Mukati
17.03.2017
enterococcus ibhakitiriya diki rakaumbwa neovhari iro riri chikamu cheyakajairika yemunhu intestinal microflora (yaimbova ma microorganisms akadaro aiiswa muboka D streptococci).
Mufananidzo: www.pinterest.ru
Kudzidzira uye ruzivo rwekurapa
Tichitarisa kumberi zvishoma, tinoona kuti vapepeti vanonyatsoziva kuti vaverengi vari kutsvaga rumwe ruzivo nezve nzira yekurapa enterococcus. Nokuda kwechikonzero ichi, isu tinotanga kukupa ruzivo pamusoro peForamu yedu, uko kune hurukuro inoshingaira pamusoro penyaya yekurapa kwehutachiona hwehutachiona hwe enterococcal muvarume. Heano mimwe misoro ine mukurumbira ine ruzivo rwakawanda inotsigirwa nekudzidzira:
Enterococcus faecalis - Musoro une ongororo pamusoro pemhedzisiro yekurapwa Enterococcus yafa! Uye ini handisati ndave - Chiitiko chekurapa Kunobvepi maruva emukati muprostate - Unoda kuziva izvi
Tinokoka munhu wose kuti apinde muhurukuro! Iyi foramu yave ichishanda kubva 2006. Dura reruzivo runoshanda mumunda wehutano hwevarume.
Zvisinei, ruzivo runoshanda harubvisi kubatsira kweruzivo rwemaitiro. Saka ngatienderere mberi…
Mhando dze enterococci. Zvikonzero zvehutachiona
Enterococci nhamba inopfuura 16 marudzi, mamwe acho anogona kukonzera zvirwere zvinotapukira zvegenitourinary system, endocarditis, etc. Inonyanya kuzivikanwa ndeyeEnterococcus faecalis (fecal enterococcus) uye Enterococcus faecium. Kunyange zvazvo nzvimbo yakajairika ye enterococci iri ura, munenge 25% yevarume vane utano hwakanaka, Enterococcus faecalis inowanikwa kune imwe nzvimbo yepamberi yeurethra. Ndicho chikonzero enterococci inorondedzerwa semukana (nguva pfupi) microflora yenhengo dzegenitourinary. Zvakare, Enterococcus faecium ndiyo inokonzera ruzhinji rwevancomycin-resistant enterococcal infections. Kusanzwa kwebhakitiriya kune mishonga inorwisa mabhakitiriya idambudziko guru remishonga yemazuva ano.
Enterococci ine zvese zvayo, nekuda kwechimiro chakakosha, uye yakawana inorwisa mabhakitiriya. Izvi zvinopa mupiro wakakosha weaya mabhakitiriya mukukura kwezvirwere zvenosocomial uye inomisa kugona kwevanachiremba maererano nechinhu chakakosha sekurapa kwe enterococcus.
Enterococcus muvarume (kazhinji - Enterococcus faecalis) inogona kukonzera zvirwere zvenhengo dzeurogenital turakiti, kunyanya kune vanhu vakaongororwa zvakakodzera zvekushandisa uye / kana kunwa mishonga inorwisa mabhakitiriya:
• prostatitis; • balanoposthitis; • urethritis; • epididymitis/orchoepididymitis; • cystitis, nezvimwewo.
Nzira dzehutachiona:
• kusangana pabonde (kunyanya kuchinjana kwenhengo-yepabonde uye yekumashure-yekubereka); • hutsanana husina kunaka mushure mekushandisa chimbuzi; • kutapurirwa kubva kuna amai kuenda kumwana achangoberekwa; • kashoma - mukugadzirisa nhengo.
Pakupinda munhengo dze genitourinary, enterococci inogona kugara mairi kubva maawa akawanda kusvika kumavhiki, pakupedzisira ichiparadzwa nemaitiro ekudzivirira. Nzvimbo iyi inodaidzwa kuti temporary carriage kana transit. Muchiitiko ichi, mutakuri anogona kutapurira pathogen kumunhu wepabonde. Kuongororwa kwe enterococcus nekutakura kwechinguva kunokwanisika nepamusoro-soro nzira (somuenzaniso, PCR).
