Ese ni iki C. Difficile? Ibimenyetso, Impamvu, n’Uko Ivurwa

C. difficile ni ubwoko bwa bakteri zishobora gutera indwara zikomeye mu mara, kuva kuri impiswi yoroheje kugeza ku mpinduka z’amaraso zikomeye zishobora no kwica. Iyi ndwara isanzwe ibaho iyo bakteri nziza ziri mu mara zangiritse, akenshi nyuma yo gufata imiti igabanya ubukana bw’uburwayi.

Nubwo izina rishobora gutera ubwoba, kumva iyi ndwara bizagufasha kumenya ibimenyetso hakiri kare no gushaka ubufasha bukwiye. Abantu benshi barakira neza bafashijwe n’ubuvuzi bukwiye, kandi hari uburyo bwiza bwo kwirinda kwandura mu gihe kizaza.

Ese ni iki C. Difficile?

Clostridioides difficile, izwi cyane nka C. diff cyangwa C. difficile, ni bakteri iba mu mara y’abantu benshi idatera ikibazo. Ikibazo gitangira iyo hari ikintu kibangamiye ubusugire bw’ubuzima bwiza mu mara, bituma C. difficile yiyongera cyane ikora uburozi.

Ubu burozi bwangiza uruhu rw’amara, bigatera kubura ubusugire bw’amaraso no kugaragara kw’ibimenyetso by’indwara ya C. diff. Bakteri zikora ibice bishobora kubaho ku biti ku mezi, bigatuma zanduza cyane mu bigo nderabuzima no muri sosiyete.

Indwara za C. difficile zikomeje kwiyongera mu myaka makumyabiri ishize. Ubu ni imwe mu ndwara zikunze kugaragara mu bigo nderabuzima, ikaba igira ingaruka ku bantu babarirwa mu bihumbi amagana buri mwaka muri Leta Zunze Ubumwe za Amerika gusa.

Ni ibihe bimenyetso bya C. Difficile?

Ibimenyetso bya C. difficile bishobora kuva ku guhindagurika gukomeye mu mirire kugeza ku ngaruka zikomeye zishobora kwica. Indwara isanzwe itangira guhinduka mu buryo bw’umubiri, kandi ishobora gukomeza niba idakize.

Dore ibimenyetso bisanzwe ushobora kugira:

• Impiswi y’amazi igaragara inshuro eshatu cyangwa zirenze buri munsi
• Kubabara mu nda, akenshi mu gice cyo hasi
• Guhindagurika k’ubushyuhe, rimwe na rimwe bikagera kuri 101°F (38.3°C) cyangwa hejuru
• Kubura ubushake bwo kurya no kugira isereri
• Kubyimbagira mu nda no kubabara mu nda
• Amaraso cyangwa umusemburo mu ntege

Mu gihe gikomeye, ushobora kubona ibimenyetso by’umubiri byongeyeho. Ibi birimo kubabara cyane mu nda, ubushyuhe bukabije burenze 102°F (38.9°C), umutima ukubita cyane, no gucika burundu amazi kubera impiswi ikabije.

Bamwe mu bantu barwara ibyo abaganga bita “indwara ikomeye” cyangwa “indwara ya C. difficile colitis”. Ubwo buryo bukomeye bushobora gutera toxic megacolon, aho amara akura cyane, cyangwa gucika kw’amara, bisaba kubagwa byihuse.

Ni iki gitera C. Difficile?

Indwara za C. difficile zibaho iyo ubusugire bwiza bw’ubuzima bwiza mu mara buhindutse, bigatuma C. diff ikura cyane. Iyo mpinduka isanzwe ibaho nyuma yo gufata imiti igabanya ubukana bw’uburwayi, ariko hari ibindi bintu byinshi bishobora gutera indwara.

