Inselele Ekhulayo Yokumelana Namagciwane
Ukwanda okusheshayo kokumelana namagciwane (i-AMR) kungenye yezinselelo ezinkulu zezempilo emhlabeni wonke zesikhathi sethu. I-World Health Organization ibhale i-MRSA njengegciwane elibaluleke kakhulu. Phakathi kwamagciwane amelana namagciwane, i-Staphylococcus aureus (MRSA) engamelana ne-methicillin kuyakhathaza kakhulu. Ngokusho kocwaningo lwe-Global Burden of Disease olwanyatheliswa ku-The Lancet (2024), ukufa okubangelwa yi-MRSA kwanda kusuka ku-57,200 ngo-1990 kwaya ku-130,000 ngo-2021 - ukwanda okuphindwe kabili eminyakeni engamashumi amathathu [1]. Ucwaningo luphinde lubikezele ukuthi ngo-2050, cishe abantu abayizigidi ezingu-40 bangalahlekelwa izimpilo zabo ngenxa yokutheleleka kwe-superbug okungamelana namagciwane. I-MRSA iholela ekuhlaleni isikhathi eside esibhedlela, izindleko zokunakekelwa kwempilo ezikhuphukile, kanye nokufa okuphezulu, ikakhulukazi phakathi kweziguli ezinakekelwa kakhulu, iziguli ezihlinzwayo, kanye nezakhamuzi ezinakekelwa isikhathi eside.
UkuqondaI-Staphylococcus aureuskanye ne-MRSA
I-Staphylococcus aureus (SA) iyimbangela enkulu yokutheleleka okuhlobene nokunakekelwa kwempilo. Iyi-coccus ene-Gram positive ekhiqiza ubuthi obuhlukahlukene kanye nama-enzyme angenayo, futhi yaziwa ngokudla kwayoukusabalala okubanzi, ukugula okunamandla, kanye namazinga aphezulu okumelanaI-thermostable nuclease gene (nuc) iyisisulu esilondolozwe kakhulu sokutholwa kwe-SA.
I-MRSA ingahlukaniswa ngezinhlobo ezintathu ngokusekelwe emvelaphi:
-I-MRSA ehlobene nokunakekelwa kwempilo (HA MRSA)- ikakhulukazi kwenzeka ezibhedlela nasezikhungweni zokunakekelwa kwesikhathi eside
-I-MRSA ehlobene nomphakathi (i-CA MRSA)- kwenzeka ngaphandle kwezindawo zokunakekelwa kwempilo
-I-MRSA ehlobene nezilwane (LA MRSA)
Izindlela Zokutheleleka kanye Nomphumela Wezokwelapha we-MRSA
I-MRSA ingangena emzimbeni ngokusebenzisaamanxeba esikhumba, ama-follicle ezinwele, noma igazi, okubangela izifo ezibangelwa ukusha. Iziguli ezinezifo zesikhumba noma ukusha zisengozini enkulu yokutheleleka yi-MRSA. I-pneumonia ingenye yezimpawu ezivame kakhulu zokutheleleka yi-MRSA, futhi ukwelashwa okungafanele kuyisithako esibalulekile ekufeni okuphezulu. Ngakho-ke, ukuxilongwa nokwelashwa kwe-MRSA pneumonia kubhekene nezinselele ezinkulu futhi kudinga ukunakwa okuseduze.
Isihluthulelo Sokuvimbela Nokulawula Ukutheleleka: Ukuhlolwa Kwasekuqaleni
Iziguli ezisezibhedlela – okuhlanganisa nalabo abasezikhungweni zokunakekelwa okujulile, emagumbini okuhlinzwa, nasezikhungweni zokunakekelwa kwesikhathi eside – zisengozini enkulu yokutheleleka yi-MRSA. Ukuhlonza kusenesikhathi ukungena kwe-MRSA ekoloni noma ukutheleleka kubalulekile ekuvimbeleni ukudluliselwa esibhedlela, ukusebenzisa izindlela zokuqapha zokuthintana, kanye nokunciphisa ukutheleleka okuthelelanayo.
Izindlela zokulima ezivamile ngokuvamile zithatha amahora angu-48-72 ukuze ziveze imiphumela. Phakathi naleso sikhathi, abathwali be-MRSA bangaba imithombo engaba khona yokudlulisela. Ukuhlolwa okusheshayo kwama-molecule kunciphisa kakhulu isikhathi sokuhlola, okuvumela ukutholwa kusenesikhathi, ukuhlukaniswa kusenesikhathi, kanye nokungenelela kusenesikhathi.
