin kumburi zuwa wasu gabobin da kyallen takarda; • sauyawar cutar zuwa nau'i na yau da kullum; • tabarbarewar ingancin maniyyi kuma, saboda haka, ci gaban rashin haihuwa na namiji; • take hakkin mizani, da sauransu.
rigakafin
Rigakafin kamuwa da cutar enterococcal shine:
• bin ka'idodin jima'i mai aminci (amfani da hanyoyin shinge na kariya, abokin tarayya na dindindin); • gano lokaci da kuma kawar da / gyara cututtuka na yau da kullum; • ingantaccen maganin cututtukan cututtukan jima'i da aka gano (musamman gonococcal, trichomonas); • salon rayuwa mai kyau (daidaita tsarin tsarin aiki da hutawa, cikakken ingantaccen abinci mai gina jiki, matsakaicin aiki na jiki, rage girman yanayin damuwa, da dai sauransu), da dai sauransu.
An gyara da ƙari akan 14.03.2021/XNUMX/XNUMX.
Abubuwan da aka yi amfani da su
1. Muhimmancin kwayoyin halittar Enterococcus a cikin rayuwar mutum. Mujallar kimiyyar lantarki "Matsalolin kimiyya da ilimi na zamani". Krasnaya Yu.V., Nesterov AS, Potaturkina-Nesterova NI FSBEI HPE "Ulyanovsk Jami'ar Jihar". 2. Sakamako na nazarin cibiyar multicenter na maganin rigakafi na enterococci. Sidorenko SV, Rezvan SP, Grudinina SA, Krotova LA, Sterkhova GV Cibiyar Bincike ta Jiha don Magungunan rigakafi, Moscow