Ukumelana nama-antimicrobial (AMR) sekungenye yezinselelo zezempilo eziphuthumayo emhlabeni wonke zesikhathi sethu. Ngokusho kwe-Uhlu Lwezifo Ezibaluleke Kakhulu Zamabhaktheriya luka-2024 (i-BPPL)ekhishwe yi-World Health Organization, amagciwane amaningana amelana ne-carbapenem—kufaka phakathiI-Acinetobacter baumannii, I-Pseudomonas aeruginosa, kanye ne-Enterobacteriaceae engamelana ne-carbapenem—zisalokhu zihlukaniswa njengeAmagciwane “Abalulekile”, okumelela izinga eliphezulu kakhulu losongo empilweni yomphakathi yomhlaba wonke. Lawa ma-pathogen ahlotshaniswa nokutheleleka okukhulu okuhlobene nokunakekelwa kwempilo kanye nezinketho zokwelapha ezilinganiselwe, okugqamisa isidingo esiphuthumayo sokuthuthukiswa kokuxilongwa, ukuqapha, kanye nokuphathwa kwama-antimicrobial.
Ama-antibiotics abelokhu eyisivikelo sethu esinamandla kakhulu ekuthelelekeni ngamagciwane. Kodwa-ke, namuhla, leli thuluzi elinamandla libhekene nosongo olukhulayo noluyingozi: ukumelana namagciwane (i-AMR). Kodwa kuthiwani uma ama-antibiotic owasebenzisayo engasasebenzi? Enye yezimbangela ezinkulu zalokhu kwehluleka i-enzyme ebizwa ngokuthii-carbapenem.
Indlela Ama-antibiotic Asebenza Ngayo
Ama-antibiotic asebenza ngokuqondisa izinqubo ezithile ngaphakathi kwamagciwane, okuphazamisa ikhono lawo lokusinda nokuzala:
- Ukwenziwa Kodonga LweseliAma-penicillin, isibonelo, aphazamisa izindonga zamaseli ebhaktheriya, okubangela ukuba aqhekeke.
- Ukukhiqizwa KwamaprotheniImithi efana ne-tetracyclines kanye nama-macrolides ivimba ama-ribosome amabhaktheriya, imise ukwakheka kwamaprotheni.
- Ukuphindaphindwa kwe-DNA/RNA: Ama-fluoroquinolones avimbela ama-enzyme ebhaktheriya adingekayo ekuphindaphindweni kwe-DNA.
- Ubuqotho be-Membrane YeseliAma-polymyxin alimaza ulwelwesi lwamagciwane, okuholela ekufeni kwamaseli.
- Izindlela Zokuguqula UmzimbaAma-Sulfonamides avimba izinqubo ezibalulekile zamabhaktheriya, njengokwenziwa kwe-folic acid.
Lezi zindlela zenza ama-antibiotic asebenze kahle kakhulu. Kodwa-ke, ukwanda kokumelana nama-antibiotic kunciphisa amandla awo, okwenza kube nzima ukwelapha ezinye izifo.
I-Carbapenemase: Indlela Yokuzivikela Yamagciwane
I-Carbapenemase iyi-enzyme ekhiqizwa amabhaktheriya athile asebenza njengesivikelo, okwenza ama-antibiotic e-carbapenem angasebenzi. Le enzyme iphula ama-carbapenems ngaphambi kokuba angene emangqamuzaneni amabhaktheriya, iwavimbele ekwenzeni umsebenzi wawo wokulwa namagciwane. Ngenxa yalokho, amabhaktheriya ane-carbapenemase angasinda futhi ande ngisho nalapho kukhona ama-antibiotic anamandla.
Inselele Yokumelana Ne-Carbapenem
Ngesikhathi amabhaktheriya akhiqiza i-carbapenemia, njengeI-Klebsiella pneumoniaefuthiI-Acinetobacter baumannii, zivame ukuhlotshaniswa nokutheleleka ezibhedlela, usongo lokumelana ne-carbapenem ludlulela ngale komndeni wakwa-Enterobacteriaceae kuphela. Amagciwane amelana ne-carbapenem angafaka namanye amagciwane ayingozi, njengeI-Pseudomonas aeruginosafuthiI-Stenotrophomonas maltophiliaLawa mabhaktheriya ayakwazi ukukhiqiza ama-enzyme e-carbapenemase, awenza amelane nezinhlobo eziningi zama-antibiotic, okwenza kube nzima ukukhetha ukwelashwa.
Ezindaweni zokunakekelwa kwempilo, ukutheleleka okumelana ne-carbapenem kungaholela ezifweni ezinde, izindleko zezokwelapha eziphakeme, ngisho nokufa.