Uyezve, enterococci mune zvishoma inogona kugara iri munhengo dzegenitourinary (inopfuurira kutakura). Kukura kwavo kunodziviswa nenzira imwechete yekudzivirira uye yakajairika microflora. Nekuderera kwehuwandu hweakajairika microorganisms uye / kana kutyorwa kwekudzivirira kwe enterococci, vanotanga kuwanda nekukurumidza, nzira yekuzvimba inokura. Kuenderera mberi kwekutakura kunowanzova asymptomatic, kunze kwenguva yekuwedzera, kuonekwa kwe enterococcus kunogoneka nePCR, nzira yetsika yekutsvakurudza. Muchiitiko ichi, panewo mukana wekutapukirwa kwemudiwa.
Apo muviri unorega kurambidza kukura kwe enterococci, kuratidzwa kwechirwere kunoitika. Zvinhu zvinotungamira mukukura kwehutachiona hwe enterococcal:
• kuvapo kwezvirwere zvakakomba; • zvirwere zvekare zvegonococcal/chlamydial; • kukanganisa kwemaitiro ekudzivirira kwenhengo dzepabonde (maitiro akadaro anosanganisira kusarerekera / kusina simba alkaline environment mu urethra, prostate antimicrobial factor, mechanical, local immunological protection) prostate antimicrobial factor - zinc-peptide complex); • kurapwa kwenguva refu kwemishonga inorwisa mabhakitiriya; • kushungurudzwa kweanesthetics yemunharaunda, zvichiita kuti urethra inopisa; • catheterization yeurinary tract kana imwe yero yekuongorora, iyo inogona kukonzera kushungurudzika kune mucous membranes; • kukwegura, nezvimwewo.
Zviratidzo zvehutachiona hweEnterococcal
Iko hakuna zviratidzo zvakananga zvekukuvadza kune genitourinary system ne enterococcus. Nekuvandudzwa kweiyo pathological process, varwere vanouya kunyunyuta hunhu hweimwe rudzi rwechirwere (zvinoenderana nenzvimbo yekuzvimba).
Urethritis inosanganiswa ne:
• kuwedzera kuwanda, zviratidzo zvinorwadza panguva yekurosa; • kubudisa urethra; • tsvuku, kutsamwa, kusagadzikana mu urethra.
Prostatitis inoratidzwa ne:
• chirwere muchimiro chekurwadziwa uye kusagadzikana mu perineum, kurwadziwa mumakumbo, kuputika / kurwadziwa mu urethra, kupisa mushure mekuita zvepabonde; • urination disorder syndrome (kuwedzera, kunzwa kwekusakwana kusina kukwana, kushaya simba / intermittent stream); • kutyorwa kwechitunha, kuburitsa (marwadzo, kupfeka kwechirume, kubuda nguva isati yakwana kana kuita zvepabonde kwenguva refu); • pamwe chete nekusingaperi urethritis - mucopurulent discharge.
Ne balanitis / balanoposthitis, varwere vanogunun'una nekurwadziwa uye kutsvuka munzvimbo ye glans penis, redness (kuvhuvhuta, maronda, kuputika), plaque, kuzvimba, kubuda. Orchiepididymitis isanganiswa yekuzvimba kwechembere (orchitis) uye epididymis yekupedzisira (epididymitis). Muchirwere chakakomba, kurwadziwa kwakanyanya kusinganzwisisike muscrotum, kuwedzera / kuomarara kweimwe testicle kana ese ari maviri, hyperemia yeganda re scrotum, kuwedzera / kuoma kwe epididymis nekurwadziwa kwakanyanya kunoonekwa. Marwadzo anodzikiswa muscrotum kana yasimudzwa. Chirwere chisingaperi chinoratidzwa nezviratidzo zvakasvibiswa, dzimwe nguva kuonekwa kweropa muurume.
