Clostridia yog cov neeg sawv cev ntawm tib neeg txoj hnyuv microflora. Lawv feem ntau nyob hauv txoj hnyuv loj, tab sis kuj tuaj yeem pom nyob rau qee qhov ntawm lub plab zom mov, nrog rau hauv qhov chaw mos thiab ntawm daim tawv nqaij.
Clostridia yog dab tsi?
Clostridia yog kab mob Gram-positive. Lawv tso tawm ib qho enzyme uas koom nrog hauv kev rhuav tshem cov protein rau hauv cov amino acids. "Clostridia" yog txhais los ntawm Greek li "spindle". Lub npe no yog vim cov txheej txheem ntawm lawv cov kev tsim tawm (lub sijhawm no, cov kab mob thicken nyob rau hauv nruab nrab ib feem thiab nqaim ntawm qhov kawg).
Tus naj npawb ntawm clostridia, uas yog ib feem ntawm cov plab hnyuv microflora, hloov pauv. Lawv tus lej nyob ntawm lub hnub nyoog ntawm tus menyuam. Hauv cov menyuam yaus hnub nyoog qis dua ib xyoos, tus qauv yog 1000 colony-forming units ib gram, hauv cov menyuam yaus hnub nyoog qis dua ib xyoos - tus qauv yog mus txog 100,000. Tag nrho cov no yog coj los rau hauv tus account thaum kuaj.
Vim li cas clostridia txaus ntshai?
Clostridioses yog cov kab mob sib kis uas cuam tshuam rau tib neeg thiab tsiaj txhu. Clostridia ua rau cov kab mob txaus ntshai xws li pseudomembranous colitis, tshuaj tua kab mob raws plab,botulism, gas gangrene, tetanus, kab mob lom thiab necrotizing enteritis. Cov kab mob tshwm sim ntawm cov kab mob yog vim tso tawm cov co toxins A thiab B thiab cov protein uas inhibits plab hnyuv contraction.
Pseudomembranous colitis thiab tshuaj tua kab mob raws plab kab mob tshwm sim feem ntau hauv tsev kho mob. Qhov no yog vim lub tsev kho mob siv ntau yam tshuaj tua kab mob thiab tshuaj tua kab mob, uas ua rau muaj cov kab mob uas ua rau cov tshuaj tua kab mob resistant. Tsis tas li ntawd, kev noj tshuaj tua kab mob yog ib qho tseem ceeb ua rau cov tsos mob ntawm clostridia los yog nce ntawm lawv cov naj npawb. Thaum kho nrog cov tshuaj zoo li no, tsis tsuas yog cov kab mob hauv plab hnyuv tau raug rhuav tshem, tab sis kuj nws cov microflora ncaj qha raug mob.
Yog tias pom clostridium hauv cov quav ntawm tus menyuam, ces niam txiv tsis tas yuav suab lub tswb. Nws yuav tsum nco ntsoov tias cov kab mob no yog cov neeg sawv cev ntawm cov plab hnyuv microflora noj qab haus huv, uas koom nrog hauv kev zom cov protein thiab txhawb nqa peristalsis. Tab sis txhawm rau zam kev txhim kho cov kab mob loj, nws yog qhov yuav tsum tau saib xyuas lawv tus lej, uas yog, txhawm rau kuaj mob tsis tu ncua.
Causes of clostridiosis
Cov genus Clostridium suav nrog ntau dua 100 hom, uas tau muab faib ua 5 pawg. Lawv feem ntau tsis txaus ntshai rau tib neeg. Clostridia nyob hauv cov hnyuv ntawm tib neeg thiab tsiaj txhu. Nrog cov quav, cov kab mob nkag mus rau hauv av, qhov chaw uas lawv tuaj yeem nyob tau ntev hauv daim ntawv spores, thiab lawv tuaj yeem pom hauv dej. Qhov chaw ntawm clotridiosis yogtsiaj thiab tib neeg.
Kev kis tus kab mob - fecal-oral. Txoj kev kis tus kab mob yog kev sib cuag-tsev neeg (los ntawm cov tais diav, khoom ua si, khaub ncaws thiab tes ntawm cov neeg koom tes). Tus kab mob Clostridia feem ntau yog tshwm sim los ntawm kev tu tus kheej tsis zoo.
