Abangaphezu kwama-40 banentsholongwane, ubuncinane abashumi-15 baye bafa, banesifo sebhaktheriya esingazi into eninzi malunga no-Elizabethkingia anophelis.
Bonke abo banesifo abane-HIV baye baba ngabantu abadala eWisconsin, ikakhulukazi abadala. Ininzi ineminyaka engaphezulu kweminyaka engama-65 ubudala kwaye ibikwa ukuba ibe nezinye iingxaki zempilo. Abanye babemakhaya asebekhulile, abanye bezibhedlele. Akucaci ukuba isifo esingakanani esele sikhona kunye nokuba usulelo olunjani lwebhaktheriya lunegalelo ekufeni.
Akubonakali ukuba yingxaki kulabo baphilile kwaye bangaphandle kwamaziko okunyamekela. Abadlali be-Epidemiologists kunye nabasebenzi bebhu labasebenzi - ukusuka kwilizwe kunye neCDC-bazama ukuqonda indlela oku kwenzeka ngayo.
Elizabethkingia anophelis Imiphumo
Esi sifo se-bhakteria singakhokelela kumfiva, ukuphefumula okufutshane, ukubola, kunye nokusulelwa kwesikhumba - i- cellulitis- enokuquka iindawo ezibuhlungu kunye nezinye iinkqubo ezibomvu zesikhumba. Kufunyenwe kwiimida zegazi zezigulane kwaye uye wadala umfanekiso weklinikhi we-sepsis.
Ngamanye amaxesha ngenxa yesifo sengqondo esipheleleyo segulane, akucaci ukuba ukutheleleka kuka-Elizabethkingia yikholoniyali - ibhaktheriya efunyenwe ngaphandle kokugula; kumntu osele egula esibhedlele, kunzima ukuxelela ukuba le nto iyingozi okanye ibangela iingxaki. Ukuba asikho i-colonizer, ubuninzi bokuba ingxaki ibangela okanye yenzeni impilo ebuthathaka? Kubonakala ukuba le bhaktiriya, nangona idlalwa njengekholoniyoni kwezinye iindawo, ibangela umonakalo wayo kule nkqaku ekwaseWisconsin.
Ibhaktheriya yenza abantu abagulayo-okanye abagulayo (bahlasela ngokukodwa abo sele begula).
Ukuxilongwa
Iimvavanyo zelabhoratri ze-Microbiology zifunekayo ukuqinisekisa ukuba intsholongwane ibangelwa ngu- Elizabethkingia anophelis.
Ukuba ibhaktheriya itholakala egazini okanye kwezinye izifo zomzimba, isampuli yomzimba womzimba ungasetyenziselwa ukwandisa ibhaktheriya kwibhubhoratri.
Iibhaktheriya zinyuka kwiipilati zebhubhoratri ezahlukileyo ezahlukahlukeneyo kunye nezixhobo ezahlukeneyo, ukubona apho iibhaktheriya zikhula nalapho zingenakukhula khona, kunye nezinye iimvavanyo, ngaloo ndlela zichonga iibhaktheriya ezikhoyo.
Ingxaki kukuba iibhaktheriya ezinokuthi zingabonakali lula. Ukuchonga akusoloko kusekho. Kulula ukuqala ukuchonga ukuba ibhaktheriya igoram okanye ilungile. U-Elizabethkingia anophelis uyigragram . Ingxaki kukuba ezininzi zee-antibiotics ezisebenza kwiibhaktheriya ezininzi ezingabonakaliyo azisebenzi ku- Elizabethkingia anophelis.
Ezinye ii Bugs ezifana
Kukho ezinye iintlobo kwi-Elizabethkingia genus. Ezi ziquka u- Elizabethkingia meningoseptica ( obonakala ngokuqhelekileyo kwizifo zabantu ), Elizabethkingia miricola, no- Elizabethkingia endophytica.
Zizo zonke i-aerobic, nonmotile, i-Gram-negative rod. Amagama amabhaktheriya awabhalwa ngamatye. Ba soloko beguquka. Ezinye zezi zityalo zisetyenziselwa ukuba yinxalenye ye- Flavobacterium .
Ezi ntlobo zifana noko; Ukulandelana kwemfuyo ye-98.6 ye-genetic kufana no-Elizabethkingia meningoseptica kunye ne-98.2 yepesenti yokufanelana no-Elizabethkingia miricola.
Unyango
U-Elizabethkingia unyango luyingozi kwaye luphathwa ngamachiza omzimba. Ingxaki ibhethriysia kaninzi ayiphenduli kwii-antibiotics eziqhelekileyo.
Amayeza anxamnye nalo angamangalisa - kwaye ekugqibeleni oogqirha babeza kufumana. Ukuchongwa kokuqala kweebhaktheriya (njengegram-negative) kuya kubakho ootitshala bezobugqirha ukuba baphathe kakubi izidakamizwa ezingenakusebenza.
U-Elizabethkingia unyango luvame ukuxhatshazwa kwii-antibiotics ezininzi ezixhaphaza i-gram-negative bacteria-aminoglycosides, kunye neziyobisi ze-β-lactam, kuquka i-carbapenems. Ezi bhaktheriya ziye zaziwa ukuba zenze i-β-lactamases iindidi (ESBL) kunye ne-metallo-β-lactamases. Oko kukuthi, ezi bhaktheriya ziyakwazi ukulwa namayeza anokuthi acingelwe, kodwa ngokusoloko ephosakeleyo, ukuba yiyona "mikhulu" enkulu kwiibhaktheriya.
Nangona kunjalo, E. meningoseptica, efana ne-Elizabethkingia yokutheleleka yi-gram-negative, ibonakala iphendule kwezinye iziyobisi ezisetyenziselwa ibhaktheriya enesigama. Oko kukuthi, u-Elizabethkingia usulelo lwaye lwaziwa ukuba uphendule kwiziyobisi ezinjengeVancomycin, ngokuqhelekileyo ukukwazi ukuphatha unyango lwe-gram-positive.
Kukho amava angaphantsi kokuphatha u- Elizabethkingia anophelis , kodwa ngaphambi kokuqhambuka, ibhaktheriya yaboniswa, ngaphandle kokuchazwa kwe-antibiotics ngaphambili, ukuxhathisa i-ampicillin, i-chloramphenicol, i-kanamycin, i-streptomycin kunye ne-tetracycline.
Kule meko, ibhaktheriya ibonakala ibonakala kuBactrim (trimethoprim / sulfamethoxazole), i-fluoroquinolones (njenge-levofloxacin okanye i-ciprofloxacin, mhlawumbi), kunye neZosyn (piperacillin / tazoctam). Ukuxilongwa kwamayeza kudla ngokucetyiswayo - njengokuba kunokwenzeka ukongezwa kweVancomycin.
Amacala kufuneka axelelwe kumagosa ezempilo karhulumente - njengoko kufuneka ukuba amacala abangela ibhaktheriya efanayo. Ngokukodwa, ezinye iintlobo ze-Elizabethkingia okanye iibhaktheriya ezinxulumene nazo kufuneka zibikwe njengokuba zisenokungazi kakuhle.