Mphamvu yopanda mphamvu ya colistin inapezeka ku United States
Panthawi ya utsogoleri wake, Purezidenti Obama adalandira zambiri zapadera polemba malamulo akuluakulu. Mtsogoleri wotsogolera amalola purezidenti kukhazikitsa ndondomeko popanda bungwe la Congress ndi kupindula ndi kukangana kwapagulu.
Ngakhale kuti akuluakulu ena a Obama adayambitsa mikangano yotsutsana ndi anthu ena, amatsutsana kwambiri ndi ena. Mwachindunji mu 2015, Obama adatulutsa ndondomeko ya ndondomeko yoteteza kachilombo ka antibiotic-resistant bacteria.
Malingana ndi utsogoleri wa Obama, izi ndi zolinga za lamulo ili:
- Pewani Kukula kwa Mabakiteriya Otsutsa ndi Kuletsa Kufalikira kwa Matenda Okaniza.
- Limbikitsani Luso Loyang'anira Zomwe Amayesa Kulimbana ndi Kutsutsana.
- Kupititsa patsogolo Chitukuko ndi Kugwiritsa Ntchito Mayeso Odziwika Odzidzimutsa ndi Odziwika kuti Azindikire ndi Kuzindikiritsa Mabakiteriya Otsutsa.
- Kupititsa patsogolo kafukufuku ndi kayendedwe kazitsamba kwa Antibiotics Zatsopano, Zochiritsira Zina, ndi Katemera.
- Kupititsa patsogolo mgwirizano wapadziko lonse ndi zidziwitso zoyenera kutsutsana ndi Antibiotic-resistant Prevention, Monitoring, Control, ndi Antibiotic Research and Development.
Pofuna kukwaniritsa zolinga izi, pulezidenti adafuna thandizo la mabungwe osiyanasiyana, kuphatikizapo Dipatimenti ya Chitetezo (DoD), Dipatimenti ya Ulimi (USDA), ndi Dipatimenti ya Zaumoyo ndi Zaumoyo (HHS). Mu May 2016, mabungwe awa anatulutsa uthenga: E. coli osagonjetsedwa ndi colistin anapezeka mwa wodwala ku Walter Reed Medical Center ku United States. Wodwalayu anali ndi matenda opatsirana mkodzo omwe mwachidwi amatha kuchiritsidwa ndi maantibayotiki ena.
Colistin ndi mankhwala omaliza otetezera matenda. Akatswiri ambiri a zachipatala, ofufuza, ndi madokotala amodzimodzi amaopa mantha a colisitin kwa nthawi ndithu. Kuwonjezera pamenepo, E. E. Coli amatha kusamutsa ma antibayotic mabakiteriya ena pogwiritsa ntchito plasmids.
N'chifukwa Chiyani Tiyenera Kuda nkhawa ndi Maantibayotiki?
Kuchokera mu 1928, poyambitsa penicillin, mankhwala opha tizilombo apulumutsa miyanda miyandamiyanda padziko lonse lapansi. Patangopita kanthawi kochepa maantibayotiki atapangidwanso, zinayambanso kusokoneza mitundu ina ya mabakiteriya. M'zaka zaposachedwapa, kukana uku kwawonjezeka komanso mabakiteriya osagwiritsidwa ntchito ndi mankhwala osokoneza bongo, kapena mankhwala ozunguza bongo , akhala oopsa kwambiri kwa thanzi labwino ndi chitetezo.
CDC ikulingalira kuti pafupifupi pafupifupi mamiliyoni awiri opatsirana mankhwala osagwiritsidwa ntchito mankhwala osokoneza bongo amapezeka chaka chilichonse ku United States chifukwa amwalira pafupifupi 23,000.