Nzira dzekuongorora
Kuongororwa kwe enterococcus munhengo dzemurume urogenital turakiti kunosanganisira:
• kuongororwa nenyanzvi; • weti yakawanda uye kuongororwa ropa; • polymerase chain reaction (inobvumira kuziva microorganism kunyange neasymptomatic carriage); • zvidzidzo zvetsika (zvikasadaro bacteriological inoculation) nekutsunga kwekunzwa kwemishonga inorwisa mabhakitiriya; • mamwe marabhoritari, akadai seRIF, ELISA, smear microscopy, nezvimwewo, pamwe chete nechaidzo (ultrasound, urethroscopy, MRI, CT) zvidzidzo zvekusabvisa zvimwe zvikonzero zvechirwere (kwete-enterococcal genital infections, tumor process, etc.) Weti sampuli dzinoongororwa murabhoritari, urume, prostate secretion, urethral discharge.
Muhupo hwekuratidzwa kwakashata kubva muurogenital turakiti, zvakakosha kunzwisisa kuti enterococcus haigoni kukonzera matambudziko akadaro. Kana zviedzo zvisina kuratidza kuvepo kwemamwe hutachiona, zvingave zvakafanira kuongorora zvakare (dzimwe nguva kunyange mune imwe murabhoritari). Chete mushure mekuregererwa kwezvimwe zvinogoneka zvirwere (Trichomonas, gonococci, chlamydia, nezvimwewo) inzira yekurapa yega yega inorayirwa kubvisa enterococci.
Enterococcus nzira dzokurapa
Muchiitiko chekuona netsaona ye enterococcus panguva yekuongorora nguva dzose, kurapwa kunokurudzirwa chete kana pane zvichemo zveunhu, kuronga kupindira kwekuvhiya panhengo dze genitourinary tract (mune mamwe mamiriro ezvinhu, chiremba angakurudzira kurapa kwakakodzera pakuronga pamuviri). Izvi zvinokonzerwa nekuti iyo microorganism yakadaro inogona kuwanikwa kazhinji muvarume vane hutano hwakakwana.
Enterococcus titers of the order of 1 * 10 in the 6th degree anoonekwa seanokosha diagnostically (kana pasina kuratidzwa kwekiriniki). Panguva imwecheteyo, asymptomatic bacteriuria (kuonekwa kwe enterococcus muweti) inogona kungoda kutariswa kwachiremba uye, kana zvichidikanwa, kuongorora nguva nenguva: zvirimwa zvinodzokororwa. Muvakomana vasina zviratidzo zvehutachiona hwehutachiwana hwehutachiwana, nguva dzose murabhoritari kuonekwa kwe enterococcus hakukurudzirwi.
Kana enterococcus ichifungidzirwa sechikonzero chega chezvinetso mumurume kubva muurogenital turakiti (urethritis, prostatitis pyelonephritis, cystitis, nezvimwewo), yakakwana yemishonga inorwisa mabhakitiriya inodiwa. Zvichipa kuwedzera kupikisa kwema microorganisms akadaro kune chiito chemishonga inorwisa mabhakitiriya, zvinonyanya kudiwa kuti uone kunzwisisika kwakakodzera kusati kwatanga kurapwa (zvinosuruvarisa, iyi inguva inopedza nguva uye haisi nguva dzose inogoneka kumisa kutanga kwekurapa).
Muzviitiko zvakawanda zvezvirwere zvinoputika zve genitourinary system muvarume, chinokonzera hutachiona ndeye fecal enterococcus (Enterococcus faecalis). Mhando iyi ye enterococcus kazhinji:
• kunzwa kune rifaximin, levofloxacin, nifuratel, mamwe matambudziko - kune doxycycline; • zvine mwero kune ciprofloxacin; • kunonoka zvishoma (kune mashizha akawanda) kune tetracycline; • isinganzwisisi kune lincomycin.