Impamvu nyamukuru zirimo:

• Koresha imiti igabanya ubukana bw’uburwayi, cyane cyane imiti igabanya ubukana bw’uburwayi nk’iya clindamycin, fluoroquinolones, na cephalosporins
• Kuguma igihe kirekire mu bitaro cyangwa mu bigo byita ku bantu bakuze
• Kubagwa vuba aha, cyane cyane imikorere y’inda
• Chemotherapy cyangwa imiti indi igabanya ubudahangarwa bw’umubiri
• Proton pump inhibitors ikoreshwa mu kuvura ibibazo by’umusemburo w’inda
• Guhuza n’ibintu byanduye cyangwa abantu banduye

Imiti igabanya ubukana bw’uburwayi ni yo ikintu gikomeye cyane kuko yica bakteri mbi n’iziza mu mara. Iyo bakteri zikurinda zigabanutse, ibice bya C. difficile bishobora gukura kandi bikwiye cyane.

Bakteri zikwirakwira binyuze mu nzira y’umusemburo w’amara, bisobanura ko ushobora kwandura ukoresheje intoki zanduye hanyuma ukakora ku kanwa cyangwa ukarya udafite isuku.

Ni ryari ukwiye kujya kwa muganga kubera C. Difficile?

Ukwiye guhamagara umuganga wawe vuba bishoboka niba ufite impiswi idashira, cyane cyane nyuma yo gufata imiti igabanya ubukana bw’uburwayi cyangwa umaze igihe mu kigo nderabuzima. Kuvurwa hakiri kare bishobora kwirinda ingaruka zikomeye no kugabanya ibyago byo kwanduza abandi.

Shaka ubufasha bw’abaganga vuba bishoboka niba ufite impiswi irenze eshatu ku munsi iminsi ibiri yikurikiranya, hamwe no kubabara mu nda cyangwa ubushyuhe. Ntugatege amatwi ngo urebe niba ibimenyetso bizagenda ubwabyo, kuko indwara za C. difficile zisanzwe zikomeza kuba mbi udafashijwe.

Hamagara ubufasha bwihuse niba ufite ibimenyetso bikomeye nko kubabara cyane mu nda, ubushyuhe burenze 102°F, ibimenyetso byo gucika amazi, cyangwa amaraso mu ntege. Ibi bishobora kugaragaza indwara ikomeye isaba ubufasha bw’abaganga vuba.

Ni ibihe bintu byongera ibyago bya C. Difficile?

Kumenya ibyago byawe bizagufasha gufata ingamba zo kwirinda no kumenya igihe ushobora kuba ufite ibyago byinshi byo kwandura. Hari ibintu bimwe na bimwe byongera ibyago byawe kurusha ibindi, kandi abantu benshi bafite ibyago byinshi.

Ibyago bikomeye cyane birimo:

• Kuba ufite imyaka irenga 65
• Koresha imiti igabanya ubukana bw’uburwayi mu mezi atatu ashize
• Kuba uri mu bitaro ubu cyangwa uherutse kubagwa
• Kuba utuye mu kigo cyita ku bantu bakuze
• Indwara z’impyiko zidakira cyangwa indwara z’amara
• Ubudahangarwa bw’umubiri buke buterwa n’uburwayi cyangwa imiti
• Kuba wararwaye C. difficile mbere
• Koresha buri gihe proton pump inhibitors

Abantu bakuze bafite ibyago byinshi kuko ubudahangarwa bwabo bushobora kuba buke kandi bafite ibyago byinshi byo gufata imiti myinshi. Kuba wararwaye C. difficile mbere byongera cyane ibyago byo kuyirwara ukundi, ibipimo byo kwisubiraho biri hagati ya 15-35%.

Abakozi bo mu buvuzi n’abantu bo mu muryango bita ku muntu urwaye C. difficile nabo bafite ibyago byinshi kubera ko bashobora kwandura. Ariko kandi, abantu bazima bafite ubudahangarwa bwiza bw’umubiri ntibakunze kwandura nubwo bahuye n’iyi ndwara.

Ni izihe ngaruka zishoboka za C. Difficile?

Nubwo indwara nyinshi za C. difficile zikira hakoreshejwe ubuvuzi bukwiye, bamwe mu bantu bashobora kugira ingaruka zikomeye zisaba ubuvuzi bukomeye. Kumenya ibyo bishoboka bizagufasha kumenya igihe ibimenyetso bikomeje kuba bibi kandi bikeneye ubufasha bw’abaganga vuba.

