Mukalowa m'chipatala , mwinamwake chinthu chomaliza chomwe mukuganiza ndi pansi. Komabe, kafufuzidwe kafukufuku akusonyeza kuti malo ochipatala ali ndi mabakiteriya ndipo akhoza kukhala ngati omwe angayambitse matenda. Ngakhale anthu samagwira pansi pamtunda, zinthu zina zomwe odwala, alendo, ndi antchito amakhudza nthawi zonse zimakhudzana ndi pansi.
Choncho, ndibwino kuchepetsa kugwirizana kwanu osati kuchipatala, komanso zinthu zomwe zimakhudza zipatala (monga nsapato, masokosi, magudumu a olumala) ndi malo othamanga (mwachitsanzo, mabatani, zidole, ndi njinga zamabedi ). Mwa kuchepetsa kugwirizana kwanu ndi zinthu izi ndikuyeretsa manja anu nthawi zambiri, mukhoza kuchepetsa chiopsezo chotenga kachilombo ka HIV ndi chiopsezo cha kufalitsa matenda kwa ena.
Kodi Zomwe Zikupezeka pa Malo Achipatala ndi Malo Ena?
M'chaka cha 2014, Desphande ndi alembi akulemba mwatsatanetsatane zoyesayesa zawo kuti adziwe zomwe zimayambira pansi pa zipatala za America.
Phunziroli, ochita kafukufukuyu adalima malo 120 pazipatala zinayi za Cleveland. Apeza zotsatirazi:
- 22 peresenti ya malo osungira pansi anali abwino kwa Staphylococcus aureus (MRSA) yosagonjetsedwa ndi methicillin
- 33 peresenti ya malo osungira pansi anali abwino kwa entroocci anticomycin (VRE)
- 72 peresenti ya malo otsika pansi anali abwino kwa Clostridium difficile (C. difficile)
- 1.4 zinthu zakuthandizira pafupipafupi zinkakhudzana ndi pansi
- 24 peresenti ya zinthu zakuthandizira kwambiri zaipitsidwa ndi tizilombo toposa umodzi
- 57 peresenti ya zinthu zonyansa zomwe zakhudzana ndi pansi zidatulutsa tizilombo toyambitsa matenda (mabakiteriya) m'manja
Zotsatira za phunziroli ndi zokhumudwitsa kwambiri chifukwa tizilombo toyambitsa matenda tingapeze matenda opatsirana kuchipatala.
MRSA ndi matenda a staph omwe angayambitse matenda a khungu, matenda a magazi, ndi chibayo ndipo sagonjetsedwa ndi mankhwala ambiri omwe amagwiritsidwa ntchito masiku onse.
VRE ingayambitse matenda opangira mkodzo ndi matenda opweteka. Zimagonjetsedwa ndi vancomycin, mankhwala amphamvu kwambiri.
Clostridium difficile amachititsa ululu m'mimba ndi kutsekula m'mimba. C. difficult ndi chifukwa chofala kwambiri cha matenda otsegula m'mimba. Zimakhala zovuta kuchoka pamtunda, ndipo zotupa zowonongeka sizingathe kuzidula. M'malo mwake, kafukufuku wasonyeza kuti mawotchi otulutsa klorini amakhala othandiza pochotsa tizilombo toyambitsa matenda. Mwamwayi, zipatala zambiri sizigwiritsa ntchito mankhwala osokoneza bongo poyeretsa pansi, ndipo sizidziwika bwino kuti zipatala zambiri zimatsuka ndi othandizira.
Phunziro lawo, Deshpande ndi alembi ena apeza kuti C. difficile sanapezeke m'nyumba zodzipatula kumene anthu omwe ali ndi matendawa amasungidwa komanso zipinda zina zomwe sizimakhala ndi anthu omwe ali ndi kachilomboka. Ndipotu, C. difficile kawirikawiri anapezeka muzipinda zopanda anthu. Choncho, zikuwoneka kuti C. difficile ndi wokhoza kufalitsa.
Kodi Tizilomboti Timafalitsa Bwanji?
