Klebsiella pneumoniae - kuyini? Igciwane Klebsiella pneumoniae: Incazelo

Klebsiella pneumoniae - kuyini? Kuyinto igciwane ukuthi kungabangela isifo esiyingozi sokuvuvukala zokuphefumula, wokugaya ukudla bese izinhlelo urinary. Ezimweni ezinjalo zidinga ukwelashwa ngokucophelela, ukunakekelwa ngezokwelashwa ngokucophelela. Futhi kubangelwa izifo nosocomial kukhona ukwelashwa nemithi ngenxa nabaningi zama-pathogen.

izakhiwo begazi

Le ndoda ezivamile Kunzima ukucabanga ukuthi kubukeka kanjani Klebsiella pneumoniae, kuyini. Morphologically ke kukhona induku encane umile okungase elise kokubili singly futhi emaqenjini. Lena igciwane Gram-negative okungukuthi, lapho ingcoliswe hematoxylin-eosin, kuba pink (kubonisa khona amaphilisi).

Ethanda ukuzalela ezindaweni ngokufinyelela okunqunyelwe umoya-mpilo, kodwa ukuba khona kwakhe, akaphelelwa impahla yayo kwamasiko. Ngo-laboratory, igciwane Klebsiella pneumoniae ikhula okuqinile kanye nama-liquid abezindaba izakhi, ukwakha amakoloni enhle empungana. It wathola igama layo ngegama owathola - the sezifo Edwin Klebs.

izinhlobo Klebsiella

Microbiologists kusukela ngesikhathi kuvulwa lesi silwanyana ezikhonjwe zinhlobo eziyisithupha Klebsiella:

- Klebsiella pneumoniae (Friedländer imbewu eletha).
- Klebsiella oxytoca.
- Klebsiella rhinoscleromatis (imbewu eletha ka Frisch - Volkovich).
- Klebsiella ozaenae (Wand Abela - Lavenberga).
- Klebsiella terrigena.
- Klebsiella planticola.

Kubantu, imbangela evame kakhulu lesi sifo ezimbili zokuqala, kodwa ukwehla amasosha omzimba, kanye nezinye izinhlobo babe pathogenic. Ngo abantu abayimiqemane esiswini futhi Klebsiella pneumoniae, izinga layo kumele singeqi 105 amagciwane ngayinye 1 igremu ka chyme. Ngaphezu kwalokho, lezi nezilwanyana ezincane zihlale khona esikhumbeni futhi ulwelwesi lwamafinyila we esihlahleni bronchial. Bayakwazi ukugcina izakhiwo zabo imikhiqizo ukudla ngamanzi nomhlabathi isikhathi eside, ukuze lesi sifo iphutha.

imithombo okutheleleka

Phakathi nabanye abaningi ezifweni anthroponotic akunakubangelwa, futhi Klebsiella pneumoniae. Kuyini lokhu? Lokhu kusho ukuthi noma kungaba umthombo ukugula abagulayo noma abathwali kwamagciwane azinazo izimpawu ezisheshe zibonakale. Ngaphakathi umzimba Klebsiella uthola ezingcolile nge ukudla noma izandla ezingcolile. Uma ukutheleleka lishaywa uhlelo bronchopulmonary, ukusabalala kwamagciwane ngeke amaconsi okungcono sisemoyeni (ukukhwehlela nokuthimula). Bonke abantu singangena kule Klebsiella, kodwa ezincane, asebekhulile kanye nabantu immunodeficiency eqenjini ephakeme linobungozi, kusukela ukukhiqizwa kabusha baphoqwe microflora emathunjini endogenously neze elawulwa.

Uma emzimbeni, igciwane ukhiqiza endotoxin okuyinto ikhishwe kuphela ngemva kokufa esiphathiswa bacterium. Kubangela imfiva kanye ukudakwa. Kukhona exotoxin ezimbili: enterotoxin futhi membranotoksin. Umsuka kuthinta emathunjini mucosa encane, futhi umphumela yesibili kubhujiswa erythrocyte, okubangela isifo sokulahlekelwa igazi.

inyumoniya

Isifo samaphaphu kubangelwa, wena ukuyichaza ke, ka Klebsiella pneumoniae. Isici nobuntu lolu hlobo ukuvuvukala Akukhona ukubukeka sebuningini foci elincane ukuvuvukala, okungase uhlangane nomunye ngaphesheya kwamanzi ukukhanya. In iziguli mgomani (kufika ku-degree amathathu nethoba), ubuthakathaka, ukucobeka, ukujuluka. Ekuqaleni lesi sifo kukhwehlela esomile, kodwa phakathi kokuthola ezimanzi, nge admixture we isikhwehlela futhi ubomvu kungenzeka ezinemishwe ngegazi. Libhekene iphika, ezimweni ezinzima - nokuvaleka kwemigudu yokuphefumula kanye edema yamaphaphu.