Iziqondiso Zokuhlolwa Kwe-Carbapenemase
Ukuze kuxazululwe usongo olukhulayo lokumelana namagciwane, izinhlangano zezempilo, okuhlanganisa ne-WHO, zigcizelela ukubaluleka kokuhlolwa kwe-carbapenem njalo nangokuhlelekile, ikakhulukazi ezindaweni ezinobungozi obukhulu. Lezi ziqondiso zibalulekile ekuphatheni ukumelana namagciwane nokuvikela impilo yomphakathi.
Ukuhlolwa Okuvamile Ezindaweni Ezinengozi EphakemeUkuhlolwa kwe-carbapenem njalo kufanele kwenziwe ezindaweni ezibucayi njengezikhungo zokunakekelwa okujulile (ama-ICU), amagumbi okuphuthumayo, kanye namagumbi okwelapha umdlavuza, lapho iziguli zisengozini enkulu yokutheleleka okungamelani nezifo.
Ukutholwa Kwasekuqaleni Nokulungiswa KokwelashwaUkutholakala kusenesikhathi kwe-carbapenemase kuvumela abahlinzeki bezempilo ukuthi balungise izinhlelo zokwelapha ngokushesha, bathuthukise imiphumela yesiguli futhi banciphise ingozi yokutheleleka isikhathi eside.
Izinqubo Zokulawula Ukutheleleka: Uma kutholakala i-carbapenemase, izinyathelo eziqinile zokulawula ukutheleleka—njengokuhlukaniswa kwesiguli kanye nezinyathelo zokuphepha zabasebenzi—ziyadingeka ukuvimbela ukusabalala kwezinhlobo ezingamelana nalesi sifo.
Ukuqapha Nokuqapha Okuqhubekayo: Ukuqapha okuqhubekayo kwe-carbapenemase ezibhedlela kubalulekile ekulandeleni izitayela zokumelana, ukuhlonza izinsongo ezivelayo, kanye nokuhlela izinyathelo zokuvimbela.
Ukuhlolwa kwe-Carbapenemase: Isihluthulelo Sokwelashwa Okuqondiwe
Ukutholwa kwe-carbapenemase okunembile kubalulekile ekukhetheni ukwelashwa okufanele nokuvimbela ukusabalala kwamagciwane amelana nemithi. Izindlela zokuhlola zifaka:
- Ukuhlolwa Kwe-PhenotypicIzindlela ezifana nokusabalalisa amadiski (ezilula futhi ezingabizi kakhulu, kodwa ezingazweli kakhulu), ukuhlolwa kwe-Hodge okuguquliwe (okuqondile kodwa okuyinkimbinkimbi), kanye nokuhlolwa kwe-Carba NP (okusheshayo kodwa okungcono kakhulu kuzilungiselelo ezilawulwayo).
- Ukuhlolwa Kwezakhi ZofuzoIzindlela ezisekelwe ku-PCR zinikeza ukutholakala okunembile kwezakhi zofuzo ze-carbapenemase, zinikeza ukuqonda okuningiliziwe ngamaphrofayili okumelana.
- Ukuhlolwa Kwegolide Le-Colloidal: Indlela yokuhlola entsha, esheshayo, futhi enembile kakhulu.
Sethula Amakhithi Ethu Okubili Okuthuthukisiwe Okuthola I-Carbapenemase
Ukuze kuxazululwe inselele ekhulayo ye-AMR, inkampani yethu inikeza amakhithi amathathu okuthola i-carbapenemase amasha—ngalinye lenzelwe ukuhlangabezana nezidingo ezahlukene zezokwelapha. Lawa makhithi avumela abahlinzeki bezempilo ukuthi bakwazi ukubona ngokushesha nangokunembile amabhaktheriya amelana namagciwane, baqinisekise ukungenelela ngesikhathi kanye nemiphumela engcono yeziguli.
- Ikhithi Yokuthola I-Carbapenemase
Isebenzisa ubuchwepheshe be-colloidal gold ukuthola i-carbapenemase okusheshayo nokuthembekile. Yenzelwe ukusetshenziswa ezibhedlela, emitholampilo, ngisho nasekhaya, okwenza inqubo yokuxilonga ibe lula ngokunemba okuphezulu.
Izici Eziyinhloko:
- Ukutholwa Okuphelele: Ikhomba izakhi zofuzo zokumelana ne-NDM, KPC, OXA-48, IMP, kanye ne-VIM esivivinyweni esisodwa.
- Imiphumela Esheshayo: Iletha imiphumela ngaphansi kwemizuzu eyi-15, uma kuqhathaniswa nezinsuku eziyi-1-2 zokuhlolwa kwendabuko.
- Kulula Ukusebenzisa: Akudingi mishini eyinkimbinkimbi noma ukuqeqeshwa okukhethekile, okwenza kube kuhle kakhulu ezindaweni ezahlukene.