Papepala la 2016 lomwe limatchedwa "Kufufuza Maofesi Achipatala Monga Gwero Loyambira Kugawidwa kwa Tizilombo Tomwe Timagwiritsa Ntchito Tizilombo Tomwe Tizilombo Tomwe Timagwiritsa Ntchito Sitikudziwa," Koganti ndi anzake adayesa kuyeza momwe magulu a tizilombo ta tizilombo toyambitsa matenda amachokera pansi akugwiritsidwa ntchito m'manja mwa odwala komanso apamwamba -kukhazikika mkati ndi kunja kwa chipinda cha chipatala.
Mu phunziroli, ofufuza anatenga bacteriophage M2, tizilombo toyambitsa matenda, omwe tinapangidwa kuti tisapangitse matenda, ndipo tinayika pamtanda wopaka matabwa pafupi ndi mabedi a kuchipatala. Kenaka anaphwanya malo osiyanasiyana kuti aone komwe tizilombo toyambitsa matendawa tifalikira.
Ofufuzawa anapeza kuti kachilomboka kakufalikira m'manja, nsapato, manja, mabedi, mabedi, matebulo, mipando, mipando ya oximeters, makapu a chitseko, kusintha kwazitali, ndi zitsulo komanso zipinda zoyandikana ndi malo osungirako odwala. Makamaka, ku malo osungirako odwala, tizilombo toyambitsa matenda tinkapeza pa makibodi, makompyuta, ndi matelefoni. Mwa kuyankhula kwina, tizilombo toyambitsa matenda pazipatala zimayendayenda.
Mwachidziŵikire, phunziro ili linali ndi malire ake.
Choyamba, kachilombo kanagwiritsidwa ntchito mmalo mwa mabakiteriya. Kafukufuku wakale, komabe, asonyeza kuti mavairasi ndi mabakiteriya amasamutsidwa mofananamo kuchokera ku fomites (zinthu) kwa zala.
Chachiwiri, ochita kafukufukuwa anaika kwambiri mabakiteriophage M2 m'chipatala; Choncho, kuyesera kumeneku kukuoneka kuti ndi zovuta kwambiri.
Chachitatu, ochita kafukufuku anafufuzira miyala yokhala ndi matabwa okhaokha osati mitundu ina ya pansi pa chipatala; Choncho, sizikudziwika bwinobwino kuti tizilombo toyambitsa matenda tikhoza kufalikira bwanji kuchokera kumalo ena monga linoleum ndi carpeting.
Chodetsa nkhaŵa chomaliza chomwe chimakhudza kusamutsidwa kwa tizilombo toyambitsa matenda kuchokera pansi kupita ku zala ndi ziwalo zina za thupi zimaphatikizapo kugwiritsa ntchito masokiti osatchera. Makoswe osapunthidwa amapangidwa ndi thonje kapena polyester ndipo amadzala ndi mapepala kuti apereke matumbo. Masokisi amenewa amachepetsa ngozi, makamaka pakati pa anthu okalamba.
Makoswe osagwiritsidwa ntchito amayenera kugwiritsidwa ntchito kanthawi kochepa chabe ndipo ali ndi zipangizo zachipatala zosagwiritsidwa ntchito. Komabe, odwala kuchipatala amawaveka iwo mozungulira nthawi yonse ndikuyenda mozungulira chipatala nawo, kumalo osungira alendo, malo ogulitsa khofi, malo ogulitsa mphatso, malo osowa, ndi zina zotero. Anthu nthawi zambiri amavala masokosi omwewo kwa masiku angapo ndikuwongolera kugona.
Mu lipoti lalifupi la 2016 lofalitsidwa mu Journal of Hospital Infection , Mahida ndi Boswell adapeza VRE pa 85 peresenti ya masokosi ndi MRSA pa magawo asanu ndi anayi. Kuwonjezera pamenepo, VRE inapezeka pa 69 peresenti ya malo omwe chipatala anayesedwa, ndipo MRSA inapezeka pa 17 peresenti ya malo oyesedwa. Zindikirani, mphamvu ya phunziro ili inali yochepa komanso yaying'ono yaying'ono.