Ingaruka zisanzwe zirimo:

• Gucika burundu amazi kubera impiswi idashira
• Kugira ibibazo by’umusemburo mu mubiri bigira ingaruka ku mutima n’imikaya
• Gucika burundu kw’impyiko kubera gucika amazi n’uburozi
• Indwara zisubira ukundi nyuma yo kuvurwa

Ingaruka zikomeye zishobora kwica kandi zisaba ubuvuzi bwihuse. Toxic megacolon ibaho iyo amara akura cyane kandi akaba afite ubukana bukabije, bishobora gutera gucika. Gucika kw’amara gutera ibyobo mu ruhu rw’amara, bituma bakteri zinjira mu nda.

Fulminant colitis ni yo ndwara ikomeye cyane, ifite ubukana bukabije mu mara bushobora gutera gucika burundu kw’amaraso no kunanirwa kw’impyiko. Sepsis ishobora kubaho iyo indwara ikwirakwira mu maraso, ikagira ingaruka ku mubiri wose.

Inkuru nziza ni uko, hakoreshejwe ubufasha bw’abaganga vuba kandi ubuvuzi bukwiye, ingaruka nyinshi zishobora kwirindwa cyangwa kuvurwa neza. Ikipe y’abaganga izakukurikirana hafi niba ufite ibyago byinshi byo kurwara indwara ikomeye.

C. Difficile ishobora kwirindwa gute?

Kwiringira indwara ya C. difficile byibanda ku kugabanya ibyago byo kwandura no kugira ubuzima bwiza bw’amara. Isuku isukuye no gukoresha imiti igabanya ubukana bw’uburwayi neza bishobora kugabanya ibyago byawe cyane.

Ingamba zo kwirinda zikomeye zirimo:

• Kwoza intoki neza n’amazi n’isabune igihe kigera ku masegonda 20
• Koresha imiti igabanya ubukana bw’uburwayi gusa iyo umuganga ayandikiye kandi ukayirangiza
• Kwiringira gukoresha imiti igabanya ubukana bw’uburwayi ku ndwara ziterwa na virusi
• Gusukura ibintu hakoreshejwe ibintu byanduza mu bigo nderabuzima
• Kuguma mu kato iyo usura abarwayi banduye
• Kugira ubuzima bwiza muri rusange no kurya indyo yuzuye

Amavuta yo gukaraba intoki gusa ntabasha kurwanya ibice bya C. difficile, bityo amazi n’isabune bikaba ari byo birinda neza. Niba uri mu bitaro cyangwa mu kigo cyita ku bantu bakuze, ntutinye kubibutsa abakozi bo mu buvuzi ko bagomba kwoza intoki mbere yo kwita kuri we.

Kugira probiotics mu gihe cyo kuvurwa no nyuma yacyo bishobora gufasha kugira bakteri nziza mu mara, nubwo ibimenyetso bikigaragara. Ibyo ubiganireho n’umuganga wawe, cyane cyane niba wararwaye C. difficile mbere.

C. Difficile imenyekanwa ite?

Kumenya C. difficile bisanzwe bikubiyemo gupima ibice by’amara kugira ngo harebwe niba hari uburozi cyangwa bakteri. Umuganga wawe ashobora gushidikanya ko ufite C. diff niba ufite ibimenyetso bisanzwe, cyane cyane nyuma yo gufata imiti igabanya ubukana bw’uburwayi cyangwa guhura n’ibigo nderabuzima.

Ibizamini bisanzwe byo gupima birimo toxin enzyme immunoassays ipima uburozi bwa C. difficile mu ntege, na polymerase chain reaction (PCR) ipima ibice by’umubiri wa bakteri. Ibipimo bya PCR birushaho kugaragaza indwara hakiri kare kurusha ibizamini by’uburozi.

Umuganga wawe ashobora kandi gusaba ibindi bipimo kugira ngo apime uburemere bw’indwara yawe. Ibyo bishobora kuba harimo ibizamini by’amaraso kugira ngo harebwe ibimenyetso by’uburakari cyangwa gucika amazi, n’ibipimo by’amashusho nka CT scans niba bakeka ko hari ingaruka nka toxic megacolon.

