Umngeni Okhulayo Wokuxhathisa Iintsholongwane
Ukwanda ngokukhawuleza kokuxhathisa iintsholongwane (i-AMR) yenye yezona ngxaki zinzima kwihlabathi liphela kwixesha lethu. I-World Health Organisation idwelise i-MRSA njengesifo esiphambili. Phakathi kwezifo ezinganyangekiyo, i-methicillin resistant Staphylococcus aureus (MRSA) ixhalabisa kakhulu. Ngokutsho kophando lweGlobal Burden of Disease olupapashwe kwiThe Lancet (2024), ukufa okubangelwe ngqo yi-MRSA kunyuke ukusuka kuma-57,200 ngo-1990 ukuya kwi-130,000 ngo-2021 - ukwanda okuphindwe kabini kwiminyaka engamashumi amathathu [1]. Olu phononongo lukwaqikelela ukuba ngo-2050, phantse abantu abazizigidi ezingama-40 banokulahlekelwa bubomi babo ngenxa yosulelo olunganyangekiyo lweentsholongwane. I-MRSA ikhokelela ekuhlaleni ixesha elide esibhedlele, iindleko zonyango ezinyukileyo, kunye nokufa okuphezulu, ingakumbi phakathi kwezigulane ezinyangekileyo, izigulane ezityandwayo, kunye nabahlali abanyangelwa ixesha elide.
UkuqondaI-Staphylococcus aureuskunye ne-MRSA
I-Staphylococcus aureus (SA) yeyona nto ibangela usulelo oluhambelana nokhathalelo lwempilo. Yi-Gram positive coccus evelisa iityhefu ezahlukeneyo kunye nee-enzymes ezihlaselayo, kwaye yaziwa ngayoukusasazeka ngokubanzi, ukuba nesifo esinamandla, kunye namazinga aphezulu okuxhathisaI-thermostable nuclease gene (nuc) yeyona nto ibalulekileyo ekufumaneni i-SA.
I-MRSA inokwahlulwa ibe ziintlobo ezintathu ngokusekelwe kwimvelaphi:
-I-MRSA enxulumene nokhathalelo lwempilo (HA MRSA)– ikakhulu kwenzeka kwizibhedlele nakwizibonelelo zokhathalelo lwexesha elide
-I-MRSA enxulumene noluntu (CA MRSA)- kwenzeka ngaphandle kweendawo zonyango
-I-MRSA enxulumene nemfuyo (LA MRSA)
Iindlela zosulelo kunye nempembelelo yeklinikhi ye-MRSA
I-MRSA ingangena emzimbeni nge-amanxeba esikhumba, iifollicle zeenwele, okanye igazi, okubangela usulelo olufunxayo. Izigulane ezinezifo zolusu okanye ukutsha zisengozini enkulu yosulelo lwe-MRSA. I-pneumonia yenye yezona mpawu ziqhelekileyo zesifo se-MRSA, kwaye unyango olungafanelekanga lunegalelo elikhulu ekufeni okuphezulu. Ke ngoko, ukuxilongwa kunye nonyango lwe-MRSA pneumonia zijongene nemingeni emikhulu kwaye zifuna ingqalelo esondeleyo.
Isihluthulelo soThintelo noLawulo loSulelo: Ukuhlolwa kwangethuba
Izigulana ezikwisibhedlele – kuquka ezo zikwiiyunithi zokhathalelo oluphezulu, iiwadi zotyando, kunye neendawo zokhathalelo lwexesha elide – zisengozini enkulu yokosulelwa yi-MRSA. Ukuchongwa kwangethuba kwe-MRSA colonization okanye usulelo kubalulekile ekuthinteleni ukosulelwa esibhedlele, ukusebenzisa amanyathelo okuthintela ukuqhambuka kwesifo, kunye nokunciphisa ukosulelwa kwabantu ngabanye.
Iindlela zemveli zokukhulisa izityalo zihlala zithatha iiyure ezingama-48-72 ukuvelisa iziphumo. Ngeli xesha, abathwali be-MRSA banokuba yimithombo enokubakho yokudlulisela. Uvavanyo olukhawulezileyo lweemolekyuli lunciphisa kakhulu ixesha lokuhlola, nto leyo evumela ukubonwa kwangethuba, ukwahlulwa kwangethuba, kunye nokungenelela kwangethuba.
