Thaum nws los tiv thaiv Clostridium difficile (C-Diff) mob plab hnyuv/mob raws plab hnyav, txiav txim siab siv tshuaj tua kab mob thiab ntsuas kev tu cev zoo yog qhov tseem ceeb. Nws tseem yog qhov tseem ceeb kom tuaj yeem paub txog cov cim thiab tsos mob ntawm Clostridium difficile infection thiab "C-dificille-colitis" (zoo ib yam li mob plab hnyuv), yog li qhov kev ntsuas tsim nyog tuaj yeem coj los kho nws thiab tiv thaiv lwm tus los ntawm kev ua tau kis kab mob.
Cov kauj ruam
Txoj Kev 1 ntawm 4: Tiv Thaiv Kab Mob Raws Li Tus Neeg Mob
Kauj Ruam 1. Tsis txhob vam khom tshuaj tiv thaiv kab mob raws plab (AD) (piv txwv li
: "Imodium AD").
Tsis txhob sim qhov ntawd ntau dua 3 hnub, vim tias khaws cov co toxins los ntawm C-Diff. Koj yuav xav tias kev tiv thaiv kev mob plab yog pab tab sis koj yuav ua rau tsaug zog, kiv taub hau, xeev siab thiab poob qhov koj qab los. Thaum kawg cov tshuaj lom tuaj yeem ua rau ntau yam kab mob (lub raum, lub siab) thiab koj txhais taw yuav o tuaj thiab koj tuaj yeem khaws ob peb litres ntawm cov kua hauv lub cev kab noj hniav (hu ua "qhov sib nrug thib peb") vim tshuaj lom tshwm sim los ntawm qhov mob plab no tsis tau tso tawm/tau tuav hauv lub cev los ntawm koj tus kws kho mob AD.
Kauj Ruam 2. Tshem cov co toxins tawm:
Koj yuav tsum tau hla BMs (mob plab hnyuv) 6, 8, 10 lossis ntau dua nyob rau ib hnub kom tshem cov co toxins tawm-thaum raug kho nrog tshuaj tua kab mob tshwj xeeb uas tuaj yeem tshem tawm C-Diff (ntau hauv ntu "Kho").
Kauj Ruam 3. Tsis txhob noj tshuaj tua kab mob yam tsis tsim nyog
Vim yog qhov pheej hmoo tias tshuaj tua kab mob tso rau koj rau kev txhim kho Clostridium difficile, nws yog ib qho tseem ceeb kom coj lawv tsuas yog thaum lawv xav tau. Tshuaj tua kab mob yuav tsis muaj feem cuam tshuam rau kev kho tus kab mob sib kis, yog li koj tus kws kho mob yuav tsis qhia tias koj noj tshuaj tua kab mob yog tias koj kis tus kab mob zoo li mob khaub thuas.
- Ceev faj: mob Clostridium difficile yuav luag tshwm sim thaum koj twb tau noj tshuaj tua kab mob rau lwm tus mob. Nws yog noj cov tshuaj tua kab mob uas ua rau koj lub cev nqus dej (lub plab) mus rau "cov kab mob tsis zoo", ua rau nws muaj peev xwm tsim kho Clostridium difficile thiab C-dificille-colitis. "Difficile" yog Latin rau nyuaj (kho).
- Thaum koj noj tshuaj tua kab mob (rau mob ua ntej), lawv feem ntau muaj txiaj ntsig zoo los kho tus mob ntawd; Txawm li cas los xij, cov tshuaj tua kab mob kuj tseem tua ntau cov kab mob zoo hauv koj cov hnyuv, uas ib txwm muaj kev tiv thaiv zoo. Nrog ntau cov kab mob zoo ploj mus, koj lub plab tsis muaj kev tiv thaiv thiab koj ua rau muaj kev kis mob Clostridium difficile.
- Yog tias koj muaj kab mob loj heev uas yuav tsum tau siv tshuaj tua kab mob, txawm li cas los xij, nws yog ib qho tseem ceeb uas koj yuav tsum ua raws nrog kev kho mob.
