Abangaphezu kuka-40 baye bathola igciwane, okungenani abangu-15 bashonile, abanesifo sengculazi esingazi kangako-Elizabethkingia anophelis.
Bonke abesenwe igciwane babe ngabantu abadala eWisconsin, ikakhulukazi abadala. Abaningi baneminyaka engaphezu kwengu-65 ubudala futhi babike ukuthi babe nezinye izinkinga zempilo. Abanye babehlala emakhaya asebekhulile, abanye bezibhedlela. Akucaci ukuthi ukugula okwenziwe ngaphambili futhi kungakanani ukutheleleka kwamagciwane okwenzeke ekufeni.
Akubonakali kuyinkinga kulabo abaphephile nabangaphandle kwezikhungo zokunakekelwa. Ama-epidemiologists kanye nabasebenzi belebhu - kusukela kuhulumeni kanye ne-CDC - bazama ukuthola ukuthi lokhu kwenzeka kanjani.
Elizabethkingia anophelis Imiphumela
Lokhu kugula okungabangela ukuphefumula, ukuphefumula, ukubola, nokutheleleka kwesikhumba - i- cellulitis - engabandakanya izindawo ezibuhlungu nakwezinye izikhathi zesikhumba. Itholakala emigodleni yegazi yeziguli futhi yenze isithombe se-clinical sepsis.
Ngezinye izikhathi ngenxa yokuthi impilo yesiguli ayimpilo encane, akucaci ukuthi ukutheleleka kuka-Elizabethkingia kuyi-colonizer - amabhaktheriya athola ngaphandle kokubangela ukugula; kumuntu osevele egula esibhedlela, kunzima ukutshela ukuthi lokhu kuyingozi noma kubangela izinkinga. Uma kungenjalo i-colonizer, ingabe igciwane lithinta kangakanani noma empeleni lidala le impilo engafanele? Kubonakala ukuthi lezi zingqikithi, nakuba zivame ukubonwa njengekolonizer kwezinye izindawo, zenza umonakalo wayo kulokhu kuqhuma okugxile eWisconsin.
Amabhaktheriya enza abantu abagulayo - noma abagulayo (kuhlasela ngokuyinhloko labo asebegula kakade).
Ukuxilongwa
Ukuhlolwa kwe-microbiology laboratory kuyadingeka ukuthola ukuthi ukutheleleka kubangelwa u- Elizabethkingia anophelis.
Uma amabhaktheriya atholakala egazini noma eminye emzimbeni omswakama, isampula yomzimba womthambo ungasetshenziselwa ukukhulisa amabhaktheriya ebhokisatri.
Ama-bacteria akhule emafetheni e-laboratory ehlukene e-laboratory anezinto ezihlukile, ukubona ukuthi amabhaktheriya akhula nokuthi awukwazi ukukhula, kanye nezinye izivivinyo, ngaleyo ndlela ekhomba amabhaktheriya akhona.
Inkinga yilabo bhaktheriya abanzi angase bangabonakali kalula. Ukukhomba akusi njalo njalo. Kulula ukuqala ukubona ukuthi ama-bacteria ayigrime noma ayihle. U-Elizabethkingia anophelis uyigugu elingalungile. Inkinga ukuthi eziningi zama-antibiotic ezisebenza kuma-bacteria amaningi angama-gram asebenza ku- Elizabethkingia anophelis.
Amanye ama-bugs afanayo
Kunezinye izinhlobo zezinhlobo ze-Elizabethkingia. Lezi zihlanganisa u-Elizabethkingia meningoseptica ( obhekene nokuvame ukungena kubantu ), Elizabethkingia miricola, no- Elizabethkingia endophytica.
Lawa onke ama-aerobic, nonmotile, ama-Gram-negative. Amagama amabhaktheriya awabhalwa ngamatshe. Bavame ukushintsha. Ezinye zalezi zinhlobo ezisetshenziselwa ukuba yingxenye ye- Flavobacterium .
Lezi zinhlobo zifana nokunye; Ukulandelana kwezakhi zofuzo ezingamaphesenti angu-98.6 kufana no-Elizabethkingia meningoseptica kanye no-98.2% wezofuzo ezifanayo no-Elizabethkingia miricola.
Ukwelapha
U-Elizabethkingia ukutheleleka kukhona amabhaktheriya futhi aphathwe ngama-antibiotics.Ingxaki amabhethri ngokuvamile ayiphenduli kuma-antibiotic ajwayelekile.
Ama-antibiotic asebenza ngokumelene nalo angase amangaze - futhi odokotela abazobe bewafinyelela kuzo. Ukuqokwa kokuqala kwama-bacterium (njengegram-negative) kuzoholela ochwepheshe bezokwelapha ukuze baphathe ngokucophelela ngezidakamizwa ezingase zingasebenzi.
Ukwelashwa kuka-Elizabethkingia kuvame ukumelana nama-antibiotic amaningi avame ukuphatha ama-bacterium-gram-negative - aminoglycosides, kanye nezidakamizwa ze-β-lactam, kubandakanya i-carbapenems. Lawa ma-bacterium ayaziwa ukwenza ama-β-lactamese (spectrum) ama-β-lactamese (ESBL) kanye nama-metallo-β-lactamese. Lokhu kusho ukuthi lawa ma-bacterium angakwazi ukulwa nemithi elwa namagciwane okuvame ukucatshangwa, kodwa ngokuvamile ngokungafanele, ukuba "izibhamu" ezinkulu ngokumelene nama-bacterium.
Kodwa-ke, i-E. meningoseptica, efana nakho konke ukutheleleka kuka-Elizabethkingia kuyi-gram-negative, kubonakala sengathi iyaphendula kwezinye izidakamizwa ezisetshenziselwa amabhaktheriya anegram. Okusho ukuthi, u-Elizabethkingia ukutheleleka kuye kwaziwa ngokuphendula izidakamizwa ezinjengeVancomycin, ngokuvamile ekwazi ukuphatha izifo zokwelapha.
Kukhona isipiliyoni esingaphansi kokuphatha u-Elizabethkingia anophelis , kodwa ngaphambi kwalokhu kuqhuma, amabhaktheriya aboniswa, ngaphandle kokutholakala kwemithi elwa namagciwane ngaphambi kokuba aziwe, ukumelana ne-ampicillin, i-chloramphenicol, i-kanamycin, i-streptomycin, ne-tetracycline.
Kule nkinga, amabhaktheriya abonakala sengathi angabonakala ku-Bactrim (trimethoprim / sulfamethoxazole), i-fluoroquinolones (njenge-levofloxacin noma i-ciprofloxacin, mhlawumbe), no-Zosyn (piperacillin / tazoctam). Ukwelashwa kokuhlanganiswa kuvame ukuphakanyiswa - njengendlela yokwengeza okungenzeka okungenzeka ku-Vancomycin.
Amacala kufanele abikwe ezikhulwini zezempilo zomphakathi - njengoba kufanele amacala abangelwa amabhaktheriya afanayo. Ngokuyinhloko, ezinye izinhlobo ze-Elizabethkingia noma ama-bacteria ahlobene kufanele abikwe njengoba kungenzeka ukuthi azikho emthethweni.