Kumenya indwara hakiri kare ni ingenzi kuko C. difficile isaba ubuvuzi budasanzwe butandukanye n’izindi ndwara z’impiswi. Umuganga wawe azaba ashaka kandi kumenya impamvu zindi zishobora gutera ibimenyetso byawe.

Ni iki kivura C. Difficile?

Ubuvuzi bwa C. difficile bwarahindutse cyane mu myaka ya vuba aha, imiti mishya igaragara ko ikora kurusha iy’imbere. Ubuvuzi umuganga wawe azakugenera biterwa n’uburemere bw’indwara yawe niba ari ubwa mbere cyangwa ukundi.

Ubuvuzi bwa mbere busanzwe burimo:

• Vancomycin (mu kanwa), isanzwe ifatwa inshuro enye ku munsi iminsi 10
• Fidaxomicin, imiti mishya igabanya ibyago byo kwisubiraho
• Metronidazole, ikoreshwa ahanini ku ndwara zoroheje cyangwa iyo indi miti idahari

Ku ndwara zisubira ukundi, umuganga wawe ashobora kugusaba ko wakomeza gufata imiti cyangwa kuyigabanya, cyangwa uburyo bushya nko gusimbuza bakteri nziza (FMT). FMT ikubiyemo guhererekanya bakteri nziza kuva ku muntu ubuzima bwe buzima kugira ngo ubusugire bwiza bw’amara busubire.

Niba ufite ingaruka zikomeye nka toxic megacolon cyangwa gucika kw’amara, ushobora kubagwa kugira ngo bakureho igice cyangiritse cy’amara. Ariko kandi, abantu benshi bakira neza hakoreshejwe imiti idafasha kubagwa.

Ikipe y’abaganga izibanda kandi ku kuvura, harimo no guha amazi kugira ngo birinde gucika amazi no gukurikirana ingaruka. Basanzwe bahagarara imiti idakenewe ishobora gutera indwara.

Uko wakwita ku buzima bwawe iwawe muri C. Difficile

Kwita ku buzima bwawe iwawe muri C. Difficile bisaba kwita cyane ku kwirinda gucika amazi, kugira imirire myiza, no kwirinda kwanduza abandi bo mu muryango. Ubuvuzi bwinshi bukorerwa iwawe keretse niba ufite ingaruka zikomeye.

Ibanda ku kuguma ufite amazi ahagije mu mubiri unywa amazi menshi meza nka amazi, amasupu, n’ibinyobwa bifite umunyu. Irinde ibinyampeke n’ibiribwa bifite fibre nyinshi, kuko bishobora kongera impiswi n’ububabare.

Fata imiti yawe uko umuganga yayandikiye, nubwo watangira kumva umeze neza mbere yo kurangiza imiti. Kudafata imiti cyangwa kuyihagarika hakiri kare bishobora gutera kunanirwa kuvurwa no kongera ibyago byo kwisubiraho.

Shyiraho ingamba z’isuku kugira ngo urinde abandi bo mu muryango wawe. Kwoza intoki kenshi n’amazi n’isabune, gusukura ubwiherero hakoreshejwe ibintu byanduza, no kwirinda gutegurira abandi ibiryo mu gihe ufite ibimenyetso.

Ikiruhuko ni ingenzi mu gukira, bityo ntukihute gusubira mu mirimo yawe isanzwe. Umubiri wawe ukeneye imbaraga zo kurwanya indwara no gukira ubukana mu mara.

Uko wakwitegura gusura umuganga

Kwitunganya mbere yo gusura umuganga bizagufasha kubona ubuvuzi bukwiye. Kora amakuru y’ibimenyetso byawe, amateka yawe y’ubuzima, n’imiti ukoresha mbere yo kujya kwa muganga.

Andika igihe ibimenyetso byawe byatangiye, ukuntu ukunda kugira impiswi, n’ibindi bimenyetso wabonye. Bandika imiti uherutse gufata, igihe umaze mu bitaro, cyangwa guhura n’ibigo nderabuzima mu mezi ashize.

Zana urutonde rwuzuye rw’imiti yose, ibinyobwa, na vitamine ukoresha. Harimo imiti yo mu maduka n’impinduka uherutse kugira mu miti yawe.