- Kev tsis kho tus kab mob tuaj yeem ua rau ntshav lom (sepsis), thiab mob txhaws cov hlab ntshav me me, txawm tias gangrene (cov nqaij tuag). Tsis txhob tso tseg kev kho tshuaj tua kab mob hauv qhov kev cia siab tiv thaiv Clostridium difficile, vim tias cov kab mob me me tuaj yeem ua rau loj thiab ua rau muaj kev phom sij rau lub neej.
Kauj Ruam 4. Cia siab tias, nrog mob me me mus rau nruab nrab nrog C-Diff, cov kws kho mob tuaj yeem sau tshuaj tshwj xeeb tshuaj tua kab mob xws li metronidazole (Flagyl), nqa los ntawm lub qhov ncauj (lossis IV yog nyob hauv tsev kho mob)
Txawm hais tias metronidazole tsis tau xaiv los ntawm FDA rau C. kis kab mob sib kis, nws tau pom tias siv los ua kom muaj txiaj ntsig zoo rau kev kis mob me me mus rau nruab nrab. Cov kev phiv los ntawm cov tshuaj metronidazole suav nrog xeev siab thiab muaj qhov iab nyob hauv koj lub qhov ncauj.
Rau qhov mob hnyav dua thiab rov tshwm sim, Vancomycin (Vancocin) tuaj yeem muab txhaj tshuaj. Fidaxomicin (Dificid) yog tshuaj tua kab mob hauv qhov ncauj uas tau pom zoo los kho tus mob C difficile. thiab tej zaum yuav raug muab coj los siv rau hauv cov xwm txheej no yog lwm txoj hauv kev. Hauv ib txoj kev tshawb fawb, qhov rov tshwm sim ntawm C. difficile hauv cov neeg uas noj fidaxomicin tau qis dua ntawm cov uas tau muab vancomycin. Txawm li cas los xij, fidaxomicin raug nqi ntau dua li metronidazole (Flagyl) thiab vancomycin. Cov kev mob tshwm sim ntawm vancomycin thiab fidaxomicin (Dificid) suav nrog mob plab thiab xeev siab. Koj tus kws kho mob yuav pab coj koj mus rau thaum cov tshuaj tua kab mob txuas ntxiv tau txais txiaj ntsig zoo rau koj kom noj, thiab thaum lawv tsis yog/thiab xav tau tso tseg
Kauj Ruam 5. Ntxuav koj txhais tes tas li
Ib ntawm txoj hauv kev tseem ceeb uas Clostridium difficile kab mob kis tau yog los ntawm kev kov cov chaw uas muaj kab mob kis los ntawm cov kab mob. Ib ntawm thaj chaw muaj kev pheej hmoo siab tshaj plaws yog cov chaw saib xyuas kev noj qab haus huv, vim tias muaj coob tus neeg mob Clostridium difficile uas tshwm sim hauv cov chaw xws li tsev kho mob, nrog rau lub sijhawm uas cov kab mob tuaj yeem muaj sia nyob ntawm qhov chaw.
- Tshwj xeeb tshaj yog tias koj nyob hauv tsev kho mob lossis lwm qhov chaw kho mob, nco ntsoov ntxuav koj txhais tes tas li. Ntxuav nrog xab npum thiab dej sov kom ntev li 20 feeb.
- Kev rub tes/kua dej raws li cawv tsis muaj txiaj ntsig.
- Cov ntaub so ntswg uas muaj 0.55% sodium hypochlorite tau pom los tua cov kab mob thiab tiv thaiv kev kis ntawm cov neeg mob.
- Txhim kho cov chaw tso quav thiab kaw lub hau ua ntej yaug kuj tseem txo qhov kev pheej hmoo kis mob.