I-SA kunye ne-MRSAUkufunyanwa kwiMacro kunye neMicro-Test
Yenzelwe ukufumanisa i-nucleic acids kwi-in vitro evela kwi-Staphylococcus aureus kunye ne-Staphylococcus aureus enganyangekiyo ne-methicillin kwiisampuli ze-sputum yomntu, iisampuli ze-nasal swab, kunye neesampuli zosulelo lolusu kunye nezicubu ezithambileyo. Ukusetyenziswa okukhethekileyo kuquka:
-Ukuthintela nokulawula usulelo kwiindawo zonyango– kwizigulana ezibhedlele, kuquka izigulana ezigula kakhulu, izigulana ezityandwayo, kunye nezigulana ezihlala ixesha elide
-Ukuxilongwa okuncediswayo kwezifo zokuphefumla– kwizigulana ezirhanelwa ukuba zinosulelo lokuphefumla lwe-SA okanye i-MRSA
-Ukuxilongwa okuncediswayo kwezifo zesikhumba kunye nezicubu ezithambileyo– kunye nezinye iimvavanyo zelebhu ezifana nenkcubeko yeentsholongwane
Isisombululo soVavanyo oluPhambili: Inkqubo ye-POCT ezenzekelayo ngokupheleleyo ye-AIO800+ SA kunye ne-MRSA
I-Macro & Micro-Test's AIO800 POCT ezenzekelayo ngokupheleleyo kunye nekhithi yokubona i-SA & MRSA, isixhobo esisebenzayo sokuthintela nokulawula usulelo esibhedlele.
-Iintlobo ezininzi zeesampulu– Iisampuli ze-sputum, ii-nasal swabs, ulusu kunye nezicubu ezithambileyo zosulelo
-Umsebenzi ozenzekelayo ngokupheleleyo– Ukulayisha ngqo kwiityhubhu zesampulu zokuqala (1.5mL–12mL); ukusebenza kancinci ngexesha, impazamo yomntu inciphisiwe
-Uvakalelo oluphezulu– Umda wokufumanisa ungaphantsi kwe-1000 CFU/mL kwi-SA nakwi-MRSA
-Iziphumo ezikhawulezayo– Ikhawuleza kakhulu kunenkcubeko yesintu, nto leyo evumela ulawulo losulelo kwangethuba
-Iifomathi ze-reagent ezimbini– Iinketho zolwelo kunye ne-lyophilized zoyisa imingeni yokugcina kunye nokuthuthwa
-Ulawulo longcoliseko olwakhelwe ngaphakathi– Inkqubo yokukhusela eneeleya ezili-11 (i-UV, i-HEPA filtration, i-paraffin sealing, njl.njl.)
-Ukuhambelana kwehlabathi– Isebenza ne-AIO800 kunye neenkqubo ze-PCR eziqhelekileyo
Iithagethi kunye nokutolikwa kweziphumo
Le khithi ibona iithagethi ezimbini:
-i-nucijini: i-gene egcinwe kakuhle nekhethekileyo ye-Staphylococcus aureus
-i-mecAijini: i-gene ephambili elawula ukumelana ne-methicillin
Ingcaciso yeziphumo
-SA negative – Akukho Staphylococcus aureus ifunyenweyo
-i-SA positive, i-MRSA positive– I-S. aureus ifunyenwe, i-mecA gene ayifunyanwanga
-i-SA positive, i-MRSA positive– Kufunyenwe i-S. aureus (MRSA) engamelana ne-Methicillin
Impembelelo yoNyango lweSigulana kunye neMpilo yoLuntu
Ukwamkela uvavanyo lwe-molecular olukhawulezileyo kunika iingenelo ezibalulekileyo:
-Ulawulo oluphuculweyo losulelo– ukuchongwa ngokukhawuleza kwabathwali be-MRSA kwenza kube lula ukuba bodwa ngexesha elifanelekileyo kwaye kunciphisa ukosuleleka esibhedlele.
-Iziphumo zonyango eziphuculweyo– ulwazi lwasekuqaleni lwe-pathogen luxhasa ukwenziwa kwezigqibo zonyango
-Ukuhlolwa kwezifo– ukufunyanwa kwe-MRSA ngokukhawuleza, kunye nolwazi lweklinikhi yesigulana, kubonelela ngolwazi lokuqala malunga nemvelaphi ye-HA MRSA okanye ye-CA MRSA, okuxhasa ukujonga usulelo esibhedlele.
-Inkxaso yokuphatha iintsholongwane– ukuqinisekiswa kwangethuba okanye ukungabandakanywa kwe-MRSA kunceda ekunciphiseni ukusetyenziswa okungeyomfuneko kwee-antibiotics ezibanzi (ezihlala zihambelana nokugweba kwezonyango)
Ukujongana nomceli mngeni we-MRSA kufuna indlela edibeneyo edibanisa ubuchwepheshe obuphambili bokuhlola kunye neendlela ezisisiseko zokulawula usulelo.Izixhobo zokuhlola ngokukhawuleza, amanyathelo okwahlulahlula asebenzayo, ukusetyenziswa ngokufanelekileyo kwee-antibiotics, kunye nokubeka esweni rhoqoziindlela ezibonakalisiweyo zokulawula i-MRSA kwiindawo zonyango.
Ukulungele ukutshintsha uvavanyo lwe-SA kunye ne-MRSA ngesampulu yokwenyani yokuphendula ngempumelelo?
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Iireferensi:
[1] AbaSebenzisani bokuchasana nezifo kwiHlabathi liphela ngo-2021. (2024). Umthwalo wehlabathi jikelele wokuchasana nezifo ezibangelwa ziintsholongwane ...
Ixesha lokuthumela: Epreli-10-2026