Y Yuav ua li cas cuam tshuam rau cov kab mob hauv plab hnyuv microflora?
Yam cuam tshuam rau txoj hnyuv microflora tau muab faib ua sab nraud thiab sab hauv.
Outer:
• ib puag ncig ntawm qhov chaw nyob ruaj khov;
• kev ntxhov siab tsis tu ncua;
• yam khoom noj khoom haus (clostridium hauv cov quav ntawm tus menyuam pom yog tias tus menyuam tau hloov mus rau kev pub mis ntxov ntxov; hauv cov neeg laus, qhov kev pheej hmoo ntawm kev tsim clostridium nce ntxiv thaum noj zaub mov nrog lub neej txee ntev);
• noj tshuaj tua kab mob, tshuaj hormonal thiab tshuaj tiv thaiv kab mob.
Teb chaws:
• tsis muaj zog ntawm lub cev tiv thaiv cov tshuaj tiv thaiv;
• hlwb retardation (postnatal hypoxia);
• CNS immaturity;
• ntxov ntxov;
• kab mob ntawm txoj hnyuv nrog cov kab mob nosocomial;
• pw tsis tsaug zog;
• kev cuam tshuam phais;
• mob ua pa nyuaj.
Clostridia tsos mob
Tshuaj tua kab mob-dissociated raws plab tsis yog tshwm sim los ntawm clostridia xwb. Cov kab mob ua rau tus kab mob no kuj yog salmonella, candida, Staphylococcus aureus, Klebsiella. Hom kab mob raws plab no yog tshwm sim los ntawm tus kab mob nosocomial. Tab sis cov me nyuam mos tsis raug rau qhov no.kab mob, raws li lawv tau txais ntau qhov kev tiv thaiv kab mob nrog niam cov kua mis, uas inhibit qhov kev loj hlob ntawm Clostridium.
Tshuaj tua kab mob sib kis tuaj yeem ua rau muaj cov tsos mob xws li mob raws plab me me mus rau mob pseudomembranous colitis, uas ua rau tuag taus hauv 30% ntawm cov neeg mob yog tias tsis kho.
Pseudomembranous colitis tshwm sim rau hnub 4-10 txij thaum pib siv tshuaj tua kab mob. Cov tsos mob tseem ceeb:
• tus yam ntxwv los ntawm qhov pib mob hnyav;
• lub cev kub siab tshaj 39.5°C;
• tsam plab;
• txo qis qab los noj mov;
• poob phaus tshwm sim;
• cov tsos mob ntawm kev qaug cawv hnyav sai sai pib tshwm;
• mob plab mob heev;
• rov ntuav;
• ntawm palpation, tus neeg mob hnov mob hauv plab hnyuv;
• copious, nyias, watery, ntsuab xim quav nrog ib tug putrid tsw;
• hnoos qeev, ntshav thiab cov seem ntawm fibrin deposits muaj nyob rau hauv cov quav.
Enteritis yog kab mob me tshaj plaws, uas feem ntau xaus tsis muaj teeb meem. Cov tsos mob ntawm tus kab mob no tsis muaj qhov tshwj xeeb.
Necrotic enteritis yog txhais los ntawm kev tsim ntawm rwj thiab erosions uas rhuav tshem cov mucous membrane. Cov tsos mob:
• qhov tshwm sim ntawm thaj chaw ntawm hemorrhagic necrosis thaum pib ntawm txoj hnyuv me;
• liab hemorrhagic area;
• muaj qhov nqaim ntawm txoj hnyuv lumen hauv thaj tsam ntawm qhov mob;
• tus neeg mob tshee hnyo,muaj kub taub hau;
• ntuav;
• mob plab zawv plab.
Clostridia hauv cov menyuam mos ua rau mob hnyav heev. Tshwj xeeb tshaj yog clostridium yog txaus ntshai rau cov me nyuam ntxov ntxov. Cov tsos mob:
• tam sim ntawd cuam tshuam loj rau tus menyuam tus mob;
• ua pa nrawm nrawm;
• cov tsos mob tshwm sim ntawm toxicosis thiab exicosis;
• lub cev tsis ua haujlwm;
• paralytic ileus.