I-SA kanye ne-MRSAUkutholwa okuvela ku-Macro kanye ne-Micro-Test
Yenzelwe ukuthola ama-nucleic acids ngaphakathi kwe-vitro avela ku-Staphylococcus aureus kanye ne-Staphylococcus aureus engamelana ne-methicillin kumasampula esikhwehlela somuntu, amasampula e-nasal swab, kanye namasampula okutheleleka kwesikhumba nezicubu ezithambile. Ukusetshenziswa okukhethekile kufaka phakathi:
-Ukuvimbela nokulawula ukutheleleka ezindaweni zokunakekelwa kwempilo– kweziguli ezibhedlela, okuhlanganisa iziguli ezinakekelwa kakhulu, iziguli ezihlinzwayo, kanye neziguli ezinakekelwa isikhathi eside
-Ukuxilongwa okusizayo kwezifo zokuphefumula– ezigulini ezisolwa ngokutheleleka kokuphefumula kwe-SA noma i-MRSA
-Ukuxilongwa okusizayo kwezifo zesikhumba nezicubu ezithambile– kanye nezinye izivivinyo zelebhu ezifana nokukhuliswa kwamagciwane
Isixazululo Sokuhlola Okuthuthukisiwe: Uhlelo lwe-POCT oluzenzakalelayo oluphelele lwe-AIO800+ SA kanye ne-MRSA
I-Macro & Micro-Test's AIO800 POCT ezenzakalelayo ngokugcwele kanye nekhithi yokuthola i-SA & MRSA, ithuluzi eliphumelelayo lokuvimbela nokulawula ukutheleleka esibhedlela.
-Izinhlobo eziningi zamasampula– Amasampula okutheleleka nge-sputum, ama-nasal swabs, isikhumba kanye nezicubu ezithambile
-Ukuhamba komsebenzi okuzenzakalelayo ngokugcwele– Ukulayisha okuqondile kusuka kumashubhu okuqala esampula (1.5mL–12mL); ukungabi nesikhathi esiningi, iphutha lomuntu elincishisiwe
-Ukuzwela okuphezulu– Umkhawulo wokutholwa ophansi njengo-1000 CFU/mL kokubili ku-SA kanye ne-MRSA
-Imiphumela esheshayo– Kushesha kakhulu kunesiko lendabuko, okuvumela ukulawulwa kokutheleleka kusenesikhathi
-Amafomethi e-reagent amabili- Izinketho zoketshezi kanye ne-lyophilized zinqoba izinselele zokugcina kanye nezokuthutha
-Ukulawula ukungcola okwakhelwe ngaphakathi– Uhlelo lokuvikela olunezingqimba ezingu-11 (i-UV, i-HEPA filtration, i-paraffin sealing, njll.)
-Ukuhambisana okubanzi- Isebenza ne-AIO800 kanye nezinhlelo ze-PCR ezijwayelekile
Imigomo kanye nokuhunyushwa kwemiphumela
Le khithi ithola izinjongo ezimbili:
-i-nuci-gene: i-gene elondolozwe kakhulu, ethize ye-Staphylococcus aureus
-i-mecAi-gene: i-gene ebalulekile elawula ukumelana ne-methicillin
Ukuhunyushwa Kwemiphumela
-SA negative - Akukho Staphylococcus aureus etholakele
-I-SA inhle, i-MRSA imbi– Kutholakale i-S. aureus, i-mecA gene ayitholakalanga
-i-SA positive, i-MRSA positive– Kutholakale i-S. aureus (MRSA) engamelana ne-Methicillin
Imiphumela Yokunakekelwa Kweziguli Nempilo Yomphakathi
Ukwamukela ukuhlolwa okusheshayo kwama-molecule kunikeza izinzuzo ezibalulekile:
-Ukulawulwa kokutheleleka okuthuthukisiwe- ukuhlonza ngokushesha abathwali be-MRSA kwenza kube lula ukuhlukaniswa ngesikhathi futhi kunciphisa ukudluliselwa esibhedlela.
-Imiphumela yokwelashwa ethuthukisiwe- ulwazi lokuqala lwe-pathogen lusekela ukwenziwa kwezinqumo zezokwelapha
-Ukuqapha kwezifo- Ukutholwa okusheshayo kwe-MRSA, kanye nolwazi lwezokwelapha lwesiguli, kunikeza ukuqonda kokuqala ngemvelaphi ye-HA MRSA noma i-CA MRSA, okusekela ukuqapha ukutheleleka esibhedlela.
-Ukusekelwa kokuphathwa kwe-antimicrobial- Ukuqinisekiswa noma ukungafakwa kwe-MRSA kusenesikhathi kusiza ekunciphiseni ukusetshenziswa okungadingekile kwama-antibiotic e-broad spectrum (njalo kuhambisana nokwahlulela kwezokwelapha)
Ukubhekana nenselele ye-MRSA kudinga indlela ehlelekile ehlanganisa ubuchwepheshe bokuhlola obuthuthukisiwe nemikhuba eyisisekelo yokulawula ukutheleleka.Amathuluzi okuhlola okusheshayo, izindlela zokuhlukanisa ezisebenzayo, ukusetshenziswa kwama-antibiotic afanele, kanye nokuqapha okuqhubekayoizindlela eziqinisekisiwe zokulawula i-MRSA ezindaweni zokunakekelwa kwempilo.
Ukulungele ukuguqula ukuhlolwa kwe-SA kanye ne-MRSA ngesampula yangempela yokuphendula kahle?
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Izinkomba:
[1] Ababambisene Nokumelana Nezifo Zomhlaba Wonke Ngo-2021. (2024). Umthwalo womhlaba wonke wokumelana namagciwane amagciwane ngo-1990–2021: ukuhlaziywa okuhlelekile okunezibikezelo eziya ku-2050. I-Lancet.
Isikhathi sokuthunyelwe: Ephreli-10-2026