Tlhōrō ena e sa keneleng kolistin e fumanoe United States
Nakong ea tsamaiso ea hae, Mopresidente Obama o fumane li-flak tse ngata bakeng sa ho fana ka litaelo tsa batsamaisi. Tsamaiso ea taolo e lumella mopresidente hore a behe moralo ntle le kakaretso ea Congress le ho rua moqoqo oa sechaba.
Le hoja tse ling tsa litaelo tsa Obama li entse hore ho be le likhohlano tsa mohanyetsi le ho ngangisana, melemo ea ba bang e ananeloa haholo. Ka ho khetheha ka 2015, Obama o ile a ntša Lenaneo la Sechaba la Khato ea ho Loantša Baktheria e Loantšang Likokoana-hloko.
Ho ea ka tsamaiso ea Obama, mona ke lipakane tsa taelo ena ea tsamaiso:
- Fokotsa ho Tsamaea ha Baktheria e Sireletsang le ho thibela ho ata ha mafu a manganga.
- Matlafatsa Tlhahlobo ea Bophelo ba Sechaba Boiteko ba ho Loantša Khahlano.
- Ho ntshetsa pele nts'etsopele le tšebeliso ea liteko tse potlakileng le tse sa hloekiseng tsa ho tseba ho tseba le ho khetholla libaktheria tse hanyetsang.
- Ho potlakisa ho etsa lipatlisiso le ts'ebeliso ea motheo bakeng sa likokoana-mafu tse ncha, Therapeutics e meng le liente.
- Ho ntlafatsa Tšebelisano ea Machaba le Matla a Meriana ea ho thibela lithibela-mafu, ho ba leihlo, ho laola le ho hlahloba likokoana-hloko.
E le ho finyella lipakane tsena, mopresidente o ile a kōpa thuso mekhatlo e fapaneng, ho kenyeletsoa Lefapha la Tšireletso (DoD), Lefapha la Temo (USDA) le Lefapha la Bophelo le Litšebeletso tsa Botho (HHS). Ka May 2016, mekhatlo ena e ile ea phatlalatsa litaba: E. coli e thibelang moriana oa colistin e ile ea sibolloa ho mokuli Setsing sa Bongaka sa Walter Reed United States. Mokuli enoa o ne a e-na le tšoaetso ea moriana e neng e le ka lehlohonolo e ka khonang ho alafuoa ka lithibela-mafu tse ling.
Colistin ke lithethefatsi tsa ho qetela ha re itšireletsa khahlanong le maloetse. Litsebi tse ngata tsa bophelo bo botle ba sechaba, bafuputsi le litsebi tsa bongaka li 'nile tsa tšaba ho qeta nako e itseng li ntse li hanyetsa colisitin. Ho feta moo, E. E. Coli o na le bokhoni ba ho fetisetsa lithibela-mafu tsena libaktheria tse ling tse sebelisang plasmids.
Ke Hobane'ng ha U Tšoenyehile ka ho Hanyetsa Likokoana-hloko?
Ho tloha ka 1928, ka ho kenngoa ha penicillin, lithibela-mafu li bolokile bophelo ba limilione tse ngata lefatšeng lohle. Nakoana ka mor'a hore ho be le lithibela-mafu, ho hanyetsa mefuta e itseng ea baktheria ho ile ha hlokomeloa. Lilemong tsa morao tjena, khanyetso ena e eketsehile mme libaktheria tse sa thibeleng lithethefatsi, kapa li- superbugs , li fetohile kotsi e tebileng ho bophelo bo botle le polokeho ea sechaba.
CDC e hakanya hore mafu a ka bang limilione tse peli a sa thibeleng lithethefatsi a hlaha selemo le selemo United States e etsang hore batho ba ka bang 23 000 ba shoe.
Ka ho phatloha ha morao tjena ho hanyetsanang le lithethefatsi , palo ea phekolo e sebetsang khahlanong le libaktheria tse joalo e fokotsehile. Ho feta moo, lithibela-mafu tse sebetsanang le likokoana-hloko tse sa thibeleng li ka ba tsa theko e boima haholo.
Colistin ke Eng?
Colistin ke ea sehlopha sa lithibela-mafu tse tsejoang e le polymyxins. Ho na le mefuta e 'meli ea polymyxin: polymyxin B le polymyxin E. Colistin ke polymyxin E le e sebelisoang ka ho fetisisa ho tse peli.
Colistin e ile ea sebelisoa ka lekhetlo la pele lilemong tsa bo-1960; Leha ho le joalo, tšebeliso ea moemeli ena e ile ea emisoa ka potlako hobane e ile ea fella ka ho ba le neurotoxicity haholo le nephrotoxicity. Ka mantsoe a mang, colistin e bakile tšenyo ea methapo le liphio, ka ho latellana.
Lilemong tsa morao tjena ka ts'ebetso ea ho hanyetsa lithethefatsi, re ile ra tlameha ho tsosolosa colistin ho loantša libaktheria tseo hona joale li hananang le lithibela-mafu tse tloaelehileng. Colistin e sebetsa ka tsela e tsotehang empa e sebetsa ka likokoana-hloko tse fokolang tsa baktheria, tse kang P aeruginosa , mefuta ea Acinetobacter le mefuta ea Klebsiella . Tlhokomeliso, mefuta ena eohle ea libaktheria e ka fella ka tšoaetso ea mali (sepsis) le tšoaetso ea matšoafo (pneumonia), tšoaetso ea moriana, mafu a letlalo le maqeba, hammoho le tšoaetso kamora 'opereishene. Ho phaella moo, libaktheria tsena li atisa ho tšoaetsa batho ba kulang haholo 'me ba fokolise tsamaiso ea' mele ea ho itšireletsa mafung.