Kauj Ruam 6. Tsis txhob koom tib lub tsev-/chaw ua haujlwm thiab thaj chaw nrog ib tus neeg uas mob raws plab
Yog tias ib tus neeg hauv tsev neeg, phooj ywg, lossis lwm tus neeg nyob hauv cov chaw saib xyuas kev noj qab haus huv cog lus raws plab, nws yog qhov tseem ceeb kom tsis txhob sib koom ib qho chaw ib yam li lawv kom txog thaum ua rau lawv mob raws plab tau lees paub. Lawv raws plab tuaj yeem yog vim Clostridium difficile, uas yog kis tau yooj yim, lossis mus rau lwm yam kab mob sib kis tau zoo heev, tsis muaj ib yam uas koj xav tau.
Khaws hauv koj tus kheej qhov chaw cais thiab zam kev sib faib khoom tuaj yeem pab koj tiv thaiv kev kis mob Clostridium difficile lossis lwm yam mob tsis xav tau
Kauj Ruam 7. Tiv tauj koj tus kws kho mob kom tiv thaiv kev tsim C-Diff thiab C-dificille-colitis, txawm tias mob raws plab me me thaum koj tab tom noj lossis tsis ntev los no tau siv tshuaj tua kab mob thiab koj tsim raws plab
Mus ntsib koj tus kws kho mob txhua lub sij hawm koj muaj mob raws plab hnyav, ua npaws, mob plab, thiab tej zaum muaj hnoos qeev, ntshav lossis pus hauv koj cov quav
Txoj Kev 2 ntawm 4: Tswj kev noj zaub mov thaum lub sijhawm tiag/lossis xav tias C-Diff lossis C-Diff-colitis
Kauj Ruam 1. Haus dej kom ntau yog tias koj mob raws plab
Dej yog qhov zoo tshaj plaws, tab sis dej nrog ntxiv sodium thiab potassium (electrolytes) kuj tseem yuav muaj txiaj ntsig. Tsis txhob haus dej uas muaj suab thaj ntau lossis muaj cawv - lossis caffeine (xws li kas fes, tshuaj yej thiab colas) - uas tuaj yeem ua rau koj cov tsos mob hnyav dua.
Kauj Ruam 2. Xaiv cov khoom noj yooj yim, zom tau yooj yim kom yooj yim C-Diff
Cov no suav nrog txiv applesauce, txiv tsawb, txiv tsawb hmoov, kua mis nyeem qaub, cov qos yaj ywm uas tau siav thiab mashed. Zam cov zaub mov muaj fiber ntau thaum muaj mob raws plab lossis mob plab hnyuv, xws li taum, txiv ntseej thiab zaub. Yog tias koj xav tias koj cov tsos mob txhim kho, maj mam ntxiv cov zaub mov muaj fiber ntau rov qab rau koj cov zaub mov noj.
- Noj ob peb pluas mov me me, ntau dua li ob peb pluas noj loj. Muab cov zaub mov me me tso rau hauv ib hnub.
- Zam cov khoom noj uas ua rau khaus. Nyob deb ntawm cov khoom qab zib, rog lossis kib, thiab lwm yam khoom noj uas ua rau koj cov tsos mob hnyav dua.
Txoj Kev 3 ntawm 4: Tiv Thaiv Kab Mob Raws Li Tus Kws Kho Mob
Kauj Ruam 1. Ua kom ntseeg tau tias koj lub chaw saib xyuas kev noj qab haus huv muaj tshuaj tiv thaiv kab mob tiv thaiv kab mob
Ib ntawm cov kauj ruam tseem ceeb hauv kev tiv thaiv Clostridium difficile kab mob ntawm cov txheej txheem (nyob rau theem ntawm kev saib xyuas kev noj qab haus huv, hauv cov chaw xws li tsev kho mob) yog kom muaj "phiaj xwm tshuaj tiv thaiv kab mob" nyob hauv qhov chaw. Qhov no yog ib txoj haujlwm uas ua kom ntseeg tau tias kws kho mob thiab lwm tus kws saib xyuas kev noj qab haus huv nyob twj ywm ua tiav txog thaum xav tau tshuaj tua kab mob thiab qhia, thiab thaum lawv tsis yog. Nws pab tiv thaiv kev siv tshuaj tua kab mob tsis tsim nyog, thiab coj los txiav txim siab ua tau zoo tshaj plaws los ntawm cov kws kho mob hauv cheeb tsam no.