On behlolwa, ohlangothini ukuvuvukala crackles ezwakalayo futhi palpation - kokunciphisa eshaywayo imisindo. Esifubeni radiograph kanye lateral kwelivi ebalulekile umthunzi ebonakalayo, ivame ukuba sesisonke.

Uma lesi sifo sitholakale umuntu isikhathi bese babela ukuphathwa efanele, kungenzeka kakhulu ukuthi ukuvuvukala kungenziwa kuphazamisekile ekuqaleni, nangaphambi kokuba isikhathi ukusakaza phezu bonke ubuso emaphashini. Kodwa endabeni yokwelashwa elingalungile noma ukwelashwa ngasekupheleni esibhedlela, cishe, isiguli kuzodingeka isithombe sepsis (ukuvuvukala generalized), kanye Kulezo zimo nokufa Izinga eliphezulu kakhulu.

Ukunqotshwa kwe-wokugaya ukudla

Lesi sifo futhi kubangelwa Klebsiella pneumoniae. Ngeshwa, it is "simaskwe" izifo gastroenterological, okwenza kube nzima ukuba nokwelapha. Isiguli efinyelela a gastroenterologist izikhalo ubuhlungu esiswini inkaba, isilungulela, isicanucanu, kwehle esesuthi, kodwa EGD (fibrogastroduodenoscopy) sikhombisa evamile noma kancane elikhanyayo mucosa esiswini. Ngeke uthinte udokotela embonweni ka Klebsiella. Kunalokho, uyoqhubeka ufake kolwelwesi futhi zibeka ukwelashwa okufanele.

Kodwa ngaphezu kwakho konke Klebsiella kuzibonakalisa ipheshana wokugaya ukudla (pheshana emathunjini) njengoba enteritis noma enterocolitis. Isiguli iya ezithathelwanayo esibhedlela ekhala imfiva, ubuthakathaka, isicanucanu, cramping besisu futhi sezinyawo ukwephulwa (uhudo kakhulu ngegazi ne isikhwehlela odorous). Lesi simo ahlale izinsuku amabili kuya kwamahlanu.

Izifo kohlelo genitourinary

Ngokuvamile Klebsiella pneumoniae ohlelweni urogenital kuzibonakalisa ngesimo pyelonephritis, cystitis kanye prostatitis. Kuye ezingeni yokulimala, iziguli esekhala ubuhlungu esifundeni lumbar, nobunzima echama futhi Erectile umsebenzi.

Uma amasosha omzimba isebenza kahle, lesi sifo singumbulali acute, kanye nokuphatha kahle umuntu uyalulama ngokuphelele. Kodwa endabeni bebancane izivikelo omzimba (asebekhulile noma izingane, immunodeficiency), lesi sifo kuthatha Yiqiniso esingamahlalakhona noma yansukuzonke.

yezinkinga

Phakathi klebsiellezov ezinzima hhayi ngaphandle yezinkinga ezifana:

- edema yamaphaphu;
- ITSH (ukushaqeka enobuthi);
- oluhambisana syndrome;
- ukuvuvukala kobuchopho.

Lesi simo kuphila kwetfu engotini, ngasinye singase siphele abanamanxeba abulalayo. Futhi uma ehlangana, amathuba okufa kwandisa. Ngemva ukutheleleka yangaphambili nesineke akha amasosha omzimba athile lezivakashi, okungukuthi, in parlance common, ngemva kwesikhathi esithile, ukuze umuntu akwazi sigule.