Penicillins, mamwe cephalosporins, ekutanga fluoroquinolones haashande kana kusimba kurwisa fecal enterococcus.
Kurapa, sekutonga, imwe mishonga yakakwana; kana ikasashanda, imwe kana musanganiswa wezvakawanda zvinogona kurongerwa. Mushure mekupera kwekosi, kuongororwa kwechipiri kwe enterococcus kunoitwa. Kurapa kwemurume wepabonde kunoitwa maererano nekurudziro yechiremba (kazhinji munyaya yekuronga pamuviri). Munyaya yehutachiona hwakavhenganiswa, mishonga inoshandiswa kune imwe neimwe pathogen inosarudzwa.
Nzira yemishonga inorwisa mabhakitiriya inowanzokwana kurapa kwakakwana. Zvisinei, mune dzimwe nguva, chiremba anogona kuwedzera kuwedzera:
• maitiro akasiyana-siyana e physiotherapeutic; • nzira yekukwirisa (inowanzo shandiswa pakuvhiringidza pathologies yeprostate gland); • gadziriro dze enzyme; • mavitamini; • immunomodulating agents; • kurapwa kwehomeopathic; • mishonga yemagariro (mabhati e decoctions uye infusions yemishonga yemishonga, kunwa cranberry juice, nezvimwewo); • kurapwa kwemunharaunda (infusions, iyo inonzi instillations, mu urethra yezvigadziriso zvezvinhu zvakasiyana-siyana zvemishonga, zvakadai seantiseptics).
Kuregeredza kurudziro yekurapa, kunyanyisa kuzvirapa uye kurapa kwevanhu hakugone chete kutungamirira kupora, asiwo zvakanyanya kuipa mamiriro emurwere. Semuenzaniso, kushungurudzwa kwekuiswa kwemishonga inorwisa mabhakitiriya muurethra kunowanzo kutungamirira mukupisa kwemucosal, iyo pachayo inoshanda sechinhu chinokonzera kukurudzirwa kwehutachiona hwehutachiona.
Matambudziko
Kana pasina kurapwa kwakakwana kwehutachiona hwe enterococcal, zvinotevera zvinogoneka:
• kugoverwa kwemaitiro ekuputika kune dzimwe nhengo uye matishu; • kuchinja kwechirwere kune chimiro chisingaperi; • kuderera kwehutano hwemurume uye, maererano naizvozvo, kukura kwekushaya simba kwevarume; • kukanganisa kwebasa re erectile, nezvimwewo.
dziviriro
Kudzivirira enterococcal infection ndiko:
• kutevedzera mitemo yepabonde yakachengeteka (kushandiswa kwezvipingamupinyi nzira dzekudzivirira, mudiwa wekusingaperi); • kuona panguva uye kubvisa / kugadziriswa kwezvirwere zvisingaperi; • kurapa kwakakodzera kwehutachiona hwepabonde (kunyanya gonococcal, trichomonas); • mararamiro ane hutano (normalization yehurumende yebasa nekuzorora, yakazara-yakazara-yepamusoro-soro yezvokudya, kurovedza muviri kwakadzikama, kuderedza mamiriro ezvinhu anonetsa, nezvimwewo), nezvimwewo.
Yakagadziriswa uye yakawedzerwa pa14.03.2021/XNUMX/XNUMX.
Kushandiswa zvinyorwa
1. Kukosha kwebhakitiriya yeEnterococcus muhupenyu hwevanhu. Electronic science magazine "Matambudziko emazuva ano esainzi uye dzidzo". Krasnaya Yu.V., Nesterov AS, Potaturkina-Nesterova NI FSBEI HPE "Ulyanovsk State University". 2. Mhedzisiro yeongororo yakawanda yemishonga inorwisa mabhakitiriya ye enterococci. Sidorenko SV, Rezvan SP, Grudinina SA, Krotova LA, Sterkhova GV State Research Center yeAntibiotics, Moscow