Ofufuzawo amatha kunena kuti masokiti omwe sali otchinga, omwe nthawi zambiri amakumana ndi chipatala, amakhala osokonezeka. Olemba amasonyeza kuti masokosiwa ayenera kutayidwa pambuyo pa ntchito ndipo asavalidwe kwa nthawi yaitali. Malinga ndi nthawi yayitali bwanji masokosiwa angaperekedwe, komabe, sichidziwikiratu, ndipo kufufuza kwina kumafunika kuchitidwa.
Kufunafuna 'Malo Oyera' Mabwalo
N'zovuta kuyeretsa chipatala kuchipatala. Zimakhalanso zovuta kufotokoza zomwe "zoyera" ziri chimodzimodzi. Ponena za chipatala, amavomereza kuti mankhwala ophera tizilombo toyambitsa matenda ndi tizilombo ta tizilombo toyambitsa matenda angathe kuthandizira kuteteza tizilombo toyambitsa matenda. Chofunika kwambiri, mankhwala osokoneza mavitamini ndi mankhwala osokoneza bongo samagwirizana. Mankhwalawa amachotsa dothi, mafuta, ndi majeremusi pogwiritsa ntchito sopo ndi madzi; pomwe, mankhwala ophera tizilombo toyambitsa matenda ndiwo mankhwala kapena mankhwala omwe amapha mabakiteriya.
Kafukufuku wambiri amasonyeza kuti kuyeretsa pansi ndi malo ena okhala ndi zotupa, motero kuchotsa dothi pokha, kungakhale kothandiza ngati kugwiritsa ntchito mankhwala ophera tizilombo toyambitsa matenda. Kuwonjezera apo, mtengo wapatali, wakupha-onse mankhwala ophera tizilombo toyambitsa matenda angapangitse kuchuluka kwa zamoyo zosagonjetsa. Mavitamini owopsa akhoza kuvulaza antchito omwe amawagwiritsa ntchito komanso kukhala oipa kwa chilengedwe.
Njira zowonongeka ndizosavomerezeka kuti zisawonongeke pansi ndi malo otsekemera m'magulu a chipatala. Njira zamakono zowonetsera mwina sizikuthandizira malo abwino kapena kugwiritsidwa ntchito mobwerezabwereza kuchepetsa bioburden kapena chiwerengero cha tizilombo toyambitsa matenda zomwe zingayambitse matenda. Njira zatsopano, kuphatikizapo tizilombo toyambitsa matenda, nthunzi, machitidwe osokoneza makompyuta, ndi ma antibiotic, ndi zovuta kuzifufuza chifukwa cha mtengo wabwino chifukwa deta ya chilengedwe sichikuyerekeza ndi zotsatira za odwala.
Kuopsa kwa kusokonezeka kwapambukukuku kumawonjezeredwanso ndi izi:
- kuwonjezeka kwa ntchito ya chipatala
- bedi lofulumira
- chiwerengero cha odwala kuchipatala
- kuphatikiza
- osawuka mpweya wabwino
Komanso, m'nthaŵi yowonjezera ndalama zowonjezera, chithandizo chokonzekera chokonzekera mtengo ndicho kuyeretsa, chomwe chimapangitsa kuti pakhale chiopsezo chotayika ndi matenda omwe angathe.
Malingana ndi nkhani ya 2014 yomwe inalembedwa mu Clinical Microbiology Reviews :
Kuchotsa dothi losawoneka ndi losawoneka kuchokera kuchipatala cha lero ndi tsogolo likufuna antchito ophunzitsidwa okwanira, kufufuza nthawi zonse, kuchuluka kwa zinthu zolimbitsa thupi, maphunziro, kupititsa patsogolo kayendedwe ka ntchito, ndi kuyankhulana kwa awiri omwe akuyenera kuyeretsa ndi omwe akuyang'anira matenda.
Kwa zaka zambiri za m'ma 200, kuyeretsa m'chipatala ndi malo ena omwe amapeza zinthu zovuta kwambiri pakati pa odwala chipatala. Nthawi zasintha ndipo lingaliro lakuti malo oterowo amakhala ngati gwero la matenda opatsidwa kuchipatala adalandira kulandiridwa kwakukulu. Komabe, sitikudziwa momwe tingagwirire ndi vutoli moyenera ndipo zotsala zambiri zatsala. Chifukwa chake, kaya ndinu wodwala kapena mlendo, ndibwino kuti mukhale osamala mukakhala m'chipatala.