Cov me nyuam yug ntxov ntxov muaj feem ntau dua li cov menyuam yaus loj tuaj yeem ua rau mob plab hnyuv thiab peritonitis vim muaj tus kab mob. Feem ntau, clostrodiasis hauv cov menyuam mos yog qhov tuag taus.
Thaum twg nws yuav tsum kuaj xyuas cov hnyuv microflora?
• Mob plab hnyuv ntev uas tsis teb rau kev kho mob.
• Clostridia hauv cov quav ntawm tus menyuam tuaj yeem ua tau, yog tias muaj cov hnoos qeev hauv cov quav, cov khoom noj uas tsis tau zom; xim tsis sib xws ntawm cov quav.
• Qhov tsis ruaj tsis khov ntawm cov quav.
• Flatulence thiab plab hnyuv colic uas tsis teb rau kev kho.
• Anemia, rickets.
• Atopic dermatitis nrog cov ntsiab lus ntawm tus kab mob thib ob.
• Kab mob ua pa nyuaj heev.
• Sepsis.
Kev kuaj mob Clostridiosis
Kev kuaj mob ntawm clostridium tshwm sim raws li cov cim hauv qab no (tus neeg mob keeb kwm):
• Kev sib koom siab ntawm kev kis kab mob nrog kev siv tshuaj tua kab mob;
• feem ntau, tus kab mob no cuam tshuam rau menyuam yaus thaum ntxovlaj;
• Clostridiosis yog tus yam ntxwv los ntawm qhov pib mob hnyav;
• kub taub hau;
• cov cim qhia ntawm kev qaug cawv hnyav;
• mob plab.
Lab diagnostics:
• Clostridia hauv cov quav ntawm tus menyuam raug kuaj pom los ntawm kev kuaj kab mob bacteriological (cov qoob loo ntawm cov khoom noj khoom haus xaiv):
• endoscopy teem sijhawm;
• mucosal biopsy qhia hauv qee kis;
• xam tomography tuaj yeem txiav txim siab tias muaj qhov tuab thiab edema ntawm phab ntsa ntawm txoj hnyuv.
Clostridia kho
Nws yog ib qho tseem ceeb uas yuav tsum tsis txhob noj tshuaj tua kab mob ua ntej pib kho rau cov kab mob clostridial.
Yog tias tus menyuam muaj Clostridium, kev kho mob yuav tsum yog los kho cov hnyuv microflora. Rau cov hom phiaj no, cov tshuaj "Bifidumbacterin", "Lactobacterin", "Bifikol", "Hilak-forte", "Lineks" thiab lwm yam yog muab.
Feem ntau pawg ntawm clostridia rhiab rau "Vancomycin", "Metronidazole". Nyob rau hauv cov ntaub ntawv loj ntawm tus kab mob, tus neeg mob tau txais kev kho mob infusion los kho cov kua dej hauv lub cev.
Hauv txhua kis, kev kho mob clostridia hauv cov menyuam yaus thiab cov neeg laus suav nrog eubiotics, enzyme npaj ("Mezim-forte", "Omez", thiab lwm yam), cov vitamins (pawg B) thiab enterosorbents ("Polysorb", ". Smecta, "Enterosgel", thiab lwm yam).
Kev Tiv Thaiv Clostridiosis
Txoj kev tiv thaiv tseem ceeb uas yuav pab kom tsis txhob kis tus kab mob Clostridium yog kev ua raws li kev cai huv thiab huv: ntxuav tes tsis tu ncua (tom qab taug kev, ua ntej noj mov, tom qab mus xyuas cov chaw pej xeem), ntxuav thiab scalding zaub thiab txiv hmab txiv ntoo nrog boiling. dej ua ntej noj mov, ua kom ntev thermal khoom ua haujlwm. Tsis tas li ntawd, nws yog ib qho tsim nyog yuav tsum ua kom muaj kev noj qab haus huv ntawm plab hnyuv microflora thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob. Tseem ceeb: Cov tshuaj tua kab mob yuav tsum tau pib tsuas yog tom qab kws kho mob tau tshuaj.