Izimpawu zesifo e izingane nabesifazane abakhulelwe

Klebsiella pneumoniae ngesikhathi sokukhulelwa - into hhayi kakhulu ezingavamile. Umzimba kubhekene umthwalo double, amasosha omzimba encishisiwe, futhi sandise amathuba baphoqwe microflora iyakhula. Njengoba isikhundla obucayi, ukuthatha noma cha ukuthatha imithi elwa namagciwane, udokotela enquma. Zonke incike ubude sokukhulelwa, izamba Klebsiella pneumoniae endaweni smear kusukela ipheshana zangasese kanye nezinga amangqamuzana amhlophe egazi. I umthamo futhi kushintshwe ngamunye. Akunakusetshenziswa akufanele aphathwe ekhaya.

Isimo ngokuvamile lapho umbuzo abakhulelwe akayena udokotela, futhi nabangani bakhe igciwane Klebsiella pneumoniae. Kuyini, futhi akakwazi ukuthola. Bese imithi amaphutha azinakugwenywa, ngaphezu kwalokho, lokhu kungalimaza umntwana.

Ngenxa buthaka amasosha omzimba izinsana nezingane ezincane futhi ngokuvamile uhlushwa microflora ezingosomathuba. Klebsiella pneumoniae ezinsaneni kubangela ukudakwa nkulu, nje okungaqondile ukuvuvukala futhi sepsis. Ngokuvamile kuba dysbiosis nge izimpawu ejwayelekile (nokubhamuka, ukwenqaba webele, kwesisindo futhi ukuhlukumeza kwesitulo).

ukuhlola

Emtholampilo ukuxilonga imbangela igciwane lalivela Klebsiella pneumoniae, kunzima ngempela, njengoba azikho izimpawu ezithile ekhomba ke. Ngakho-ke, uphethwe syndromic bese baqinisekisa bacteriologically. Njengoba ukwaziswa igazi efanelekayo, umchamo, isikhwehlela, cerebrospinal fluid, Bile futhi impahla kwesigamu.

Klebsiella pneumoniae e umchamo ukutholwa isiko nobe luhlolo ezincane. Ukuze lokhu ezibonakalayo kuhlinzwa kwi medium izakhi noma lehla ungene nge-slide engilazi kuhlolwa ngesibonakhulu.

Izindlela efanayo ingatholakala indle Klebsiella pneumoniae, kodwa kuphela uma ungazange ubone impahla Kuthi ezahlukene. Ukuze qualitative impahla ucwaningo ukuze zithunyelwe elabhorethri ngaphakathi isigamu sehora ngemva kocingo.

Ngemva kwamasonto amabili ukusuka ekuthomeni lesi sifo, ungathumela igazi serology. Lisinika ukulinganisa kobukhulu inqubo kanye nesimiso somzimba sokuzivikela.

ukwelashwa

Amaqhinga ukwelashwa udokotela ekhetha ngamunye Icala ethize. Lokhu kuncike uhlobo lesi sifo, namandla aso kanye izici nesineke. Ngokuvamile, iziguli zithola ukwelashwa sinenkonzo yokunakekela iziguli emakhaya.

Okokuqala esimisiwe bacteriophages ethize. Badinga ukuze uyiswe kathathu ngosuku ngaphambi kokudla. Futhi kungenzeka ukuphatha samuntu ngemlomo ngaloko lokusandza kwenteka izidakamizwa emzimbeni i enema. Inkambo yokwelashwa kungaba isukela izinsuku ezinhlanu kuya kweziyishumi. Esigabeni esilandelayo probiotics ziyadingeka ukubuyisela flora evamile emathunjini. Badinga ukuphuza okungenani izinsuku eziyishumi, futhi mhlawumbe amasonto amabili noma amathathu.

Kwamaphilisi kukhona cephalosporins ekhethiwe futhi fluoroquinolones kukhona isizukulwane sesithathu nesesine, aminoglycosides futhi tetracyclines.

Kuleso sibhedlela, iziguli esibhedlela izimpawu ezilandelayo: i okubi kakhulu izimpawu, imfiva, septicemia. Ngempela ukuba yokwelapha lingaze futhi pathogenetic okuhloswe ngalo ukubhekana izimpawu zesifo kanye nokwenza kube lula isimo lesiguli.

prophylaxis Nonspecific ngoba klebsiellezov akuyona kwenziwe, njengoba kungekho umuthi wokugoma. Ngakho-ke, zonke ihilela imfundo nempilo yezingane kanye nabantu abadala, futhi ukuqina ukwelashwa okufika ngesikhathi futhi ngempumelelo yezifo ezithathelwanayo.