Kauj Ruam 2. Xav txog muab qib siab ntawm cov kab mob muaj txiaj ntsig zoo/kab mob
Kev kho mob nrog Saccharomyces boulardii hauv cov uas yog tsis immunocompromised nrog C difficile kuj tseem yuav pab tau.
- Cov uas muaj kev tiv thaiv qis/qis hauv cov qe ntshav dawb tuaj yeem tawm tsam hauv lub plab los ntawm cov kab mob feem ntau zoo, yog li ceev faj yog txhawm rau txhawm rau tuaj yeem tua cov kab mob zoo ua rau kis mob, nrog rau cov kab mob phem. Thaum rov zoo los ntawm C-Diff, tus neeg mob tuaj yeem noj qab haus huv txaus los noj kaum tawm txhiab lab units ntawm ntau hom kab mob zoo/-germs (hu ua probiotics)-yog tias lub cev tiv thaiv kab mob muaj zog yog li probiotics tuaj yeem pab tua tawm qhov phem C -Diff cov kab mob thiab tiv thaiv kev loj hlob los ntawm C-Diff. Cov kab mob zoo tuaj yeem tau txais qhov twg nws tsis yog thaum muaj kev tiv thaiv qis.
- Cov kab mob zoo yuav raug tua los ntawm yuav luag txhua cov tshuaj tua kab mob. Tab sis tsuas yog ob peb tus tuaj yeem tua C-Diff vim tias nws muaj daim ntawv spore/zoo ib yam li menyuam dev uas tsis tau tua yooj yim, yog tias tag nrho, los ntawm cov tshuaj tua kab mob feem ntau.
- Qee zaum, thaum noj qab haus huv, noj cov kab mob zoo (probiotics) los tiv thaiv kev pib loj hlob los ntawm C-Diff.
- Tom qab kho tshuaj tua kab mob thiab nrog lub cev tiv thaiv kab mob, tus neeg mob yuav xav tau ntau cov tshuaj probiotics raws li kev tiv thaiv kev rov tshwm sim. Cov kab mob zoo yog qhov tseem ceeb heev rau kev tsis tso cai rau kis tus kab mob tshiab. Kev coj noj coj ua ua kua mis yogurt tuaj yeem pab qee yam tab sis tsis txaus.
- Kuj tseem muaj cov khoom muag raws li prebiotics (ua ntej/ua ntej vs pro/rau). Cov no yog cov ntaub ntawv ntawm saccharides/zoo li cov piam thaj tsis txaus uas tau hais los ua zaub mov kom ntxiv dag zog rau cov kab mob zoo/probiotics hauv txoj hnyuv.
Kauj Ruam 3. Ntxuav koj txhais tes, siv hnab looj tes yas rau kev ua haujlwm yooj yim/mus ntsib
Ntxiv cov yas, npog tag nrho lub tsho, yog tias koj yuav tsum muaj kev sib cuag nrog tus neeg mob, lub txaj, txoj kab txaj, rooj qhov rooj thiab rooj tog zaum siv los ntawm tus neeg mob. Nws yog qhov tseem ceeb uas kws kho mob, kws saib xyuas neeg mob, thiab lwm tus kws tshaj lij kho mob ntxuav lawv txhais tes tas li. Qhov zoo tshaj, cov kws kho mob yuav tsum hnav lub hnab looj tes tsis huv lossis ntxuav lawv txhais tes txhua lub sijhawm lawv nkag mus thiab tawm ntawm tus neeg mob chav. Lub tsho yas yuav tsum tau muab tso rau hauv chav tsev thiab tom qab ntawd raug tshem tawm sab hauv chav/ntawm lub qhov rooj ntawm tus neeg mob qhov chaw thiab pov tseg ntawm cov pov tseg loj tuaj yeem hauv chav ntawd.
