Le ngqungquthela engamelana ne-colistin yafunyanwa e-United States
Ngethuba lokulawula kwakhe, uMongameli Obama ufumene i-flak eninzi yokukhupha imiyalelo elawulayo. Umyalelo olawulayo uvumela umongameli ukuba abeke umgaqo-nkqubo ngaphandle kwegalelo leNgqungquthela kunye nokuxhamla ingxoxo yenxaxheba yoluntu.
Nangona ezinye ze-oda ezilawulayo zika-Obama ziye zabangela ukuphikisana nokuxabana, inzuzo yabanye iyakuthandwa kakhulu. Ngokukodwa ngo-2015, u-Obama wakhupha isicwangciso seNational Action Plan sokulwa neBhakteria engapheliyo.
Ngokutsho kolawulo luka-Obama, nantsi iinjongo zalo myalelo olawulayo:
- Ukunciphisa ukuHlaba kweBhaktheriya engaxhomekiyo kunye nokukhusela ukusasazeka kwezifo ezichasayo.
- Qinisekisa i-National One-Health Surveillance Efforts to Combat Resistance.
- Ukuphuhliswa koPhuhliso kunye nokuSebenza kweeNzululwazi zokuHlola eziKhuselekileyo kunye neNgcaciso zeNgcaciso kunye neCandelo leBhakteria engavumiyo.
- Ukukhawulezisa uphando kunye noPhando oluPhambili kunye noPhuhliso lweeNtsholongwane eziNtsha, ezinye i-Therapeutics, kunye neeViccini.
- Ukuphucula ukuBambisana kwamazwe ngamazwe kunye neZakhono zoLwazi lokuSithintela ulwaNtsholongwane, ukuChengisisa, uLondolozo, kunye noPhando loPhuhliso lweeNtsholongwane.
Ukuhlangabezana nale njongo, umongameli wacela uncedo lwemibutho eyahlukeneyo, kubandakanywa neSebe lezoKhuseleko (iDoD), iSebe lezoLimo (i-USDA), kunye neSebe lezeMpilo kunye neNkonzo zoLuntu (HHS). NgoMeyi 2016, ezi arhente zikhuphe iindaba: i- coli -resistant mcr-1 E. coli yafunyanwa kwisigulane kwi-Medical Centre yaseWalter Reed eUnited States. Esi sigulane saba ne- infection tract (tract infection ) eyayinenhlanhla yokunyangwa ngenye i-antibiotic.
UColistin uyisicatshulwa sokugqibela ekukhuselaneni nezifo. Uninzi lweengcali zempilo yoluntu, abaphandi kunye neekliniki ngokufanayo baye babesaba ukunyanzelwa kwe-colisitin ixesha elithile. Ukongezelela, i- mcr-1 E. E. iyakwazi ukutshintshela le ntsholongwane yokuphikisana namanye amabhaktheriya usebenzisa i-plasmids.
Kutheni Ukhathazeka Ngokuchasana Nee-Antibiotic?
Ukususela ngowe-1928, ngokuqaliswa kwe-penicillin, i-antibiotics igcine ubomi bezigidi eziliqela emhlabeni jikelele. Kungekudala emva kokusungulwa kwee-antibiotics, ukuchasana phakathi kweengxaki ezithile zebhaktheriya kwaqatshelwa. Kwiminyaka yakutshanje, olu xhatshazo luye lwanyuka kwaye ibhaktheriya engaxhatshazwayo ngamachiza, okanye i- superbugs , ibe yingozi enkulu kwimpilo yoluntu kunye nokhuseleko.
I-CDC ilinganisela ukuba phantse izigidi ezi-2 izifo ezikhuselekanga iziyobisi zenzeke ngonyaka e-United States ezibangelwa ukufa kwabalinganiselwa kuma-23,000.
Ngokuqhuma kwangoko kutshatyalaliswa kwamagciwane amaninzi , inani lezonyango ezisebenza ngokubhekiselele kwiibhaktheriya ziye zancipha. Ukongezelela, iilabiyoti ezenza izidalwa ezinqabileyo zingabiza kakhulu.
Yintoni uColistin?
UColistin ungowesigaba se-antibiotics ebizwa ngokuba yi-polymyxins. Iintlobo ezimbini ze-polymyxins zikhoyo: i-polymyxin B kunye ne-polymyxin E. Colistin yi-polymyxin E kunye neyona ndlela isetyenziswa kakhulu kubini.
UColistin waqala ukusetyenziswa ngawo-1960; nangona kunjalo, ukusetyenziswa kwe-arhente kwanyanzelwa ngokukhawuleza kuba kubangele i-neurotoxicity kunye nephrotoxicity. Ngamanye amazwi, i-colistin yabangela umonakalo wesibindi kunye nentso, ngokulandelanayo.
Kwiminyaka yakutshanje kunye nokunyuka kwamanyathelo amaninzi, kuye kwafuneka sibuyisele kwakhona i-colistin ukulwa neebhaktheriya ezithi zichasene nezinye iziza-antibiotics eziqhelekileyo. UColistin usebenza ngokuphawulekayo kodwa usebenza kwiincwageni ezimbalwa ze-bacteria, njengeP aeruginosa , iintlobo ze- Acinetobacter kunye neentlobo ze- Klebsiella . Ingqalelo, zonke iintlobo ezahlukeneyo zeebhaktheriya zingabangela ukusuleleka kwegazi (sepsis) kunye nokusuleleka kwemiphunga (pneumonia), izifo ezithintela umchamo, izifo zesikhumba kunye nezilonda, kunye nokusuleleka emva kokuhlinzwa. Ukongezelela, ezi bhaktheriya ziyabachaphazela abantu abagula kakhulu kwaye baye bahlaziya amajoni omzimba.