Chifukwa cha kuphulika kwaposachedwapa kwa mankhwala osokoneza bongo , chiwerengero cha mankhwala omwe amagwira ntchito motsutsana ndi mabakiteriya oterewa akuchepa. Kuwonjezera pamenepo, maantibayotiki omwe amachititsa zamoyo zosagonjetseka akhoza kukhala okwera mtengo kwambiri.
Kodi Colistin N'chiyani?
Colistin ndi wa gulu la mankhwala opha tizilombo omwe amatchedwa polymyxins. Mitundu iwiri ya polymyxins imapezeka: polymyxin B ndi polymyxin E. Colistin ndi polymyxin E ndipo amagwiritsidwa ntchito kwambiri ndi awiriwo.
Colistin anayamba kugwiritsidwa ntchito m'ma 1960; Komabe, kugwiritsiridwa ntchito kwa wothandizirayi kunayimitsa msanga chifukwa chachititsa kuti thupi la neurotoxicity ndi nephrotoxicity likhale lofunika kwambiri. Mwa kuyankhula kwina, colistin inachititsa kuti mitsempha ndi kuwonongeka kwa impso, ziwoneke.
M'zaka zaposachedwapa ndi kukwera kwa mankhwala osokoneza bongo, takhala tikubwezeretsanso colistin kuti tipewe mabakiteriya omwe tsopano akutsutsana ndi maantibayotiki ochiritsira. Colistin ndi othandiza kwambiri koma amagwira ntchito pa tizilombo toyambitsa matenda, monga P aeruginosa , mitundu ya Acinetobacter , ndi mitundu ya Klebsiella . Zindikirani, mitundu yonseyi ya mabakiteriya ingayambitse matenda opatsirana (magazi) (sepsis) ndi matenda a m'mapapo (matenda a chibayo), matenda opangira mkodzo, matenda a khungu ndi zilonda, komanso matenda pambuyo pa opaleshoni. Kuonjezerapo, mabakiteriyawa amachiza anthu omwe akudwala kwambiri ndipo amachititsa chitetezo cha mthupi.
Kusamutsidwa kwa Antibiotic Resistance ndi Plasmids
Chomwe chimapangitsa kuti vuto la E. Coli likhale lopanda colistin ndilo lingathe kusinthitsa mauthenga a ma genetic pofuna kukana mabakiteriya ena kudzera mu plasmids (ie, mcr-1 kapena plasmid-mediated polymyxin resistance mechanism).
Monga momwe tafotokozera mu The Lancet mu November 2015, akatswiri a ku China anali oyamba kupeza izi zatsopano. Ofufuzawa adapeza mabakiteriya omwe sagonjetsedwa panthawi yofufuza polojekiti akuyesa kutsutsana ndi mankhwala ophera tizilombo toyambitsa matenda pakati pa Escherichia coli, yomwe imapezeka kuchokera ku zinyama.
Pakadutsa pakati pa ma Chinese omwe amatulukira mabakiteriyawa ndi mabakiteriyawa omwe amapita ku Gulu la Zida la Walter Reed, komwe akatswiri a federal adapeza kuti izi zikuchitika m'mayiko ena ambiri, zomwe zikutanthauza kuti zafala kale lonse.
Mwamwayi, kufufuza kufufuza ndi njira yowunikira yotsutsana ndi National Antimicrobial Resistance Monitoring System-ntchito yowonongeka pakati pa USDA, Health and Human Services (HHS), ndi dipatimenti yosiyanasiyana ya zaumoyo ndi zapansi-akuwonetsa kuti kudzipatula kwa E. coli zosagonjetsedwa ndi colistin ndizosawerengeka . Komanso, kuchoka ku Salmonella ndi Klebsiella , mabakiteriya ena, sanasonyeze umboni wa mcr-1 gene.
Kusamutsidwa kwa chibadwa pakati pa mabakiteriya ndi okongola kwambiri. Sikuti kokha kachipatala kamene kakhonza kutumizira kukana ana-omwe amatchulidwa ngati othandizira-koma mabakiteriya angathenso kusamutsa chidziwitsochi kudzera mwazomwe zimapangidwira. Mwa kuyankhula kwina, ngakhale atatha kupanga bakiteriya ikhoza kutenga mauthenga achibadwa kuchokera ku bactriyamu ina.