- Ntxuav, lossis tso hnab looj tes tshiab thaum koj nkag mus, ua kom ntseeg tau tias koj tsis nqa cov kab mob Clostridium difficile mus rau hauv tus neeg mob tsis muaj mob.
- Ntxuav los yog tshem hnab looj tes thaum koj tawm mus kom ntseeg tau tias tsis muaj kab mob (suav nrog ua tau Clostridium difficile) raug thauj tawm ntawm tus neeg mob qhov chaw hauv txoj kev uas yuav kis tau rau lwm tus.
Kauj Ruam 4. Xyaum "tiv thaiv kev tiv thaiv" thaum twg los xij ib tus neeg muaj mob raws plab
Vim tias raws plab yog ib qho qhia tau tias tuaj yeem kis tau Clostridium difficile, nws yog qhov tseem ceeb rau cov neeg ua haujlwm saib xyuas kev noj qab haus huv kom xyaum "tiv thaiv kev tiv thaiv" txhua lub sijhawm tus neeg mob muaj mob raws plab. Qhov no suav nrog hnav lub tsho, daim npog ntsej muag, thiab hnab looj tes txhua lub sijhawm lawv nkag mus rau hauv qhov chaw, thiab muab cov khoom pov tseg tam sim ntawd tom qab siv kom tsis txhob kis mus rau lwm qhov chaw sab nraud.
Yog tias koj nyob ib puag ncig ib tus neeg uas tsis muaj mob raws plab (piv txwv li qhov ua rau tsis paub, yog li nws yuav yog Clostridium difficile), nws yog qhov tseem ceeb kom tsis txhob kov qhov chaw sib koom lossis cov khoom sib koom yog tias koj tsis xav ntes (lossis kis tau)
Kauj Ruam 5. Ntxuav thiab tua kab mob nrog tshuaj tsuag los yog ntaub so
Tsis txhob siv cov tshuaj ntxuav kom thov tua 99.9% ntawm cov kab mob. C-Diff nyob hauv 0.1% tsis yog txhua tus raug tua los ntawm hom tshuaj ntxhua khaub ncaws. Tshuaj tua kab mob rau txhua qhov chaw sib koom, pob qhov rooj, qhov rooj thiab qhov rooj qhov rooj, khoom siv, lossis lwm yam khoom uas tus neeg mob - lossis cov hnab looj tes tuaj ntsib tau. Siv cov tshuaj dawb tov, so los yog tshuaj tsuag kom huv ib puag ncig uas tuaj yeem kis nrog Clostridium difficile spores. Nov yog hom kev ua kom huv tshaj plaws, thiab nws yog qhov yuav tsum tau ua hauv tsev kho mob (thiab hauv tsev).
- Ib txwm siv hnab looj tes thaum tu thiab tua kab mob cov khoom siv, ib puag ncig ib puag ncig, thiab lwm yam khoom sib koom.
- Txuas ntxiv rau kev mob siab rau tu cev thiab tu kom huv kom txog thaum muaj tus kab mob Clostridium difficile tau raug txiav txim nrog kev kuaj mob.
Kauj Ruam 6. Nug lub chaw kuaj mob kom qhia rau koj txog cov txiaj ntsig tau sai li sai tau
Txhua tus neeg mob hauv tsev kho mob lossis chaw saib xyuas mob nkeeg uas muaj mob raws plab yuav muaj tus qauv xa mus rau lub chaw kuaj ntshav kuaj seb puas muaj Clostridium difficile. Yog tias qhov kev ntsuam xyuas rov qab zoo, lub chaw kuaj ntshav yuav ceeb toom rau cov neeg ua haujlwm tam sim kom muaj kev ceev faj tsim nyog tuaj yeem tswj hwm ib puag ncig tus neeg cuam tshuam.