- Ukusetshenziswa Kahle Kwezindleko: Ihlanganisa izivivinyo ezinhlanu zibe yinye, isindisa isikhathi kanye nezinsiza.
- Ukunemba Okuphezulu: Inikeza ukuzwela okungu-95% ngaphandle kwemiphumela emibi evela kumagciwane avamile afanaI-Klebsiella pneumoniaenomaI-Pseudomonas aeruginosa.
- Isicelo Esibanzi: Kufanelekela izindawo ezincishisiwe izinsiza kanye nokulawulwa kokutheleleka okuqondile.
- Ikhithi Yokuthola Izakhi Zofuzo Zokumelana Ne-Carbapenem (i-Fluorescence PCR)
IIkhithi Yokuthola Izakhi Zofuzo Zokumelana Ne-Carbapenemiklanyelwe ukuhlaziywa okujulile kwezakhi zofuzo kokumelana ne-carbapenem. Le khithi ilungele ukubhekwa okuphelele emalabhorethri emitholampilo, inikeza ukutholakala okunembile kwezakhi zofuzo eziningi zokumelana ne-carbapenem.
Izici Eziyinhloko:
- Ukusampula Okuguquguqukayo: Ingabona ngqo kusuka kumakholoni ahlanzekile, isikhwehlela, noma ama-rectal swabs—akudingeki ukukhuliswa.
- Izindleko Ezincishisiwe: Ithola izakhi zofuzo eziyisithupha ezibalulekile zokumelana ekuhlolweni okukodwa, isusa isidingo sokuhlolwa okuphindaphindiwe kanye nokulondolozwa kwezinsiza.
- Ukuzwela Okuphezulu Nokucacile: Ithola i-CFU/mL ephansi njenge-1000 ngaphandle kokuhlangana nezinye izifo zokuphefumula noma izakhi zofuzo zokumelana njenge-CTX, i-mecA, i-SME, i-SHV, kanye ne-TEM.
- Iphrothokholi Yesampula Yempendulo:
- Ukuhambisana Okubanzi: Isebenza kahle ngamathuluzi e-PCR ajwayelekile ukuze kube lula ukuhlanganiswa emisebenzini yelabhorethri ekhona.
- I-Klebsiella Pneumoniae, i-Acinetobacter Baumannii kanye ne-Pseudomonas Aeruginosa kanye ne-Drug Resistance Genes (i-KPC, i-NDM, i-OXA48 kanye ne-IMP) Multiplex Detection Kit (i-Fluorescence PCR)
Le khithi ihlanganisa ukuhlonza amabhaktheriya kanye nezindlela zawo zokumelana ezihambisana nawo zibe yisici esisodwa sokuqonda okulula.
- Ukutholwa Okuphelele: I-Multiplex PCR Ithola amagciwane amathathu abalulekile ebhaktheriya—i-Klebsiella pneumoniae (Kp), i-Acinetobacter baumannii (Aba), kanye ne-Pseudomonas aeruginosa (Pa)—futhi ithola izakhi zofuzo ezine ezibalulekile ze-carbapenemase—i-KPC, i-NDM, i-OXA48, kanye ne-IMP esivivinyweni esisodwa, okwenza inqubo yokuxilonga ibe lula.
- Ukuzwela Okuphezulu:Iyakwazi ukuthola i-DNA yebhaktheriya ngamanani aphansi njenge-1000 CFU/mL, iqinisekisa ukuhlonza okuthembekile ngisho nasezibonelweni zomthwalo webhaktheriya ophansi.
- Isekela Ukwenza Izinqumo Zezokwelapha:Isiza ekuphathweni kwezokwelapha ngesikhathi esifanele nangokufanele ngokuhlonza izinhlobo ezingamelana namagciwane kusenesikhathi, okusiza ekukhetheni ukwelashwa okusebenzayo okulwa namagciwane.
- Ukuhambisana Okubanzi: Isebenza kahle ngamathuluzi e-PCR ajwayelekile ukuze kube lula ukuhlanganiswa emisebenzini yelabhorethri ekhona.
Lezi zinsiza zokuthola ezintathu zinikeza abahlinzeki bezempilo amathuluzi abawadingayo ukubhekana ne-AMR emazingeni ahlukene—kusukela ekuhlolweni okusheshayo kwendawo yokunakekelwa kuya ekuhlolweni okuningiliziwe kwezakhi zofuzo—ukuqinisekisa ukungenelela ngesikhathi esifanele kanye nokunciphisa ukusabalala kwamagciwane amelana namagciwane.
UkulwaI-AMRngokunemba
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Isikhathi sokuthunyelwe: Mashi-16-2026