Tegura ibibazo ku ndwara yawe, uburyo bwo kuvurwa, n’icyo witeze mu gihe cyo gukira. Baza uburyo bwo kwirinda kwisubiraho n’igihe ushobora gusubira mu mirimo yawe isanzwe.

Niba bishoboka, zana ibice by’amara niba ibiro by’umuganga bishobora kubipima, cyangwa witegure kubitanga mu gihe ugiye kwa muganga. Ibi bishobora kwihutisha igikorwa cyo gupima no kugufasha kuvurwa vuba.

Icyingenzi kuri C. Difficile

C. difficile ni indwara ikomeye ariko ikirwa y’ubwoko bwa bakteri ikunda kwibasira abantu bafite bakteri nziza mu mara zangiritse kubera imiti cyangwa ibindi bintu. Nubwo ishobora gutera ingaruka zikomeye, abantu benshi barakira neza hakoreshejwe imiti ikwiye.

Kumenya indwara hakiri kare no kuvurwa ni ingenzi kugira ngo ubone umusaruro mwiza. Niba ufite impiswi idashira, cyane cyane nyuma yo gufata imiti igabanya ubukana bw’uburwayi cyangwa umaze igihe mu bigo nderabuzima, ntutinye kuvugana n’umuganga wawe.

Kwiringira bikomeza kuba ingamba yawe nziza, ibanda ku isuku y’intoki, gukoresha imiti igabanya ubukana bw’uburwayi neza, no kugira ubuzima bwiza muri rusange. Ufashijwe n’ubuvuzi bukwiye, ushobora gukira indwara ya C. difficile no gufata ingamba zo kwirinda izindi ndwara mu gihe kizaza.

Wibuke ko kuba warwaye C. difficile ntibigaragaza ko udafite isuku cyangwa ko hari ikosa ryawe. Ni indwara isanzwe mu bigo nderabuzima ishobora kwibasira uwo ari we wese mu gihe gikwiye.

Ibibazo Bikunze Kubahwa kuri C. Difficile

Q1. C. difficile imara igihe kingana iki ivuwe?

Abantu benshi batangira kumva bameze neza mu minsi 2-3 nyuma yo gutangira kuvurwa neza, ibimenyetso bikagenda burundu mu minsi 7-10. Ariko kandi, bamwe mu bantu bashobora kugira ibibazo byo mu mirire igihe kirekire ibyumweru byinshi uko bakteri nziza mu mara zisubira.

Q2. C. difficile ishobora gusubira nyuma yo kuvurwa?

Yego, C. difficile ishobora gusubira mu bantu 15-35%, akenshi mu byumweru 2-8 nyuma yo kurangiza kuvurwa. Kwongera kurwara bibaho kuko ibice bishobora kuba mu mara kandi bikongera gukora iyo ibintu byiza.

Q3. C. difficile yandura abantu bo mu muryango?

C. difficile ishobora kwanduza abantu bo mu muryango binyuze mu guhuza n’ibintu byanduye, ariko abantu bazima bafite bakteri nziza mu mara ntibakunze kwandura. Kora isuku y’intoki, sukuma ubwiherero hakoreshejwe ibintu byanduza, kandi wirinda guhana ibintu.

Q4. Probiotics ishobora gufasha kwirinda C. difficile?

Ubushakashatsi bumwe bugaragaza ko probiotics zimwe na zimwe zishobora gufasha kwirinda indwara za C. difficile, cyane cyane iyo zifashwe mu gihe cyo kuvurwa. Ariko kandi, ibimenyetso bikigaragara, kandi si probiotics zose zikora kimwe.

Q5. Ni ibihe biribwa nakwirinda mu gihe ufite indwara ya C. difficile?

Mu gihe cy’indwara, irinde ibinyampeke, ibiryo bifite fibre nyinshi, ibiryo birimo ibirungo, n’ibindi bisanzwe bikubabaza mu nda. Ibanda ku biribwa byoroshye, birya neza nka bananes, umuceri, applesauce, na toasts. Kora isuku y’intoki, kandi usubire mu biribwa bisanzwe uko ibimenyetso bigenda bigabanuka.