Txoj Kev 4 ntawm 4: Paub thiab Kho Clostridium difficile
Kauj Ruam 1. Paub txog cov cim thiab tsos mob ntawm tus mob Clostridium difficile
Nws yog ib qho tseem ceeb kom tuaj yeem paub txog cov cim thiab tsos mob ntawm Clostridium difficile tus kab mob, ob qho tib si kom tus neeg raug cuam tshuam tuaj yeem tau txais kev kho mob, thiab tseem kom lwm tus tuaj yeem xyaum ntsuas kev tiv thaiv kom tsis txhob kis tus kheej. Cov cim thiab cov tsos mob ntawm tus mob hnyav suav nrog:
- Cov dej raws plab (txog li 10 txog 15 zaug hauv ib hnub, mus ntsib koj tus kws kho mob tom qab tsawg kawg peb ntu hauv ib hnub) ntev li ob lossis ntau hnub.
- Ua npaws tau - xws li tshaj 100.4 F (kwv yees li 41 C)
- Mob plab thiab mob
- Xeev siab
- Lub plawv dhia ceev
- Ntshav los yog lub qhov zis (zoo li hnoos qeev) hauv cov quav
- Lub cev qhuav dej (vim yog raws plab thiab tsis nqhis dej)
- Ua tsis qab los noj mov
- Poob phaus
- Lub plab o (kua tuav hauv plab kab noj hniav)
- Cov ko taw o (thiab txiv neej gonads thaum kawg)
- Lub raum tsis ua haujlwm (nrog tso zis tsawg lossis tsis muaj peev xwm tso zis) yog ua tau los ntawm cov co toxins ntawm C-Diff
- Kev nce hauv cov qe ntshav dawb suav
Kauj Ruam 2. Nres tshuaj tua kab mob uas koj tab tom noj yog tias koj muaj mob raws plab
Vim tias Clostridium difficile yog tus kab mob uas feem ntau tshwm sim thaum ntau dhau koj cov kab mob zoo raug tua los ntawm kev siv tshuaj tua kab mob. Yog tias koj tsim cov cim thiab tsos mob thiab kuaj pom zoo rau Clostridium difficile nws yog qhov tseem ceeb kom nres koj cov tshuaj tua kab mob tam sim ntawd. Qhov no yuav tiv thaiv kev kis tus kab mob tsis zoo. Koj tus kws kho mob yuav muaj tshuaj tua kab mob los kho Clostridium difficile, uas feem ntau yuav txawv dua li cov tshuaj tua kab mob uas koj tau siv thawj zaug.
- Kev kho tshuaj tua kab mob thawj zaug rau kab mob Clostridium difficile yog tshuaj tua kab mob hu ua metronidazole (Flagyl).
- Lwm yam tshuaj tua kab mob uas tuaj yeem sim suav nrog Vancomycin lossis Fidaxomicin.
Kauj Ruam 3. Ceev faj ntawm qhov pheej hmoo rov tshwm sim
Txawm tias thaum Clostridium difficile kab mob tau ua tiav kev kho mob, lawv tau rov tshwm sim sai sai ntawm txoj kev kwv yees li 20% ntawm cov neeg mob. Yog li ntawd, tom qab tau txais kev kho mob, nws yog ib qho tseem ceeb uas yuav tau saib xyuas lwm yam mob raws plab lossis lwm yam tsos mob, thiab mus nrhiav kev pab kho mob tam sim yog tias koj xav tias koj yuav rov muaj dua.
- Kev rov tshwm sim yuav rov kho nrog tshuaj tua kab mob tshwj xeeb rau tus kab mob Clostridium difficile.
- Kev rov qab tuaj yeem tshwm sim tsis pub dhau hnub lossis ntau lub lis piam, tshwj xeeb tshaj yog tias koj cov tshuaj probiotics tsis rov qab los. Kev nthuav qhia kho mob tej zaum yuav zoo ib yam lossis hnyav dua li kev nthuav qhia thawj zaug.
- Rau cov tib neeg uas muaj ntau yam rov tshwm sim, muaj kev kho mob tshiab hu ua "hloov quav" (hloov quav) uas yog qhov tshiab, tab sis tau qhia ua tiav ntawm kev kho Clostridium difficile zoo.
