Cudurka 'Pseudomembranous colitis'

Cudurka 'Pseudomembranous colitis' waxaa loola jeedaa barar ama barar ku dhaca xiidmaha waaweyn (xiidanka) sababtoo ah koritaanka badan ee Clostridioides oo dhib badan (C adag) bakteeriya.

Infekshankani waa sababaha ugu badan ee shubanka ka dib isticmaalka antibiyootigga.

Ku C adag bakteeriyada caadi ahaan waxay ku nooshahay xiidmaha. Si kastaba ha noqotee, in badan oo bakteeriyadan ka mid ah ayaa laga yaabaa inay koraan markii aad qaadato antibiyootiko. Bakteeriyadu waxay siisaa sun xoog leh oo keenta caabuq iyo dhiig ku dhaca xuubka xiidmaha.

Antibiyootiko kasta ayaa sababi kara xaaladdan. Daawooyinka mas'uulka ka ah dhibaatada inta badan waa ampicillin, clindamycin, fluoroquinolones, iyo cephalosporins.

Bixiyeyaasha daryeelka caafimaadka ee isbitaalka ayaa laga yaabaa inay u gudbiyaan bakteeriyadaan qof kale.

Cudurka 'Pseudomembranous colitis' kuma dhacdo carruurta, waana ku yar tahay dhallaanka. Badanaa waxaa lagu arkaa dadka isbitaalka ku jira. Si kastaba ha noqotee, waxay ku sii badanaysaa dadka qaata antibiyootikada oo aan ku jirin isbitaal.

Waxyaabaha halista keena waxaa ka mid ah:

• Da 'weyn
• Isticmaalka antibiyootigga
• Isticmaalka daawooyinka daciifiya habka difaaca jirka (sida daawooyinka kimoterabiga)
• Qalliin dhowaan dhacay
• Taariikhda colitis pseudomembranous
• Taariikhda ulcerative colitis iyo cudurka Crohn

Calaamadaha waxaa ka mid ah:

• Calool xanuun (khafiif ama daran)
• Saxaro dhiig leh
• Qandho
• Ku boorri inaad saxarooto
• Shuban biyood (badanaa 5 ilaa 10 jeer maalintii)

Tijaabooyinka soo socda waa la samayn karaa:

• Baarista walamadka ama sigmoidoscopy-dabacsan
• Immunoassay oo loogu talagalay sunta dhibta leh ee saxarada ku jirta
• Imtixaano saxaro ah oo cusub sida PCR

Antibiyootikada ama daawada kale ee keenta xaaladda waa in la joojiyaa. Metronidazole, vancomycin, ama fidaxomicin ayaa badanaa loo isticmaalaa in lagu daaweeyo dhibaatada, laakiin daawooyin kale ayaa sidoo kale loo isticmaali karaa.

Xalalka elektroolka ama dareeraha lagu bixiyo xididka ayaa laga yaabaa in loo baahdo si loo daaweeyo fuuqbaxa shubanka awgiis. Marar dhif ah, qalliin ayaa loo baahan yahay si loogu daaweeyo infekshannada ka sii daraya ama aan ka jawaabin antibiyootikada.

Antibiyootikada muddada-dheer ayaa loo baahan karaa haddii ay C adag caabuqa ayaa soo noqda. Daaweyn cusub oo loo yaqaan 'fecal microbiota transplant ("stool transplant") ayaa sidoo kale wax ku ool u noqotay infekshannada soo noqda.

Bixiyahaagu sidoo kale wuxuu kugula talin karaa inaad qaadato daawada probiotics haddii infekshanku soo noqdo.

Aragtida ayaa wanaagsan inta badan kiisaska, haddii aysan jirin wax dhibaatooyin ah. Hase yeeshe, ugu yaraan 5tii infekshan ee infekshan ah ayaa soo laaban kara oo u baahan daaweyn dheeraad ah.

Dhibaatooyinka waxaa ka mid noqon kara:

• Fuuqbax leh dheelitir la'aanta elektroolka
• Daloolinta (daloolka) xiidanka
• Sunta megacolon
• Dhimasho

Wac adeeg bixiyahaaga haddii aad isku aragto astaamaha soo socda:

• Saxaro kasta oo dhiig leh (gaar ahaan ka dib qaadashada antibiyootikada)
• Shan ama in ka badan oo dhacdo shuban ah maalintii in ka badan 1 illaa 2 maalmood
• Xanuun caloosha oo daran
• Calaamadaha fuuqbaxa

Dadka uu ku dhacay colitis 'pseudomembranous colitis' waa inay u sheegaan adeeg bixiyayaashooda ka hor intaanay mar labaad qaadan antibiyootig. Sidoo kale aad ayey muhiim u tahay in gacmaha si fiican loo dhaqo si looga hortago in jeermiska loo gudbiyo dadka kale. Nadiifiyeyaasha aalkolada had iyo jeer ma shaqeeyaan C adag.

Xiidmaha la xiriira antibiyootikada; Colitis - pseudomembranous; Cudurka 'colitis' C adag - pseudomembranous

• Nidaamka dheefshiidka
• Xubnaha habka dheefshiidka

Gerding DN, Johnson S. Cudurrada Clostridial. Gudaha: Goldman L, Schafer AI, eds. Daawada Goldman-Cecil. 26aad. Philadelphia, PA: Elsevier; 2020: cutubka 280.

Gerding DN, Young VB. Donskey CJ. Clostridiodes oo dhib badan (hore Clostridium wuya) caabuq Gudaha: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, iyo Bennett Mabaadi'da iyo Ku Dhaqanka Cudurada faafa. 9aad. Philadelphia, PA: Elsevier; 2020: cutubka 243.

Kelly CP, Khanna S. Shuban-biyoodka la xiriira antibiyootikada iyo clostridioides oo dhib badan caabuq Gudaha: Feldman M, Friedman LS, Brandt LJ, eds. Cudurka caloosha iyo beerka ee Sleisenger iyo Fordtran. 11aad. Philadelphia, PA: Elsevier; 2021: cutubka 112.

McDonald LC, Gerding DN, Johnson S, iyo al. Tilmaamaha tababarka caafimaadka ee loogu talagalay Cudurka Cudurka 'Clostridium' ee dadka waaweyn iyo carruurta: Cusboonaysiinta 2017 ee Ururka Cudurada Infekshinka ee Ameerika (IDSA) iyo Bulshada Daryeelka Caafimaadka Epidemiology ee Ameerika (SHEA). Clin Infect Dis. 2018; 66 (7): 987-994. PMID: 29562266 pubmed.ncbi.nlm.nih.gov/29562266/.