Ukutshintshwa kweNtsholongwane yama-Antibiotics ngamaPlasmids
Yintoni eyenza le nkathazo entsha ye-colistin ye-E. Coli ingxaki kukuba iyakwazi ukudlulisela ulwazi lwezofuzo ngokuchaneka kwamanye amabhaktheriya nge-plasmids (okt, i- mcr-1 okanye iplasmid-mediated polymyxin resistance mechanism).
Njengoko kuchazwe kwiLancet ngoNovemba 2015, abaphandi baseTshayina babenokuqala ukufumana le nto entsha. Abaphandi bafumene le bhaktiriya engapheliyo ngexesha leprojekthi yokuhlola iliso ngokukhawuleza ukuxhatshazwa kwe-antimicrobial phakathi kwe- Escherichia coli esekelwe kwizilwanyana ekutya.
Ngexeshana phakathi kokutholakala kweTshayina kwale bhaktiriya kunye neebhaktheriya ezivela kwiziko leMpi leSizwe lakwaWalter Reed, apho abaphandi bombutho baqaphele khona, le ndawo ifunyenwe kwamanye amazwe aphindaphindiweyo, oko kuthetha ukuba sele sele isasaze umhlaba jikelele.
Ngenhlanhla, uphando olulandelelwano lwe-National Antitimicrobial Resistance Monitoring System-ulungelelaniso phakathi kwe-USDA, iiNkonzo zezeMpilo kunye nezoLuntu (HHS), kunye neSebe lezeMpilo kunye neendawo zengingqi-libonisa ukuba i-isolation ye- E. coli engamelana ne-colistin ayinqabile . Ukongezelela, i- Salmonella ne- Klebsiella , ezinye iindidi zebhaktheriya, azibonakalanga ubungqina be-genetic mcr-1.
Ukutshintshwa kolwazi lwezofuzo phakathi kwebhakteria luhle kakhulu. Akunako kuphela ukutshintshwa kweengcatshulwa kolwazi ukukhangela inzala-ekuthiwa yi-transmission-kodwa iibhaktheriya zingaphinde zitshintshise olo lwazi ngokusebenzisa ukutshintshiselwa kwegazi. Ngamanye amazwi, nangona emva kokuba ibhakteriki yenziwe iyakwazi ukufumana ulwazi lwe-genetic kwenye ibhetri.
Ngokukodwa, le nkqubo yokudluliselwa kwemizi ehambelana nayo ixutywa ngamaplasmids, okanye iibhanki ezihamba ngokungafaniyo ezincinane, iisetyhula, i-DNA ephindwe kabini, ehluke kwi-DNA ye-chromosomal DNA. I-Plasmids iqulethe ulwazi oluxhasayo i-genetic benefits to bacteria, ezinjengokuchasana nemithi. Ngokugqithiswa kwe-gene, i-plasmids idluliselwa phakathi kweebhaktheriya.
Masifake ukutshintshwa kwemizimba echanekileyo ye-antibiotitic resistance genes ngendlela ebonakalayo (nangona i-silly). Cinga ukuba wawukho emcimbini kwaye omnye umntu wayenekhono lomlingo lokumelana ne-cyanide. Ubunakho bemilingo bekhowudiwe kwiijeni zakhe kwaye kunokudluliselwa kubantwana bakhe. Ukongezelela, lo mkhono ungadluliselwa komnye umntu ngokuthatha nje i-cocktail yakhe. Ngaphambi kokuba wazi, wonke umntu uthatha isiphuzo esiphuzayo. Ukongezelela, abanye abavuyiweyo kwiqela banemikhankaso yabo emilenzeni, abesebenzela abanye ngezobuqu zabo. Ngaphambi kokuba uyakwazi, abathile bezemidlalo baye bagcina isigxina sokuxhatshazwa okubancedisa ukulwa neentlobo ezahlukeneyo zobuthi.
Isiphelo
Isongelo esiphilayo sokuthi ukukhangeka kwe-colistin ekutshatyalaliswayo kunokubangela ukukhathazeka. Njengomntu, unokwenza inxalenye yakho ukunciphisa intshutshiso ye-antibiotic ngokuthatha i-antibiotics kuphela xa ufuna. Kufuneka uqiniseke kwakhona ukuba uzalise ikhosi yakho yonke ye-antibiotics, ekubeni ukuyeka ukukhawuleza kukukhuthaza ukukhula kweengcinezelo ezingenazinyango. Ekugqibeleni, ngenxa yokuba i- mcr-1 E. Coli kunye nezinye iibhaktheriya ziyafumaneka kwimveliso nenyama yeenkukhu, kuseloko kuluvo oluhle ukupheka ukutya kwakho ngaphambi kokusetyenziswa.
Imithombo:
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I-Carroll KC, i-Hobden JA, iMiller S, i-Morse SA, i-Mietzner TA, i-Detrick B, i-Mitchell TG, i-McKerrow JH, i-Sakanari JA. Microbial Genetics. Ku: I-Carroll KC, i-Hobden JA, iMiller S, i-Morse SA, i-Mietzner TA, i-Detrick B, i-Mitchell TG, uMckerer JH, i-Sakanari JA. eds. Jawetz, Melnick, & Adelberg's Medical Microbiology, 27e . New York, NY: McGraw-Hill; 2015. Ukufikeleleka ngoMeyi 29, 2016.
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