Kwenikweni, njira iyi yoperekera mazira imaphatikiziridwa ndi plasmids, kapena mabotolo osasuntha a DNA, aang'ono, omwe ali ndi magawo awiri, omwe ali osiyana ndi DNA ya chromosomal ya selo. Zakudya zam'mimba zimakhala ndi mfundo zomwe zimapangitsa kuti majeremusi apindule ndi mabakiteriya monga antibiotic. Ndi mavitamini osasunthika, ma plasmid amasamutsidwa pakati pa mabakiteriya.
Tiyeni tiike zowonongeka za majeremusi ya ma antibiotic kukana majeremusi mu lingaliro pogwiritsa ntchito ((ngakhale kupusa pang'ono) kufanana. Tangoganizirani kuti mudali phwando ndipo munthu wina adali ndi mphamvu zamatsenga kukana cyanide. Mphamvu zamatsengazi zinkalembedwera m'magulu ake ndipo zikhoza kuperekedwa kwa ana ake. Kuonjezerapo, luso limeneli likhoza kupitsidwira kwa munthu wina mwa kungotenga zakudya zake zokha. Musanadziwe, aliyense akumwa zakumwa. Kuwonjezera pamenepo, ena okondwerera patsiku ali ndi mphamvu zawo zamatsenga kuti ziwone poizoni, zomwe zimagawidwa ndi ena pogwiritsa ntchito mphamvu zawo. Musanadziwe zimenezi, anthu ena ogwira nawo ntchito akugwira ntchito yotsutsa zomwe zimawathandiza kuthana ndi poizoni.
Kutsiliza
Choopsa cha existential chomwe chikhoza kusokonezedwa ndi colistin chimakhala chokhumudwitsa. Monga munthu, mukhoza kuchita mbali yanu kuchepetsa mankhwala osokoneza bongo mwa kumwa mankhwala opha tizilombo pokhapokha ngati mukufunikira. Muyeneranso kutsimikiziranso kukwaniritsa njira yanu yonse ya antibiotic, popeza kutha kwa msanga kumalimbikitsa kukula kwa mankhwala osagwiritsidwa ntchito ndi mankhwala. Potsirizira pake, chifukwa E. E. Coli ndi mabakiteriya ena amapezeka mu nyama ndi nkhuku, nthawi zonse ndibwino kuti muphike chakudya chanu musanamwe.
Zotsatira:
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Carroll KC, Hobden JA, Miller S, Morse SA, Mietzner TA, Detrick B, Mitchell TG, McKerrow JH, Sakanari JA. Microbial Genetics. Mu: Carroll KC, Hobden JA, Miller S, Morse SA, Mietzner TA, Detrick B, Mitchell TG, McKerrow JH, Sakanari JA. eds. Jawetz, Melnick, ndi Medical Microbiology ya Adelberg, 27e . New York, NY: Hill ya McGraw; 2015. Idapezeka pa May 29, 2016.
Liu, Yi-Yun et al. Kuwonekera kwa njira ya MCR-1 yokhala ndi mankhwala a plasmid yomwe imaphatikizapo mtundu wa plasmid. Zinyama ndi anthu ku China: kuphunzira kwa bibiological ndi maselo. Matenda Opatsirana a Lancet , Voliyumu 16, Gawo 2, 161 - 168.
Ram S, Mpunga PA. Mutu 144. Matenda a Gonococcal. Mu: Longo DL, Fauci AS, Kasper DL, Hauser SL, Jameson J, Loscalzo J. eds. Mfundo za Harrison za Internal Medicine, 18e . New York, NY: Hill ya McGraw; 2012. Idapezeka pa October 25, 2014.