Kusunga Chipatala
Mukavomerezedwa ku chipatala kapena kukachezera wokondedwa wanu, ndibwino kuti mupitirize kuyenda mopepuka ndipo chitani zodzitetezera zomwe zimachepetsa chiopsezo cha matenda. Ngakhale simungatenge kachilombo mukatha kukhudza zinthu, mukhoza kufala matendawa kwa omwe angatenge kachilomboka. Mwachindunji, chipatala cha ma immunocompromised hospitali omwe ali ndi matenda osiyanasiyana ali pachiopsezo chachikulu cha kuchipatala. Inu simukufuna kuchita chirichonse chomwe chingapangitse anthu awa kudwala kwambiri.
Nazi njira zina zomwe mungatengere kuchipatala:
- Sambani manja anu ndi sopo kapena madzi osamba m'manja kapena mowa mowa polowera kapena kutuluka m'chipinda, mutagwira wodwala komanso mutatha kugwiritsa ntchito chipinda choyambira.
- Peŵani kukhudza odwala kwambiri.
- Sambani manja anu bwinobwino ndipo musakhudze zouma ndi mapulusa mukatha kutsuka manja anu.
- Onetsetsani kuti mukuwumitsa manja anu mutatha kugwiritsa ntchito sopo ndi madzi.
- Chitani zabwino kuti musagwirizane ndi mabatani, mafakitale a chipatala, nsalu zogona, nsapato, masokosi ndi zinthu zina zomwe zingasokonezeke.
- Musagwire pansi (kumveka mopusa koma izi zimachitika-funsani kholo lililonse).
- Ngati wokondedwa ali patokha, valani zovala ndi magolovesi mukamayendera.
Ngati muli wodwala kuchipatala, mutha kutsatira zambiri zomwe mukutsatira ndikuyesetsani kukhalabe ndi tizilombo toyambitsa matenda. Komanso, kumbukirani kuti muli ndi ufulu wanu kuti muchepetse chiopsezo chanu cha matenda, ndipo ndibwino kufunsa njira iliyonse yoopsa imene mungayang'ane pakati pa ogwira ntchito kuchipatala. Mwachitsanzo, ogwira ntchito kuchipatala ayenera kutsuka manja awo kapena kugwiritsa ntchito oyeretsa m'manja musanayambe kukukhudzani, ngakhale atagwiritsa ntchito magolovesi.
Pomaliza, usakhale wamanyazi pakupempha makosi atsopano osasunthika pamene mukufunikira. Simukuyenera kuvala masokosi omwewo nthawi yaitali kapena kugona mmenemo. Ngati mumayenda mozungulira chipatala ndi masokosiwa, sungani pazomwe mukubwerera ndikusamba manja bwino.
> Zosowa
> Wopanga SJ. Kulamulira Chithandizo cha Chipatala Cholandira: Ganizirani za Ntchito ndi Mafilimu Amtundu Watsopano wa Kutaya Katemera. Kachipatala kowonongeka. 2014; 27 (4): 665-690.
> Deshpande A et al. Kodi Nyumba Zachibwibwi Zidzakhala Zosamalidwa Zotumizira Clostridium difficile ndi Methicillin-Resistant Staphylococcus aureus? (Abstract). 2014.
> Koganti S et al. Kufufuza kwa Mabwalo Achipatala Monga Chothandizira Kugawidwa kwa Tizilombo Tomwe Tikumagwiritsa Ntchito Tizilombo Tomwe Tizilombo Tomwe Timagwiritsa Ntchito Tizilombo Tomwe Timapanga Tizilombo Tomwe Timapanga Tizilombo Tomwe Timapanga. Kugonjetsedwa ndi Matenda Achipatala. 2016. 37 (11); 1374-1377.
> Mahida N ndi Boswell T. Zosakaniza zopanda pake: malo ogwiritsira ntchito mankhwala osagwiritsira ntchito mankhwala osokoneza bongo m'mabungwe? Journal of Infection Hospital . 2016; 94: 273-275.