Ho fetisoa ha ho hanyetsa likokoana-hloko ka li-Plasmids
Se etsang hore khathatso ena e ncha ea colistin ea E. Coli ke hore e ka fetisetsa tlhahisoleseding ea liphatsa tsa lefutso e ngotsoeng bakeng sa ho hanyetsa libaktheria tse ling ka li-plasmids (ke hore, mcr-1 kapa plasmid-mediated polymyxin resistant mechanism).
Joalokaha ho tlalehiloe ho The Lancet ka November 2015, bafuputsi ba Sechaena ke bona ba pele ba ileng ba fumana mokhoa ona o mocha o moholo. Bafuputsi ba fumane libaktheria tsena tse sa phekoleheng nakong ea morero oa ho hlahloba likokoana-hloko ho hlahloba likokoana-hloko tse thibelang likokoana-hloko har'a Escherichia coli e fumanoang liphoofolong ka lijo.
Ka nakoana pakeng tsa ho fumanoa ha li-baktheria tsena tsa Sechaena le libaktheria tsena tse hlahelang Setsi sa Masole sa Sechaba sa Walter Reed, moo bafuputsi ba mebuso ba e khethileng, sena se hlollang se fumanoe linaheng tse ling tse 'maloa hape, se bolelang se se se ntse se jele setsi.
Ka lehlohonolo, lipatlisiso tsa morao-rao ke Ts'ebetso ea Ts'ireletso ea Sechaba ea Likokoana-hloko-boiteko bo kopanetsoeng pakeng tsa USDA, Bophelo bo Botle le Botho ba Sechaba (HHS), le lefapha le fapaneng la bophelo bo botle ba naha le ba sebakeng sena-le bontša hore likhetho tsa E. coli tse sa thibeleng ke colistin li sa fumanehe . Ho feta moo, ho ikarola ho Salmonella le Klebsiella , mefuta e meng ea libaktheria, ha ea ka ea bontša bopaki ba liphatsa tsa mcr-1.
Ho fetisoa ha boitsebiso ba liphatsa tsa lefutso pakeng tsa libaktheria ke mokelikeli o motle. Hase feela boitsebiso ba ho fetisetsa boitsebiso ba libaktheria bakeng sa ho hanyetsa bana-bo boleloang e le phetisetso-empa libaktheria li ka boela tsa fetisetsa boitsebiso boo ka ho fetisa liphatsa tsa lefutso. Ka mantsoe a mang, esita leha kamora baktheria e thehoa e ka nka boitsebiso ba liphatsa tsa lefutso ho tsoa ho baktheria e 'ngoe.
Haholo-holo, mokhoa ona oa ho fetisa liphatsa tsa lefutso o lekanngoa ke li-plasmids, kapa li-bits tse nyenyane, tse chitja, tse nang le mefuta e mabeli, tse fapaneng le DNA ea chromosomal ea sele. Li-plasmids li na le tlhahisoleseding e etsang hore liphatsa tsa lefutso li be le melemo ea libaktheria, tse kang lithibela-mafu tse hanang. Ka ho fetisa liphatsa tsa lefutso, li-plasmids li fetisoa har'a libaktheria.
A re ke re behe lipapali tsa likokoana-hloko tsa likokoana-hloko tse nang le likokoana-hloko tse nang le likokoana-hloko ka tsela e hlalosang (le hoja e le lefeela). Ak'u nahane u le moketeng 'me motho e mong o na le bokhoni ba boselamose ba ho hanyetsa cyanide. Bokhoni bona ba boselamose bo ne bo kentsoe ka har'a liphatsa tsa lefutso tsa hae mme bo ka fetisetsoa ho bana ba hae. Ho phaella moo, bokhoni bona bo ka fetisetsoa ho motho e mong ka hore feela a nke thepa ea hae ea lijo. Pele o e tseba, motho e mong le e mong o noa seno sa hae. Ho feta moo, ba bang ba ratang mekete ea moketeng ba na le mekhoa ea bona ea boselamose ho chefo, eo ka eona ba arolelanang le ba bang ka bongata ba bona. Pele o e tseba, batho ba bang ba kenang lipolotiking ba bolokile sehlopha sa likheo tse ba thusang ho loantša chefo e fapa-fapaneng.
Qetello
Tšokelo ea existential eo ho hanyetsanoang ha colistin e ka fetisoang ho eona e ka 'na ea ikutloa e sa tšoenyehe. Joaloka motho ka mong, u ka etsa karolo ea hau ho fokotsa lithibela-mafu ka ho nka lithibela-mafu hafeela u hloka. U lokela ho etsa bonnete ba hore u phethe tsela eohle ea lithibela-mafu, kaha ho khaotsa pele ho nako ho khothalletsa ho hōla ha mefuta e sa thibeleng lithethefatsi. Qetellong, kaha E. Coli le likokoana-hloko tse ling li ka fumanoa lihlahisoa tsa nama le likhoho, kamehla ke khopolo e ntle ho pheha lijo tsa hau pele u noa.
Lisebelisoa:
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Carroll KC, Hobden JA, Miller S, Morse SA, Mietzner TA, Detrick B, Mitchell TG, McKerrow JH, Sakanari JA. Likokoana-hloko tsa Microbial. Ka: Carroll KC, Hobden JA, Miller S, Morse SA, Mietzner TA, Detrick B, Mitchell TG, McKerrow JH, Sakanari JA. eds. Jawetz, Melnick, le Medical Microbiology ea Adelberg, 27e . New York, NY: Hill ea McGraw; 2015. Fihletsoeng ka la 29 May, 2016.
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