Streptococcal septicemia wa wakhanda

Septicemia ya gulu B (GBS) septicemia ndi matenda oyambitsidwa ndi bakiteriya omwe amakhudza makanda obadwa kumene.

Septicemia ndi matenda omwe amapezeka m'magazi omwe amatha kupita ku ziwalo zosiyanasiyana za thupi. GBS septicemia imayambitsidwa ndi bakiteriya Streptococcus agalactiae, yomwe imadziwika kuti gulu B, kapena GBS.

GBS imapezeka mwa akulu ndi ana okulirapo, ndipo nthawi zambiri siyimayambitsa matenda. Koma zimatha kupangitsa ana obadwa kumene kudwala kwambiri. Pali njira ziwiri zomwe GBS imatha kupatsira mwana wakhanda:

• Mwana atha kutenga kachilomboka podutsa ngalande yobadwira. Poterepa, ana amadwala pakati pa masiku obadwa ndi masiku 6 amoyo (makamaka m'maola 24 oyamba). Izi zimatchedwa matenda oyamba ndi GBS.
• Khanda limakhalanso ndi kachilombo atabereka mwa kukumana ndi anthu omwe ali ndi kachilombo ka GBS. Pachifukwa ichi, zizindikiro zimawonekera pambuyo pake, pamene mwana ali ndi masiku 7 mpaka miyezi 3 kapena kupitirirapo. Izi zimatchedwa matenda oyamba ndi GBS.

GBS septicemia tsopano imachitika pafupipafupi, chifukwa pali njira zowonera ndikuchiza amayi apakati omwe ali pachiwopsezo.

Zotsatirazi zikuwonjezera chiopsezo cha khanda ku septicemia ya GBS:

• Kubadwa patadutsa milungu itatu isanafike nthawi yake (kusanakhwime), makamaka ngati mayi ayamba kubereka asanabadwe (asanabadwe)
• Amayi omwe abereka kale mwana yemwe ali ndi GBS sepsis
• Amayi omwe ali ndi malungo a 100.4 ° F (38 ° C) kapena kupitilira apo pakubereka
• Amayi omwe ali ndi gulu B streptococcus m'mimba mwake, kubereka, kapena kwamikodzo
• Kung'ambika kwa madzi (kuswa madzi) kutadutsa maola 18 mwana asanabadwe
• Kugwiritsa ntchito intrauterine fetal Monitoring (scalp lead) panthawi yogwira ntchito

Mwana atha kukhala ndi izi:

• Kuda nkhawa kapena kupsinjika
• Maonekedwe abuluu (cyanosis)
• Mavuto akupuma, monga kuwombera m'mphuno, phokoso laphokoso, kupuma mwachangu, komanso nthawi yayifupi osapuma
• Zachilendo kapena zosazolowereka (mwachangu kapena pang'onopang'ono) kugunda kwa mtima
• Kukonda
• Maonekedwe otumbululuka (pallor) okhala ndi khungu lozizira
• Kudya moperewera
• Kutentha kwa thupi kosakhazikika (kotsika kapena kotsika)

Kuti muzindikire septicemia ya GBS, mabakiteriya a GBS ayenera kupezeka mchitsanzo cha magazi (chikhalidwe chamagazi) chotengedwa kuchokera kwa mwana wakhanda wodwala.

Mayesero ena omwe angachitike ndi awa:

• Mayeso okutira magazi - nthawi ya prothrombin (PT) ndi nthawi yapadera ya thromboplastin (PTT)
• Mpweya wamagazi (kuti muwone ngati mwana akufuna thandizo popuma)
• Kuwerengera kwathunthu kwa magazi
• Chikhalidwe cha CSF (kuti muwone ngati meninjaitisi)
• Chikhalidwe cha mkodzo
• X-ray ya chifuwa

Mwana amapatsidwa maantibayotiki kudzera mumtsempha (IV).

Njira zina zothandizira zitha kuphatikizira:

• Thandizo la kupuma (chithandizo cha kupuma)
• Madzi operekedwa kudzera mumitsempha
• Mankhwala obwezeretsa mantha
• Mankhwala kapena njira zothetsera mavuto a magazi
• Thandizo la oxygen

Mankhwala otchedwa extracorporeal membrane oxygenation (ECMO) atha kugwiritsidwa ntchito pamavuto akulu. ECMO imaphatikizapo kugwiritsa ntchito mpope kufalitsa magazi kudzera m'mapapu opangira kubwerera m'magazi amwana.

Matendawa akhoza kupha moyo popanda kuthandizidwa mwachangu.

Mavuto omwe angakhalepo ndi awa:

• Kufalikira kwa intravascular coagulation (DIC): Matenda akulu pomwe mapuloteni omwe amayendetsa kutsekedwa kwa magazi amagwiranso ntchito modabwitsa.
• Hypoglycemia, kapena shuga wotsika magazi.
• Meningitis: Kutupa (kutupa) kwa nembanemba yophimba ubongo ndi msana wam'mimba chifukwa cha matenda.

Matendawa amapezeka atangobadwa kumene, nthawi zambiri mwanayo akadali mchipatala.

Komabe, ngati muli ndi mwana wakhanda kunyumba yemwe akuwonetsa zizindikiro za vutoli, pitani kuchipatala mwachangu kapena pitani ku nambala yadzidzidzi (monga 911).

Makolo ayenera kuyang'ana pazizindikiro m'masabata 6 oyamba a mwana wawo. Matenda oyamba a matendawa amatha kutulutsa zizindikilo zovuta kuziwona.

Pofuna kuchepetsa chiopsezo cha GBS, amayi apakati ayenera kukayezetsa bakiteriya pamasabata 35 mpaka 37 ali ndi pakati. Mabakiteriya akapezeka, amayi amapatsidwa maantibayotiki kudzera mumitsempha panthawi yobereka. Ngati mayi ayamba kubala masiku asanakwane milungu 37 ndipo zotsatira za mayeso a GBS sizikupezeka, ayenera kulandira mankhwala opha tizilombo.

Ana obadwa kumene omwe ali pachiwopsezo chachikulu amayesedwa matenda a GBS. Amatha kulandira maantibayotiki kudzera mumtsempha munthawi ya 30 mpaka 48 maola oyamba kufikira zotsatira zakupezeka. Sayenera kutumizidwa kunyumba kuchokera kuchipatala asanakwanitse zaka 48.

Nthawi zonse, kusamba m'manja moyenera kwa osamalira ana, alendo, ndi makolo kumathandiza kuteteza kufalikira kwa mabakiteriya khanda litabadwa.

Kuzindikira koyambirira kumatha kuchepetsa kuchepa kwa zovuta zina.

Gulu la gulu B; GBS; Kupweteka kwachinyamata; Neonatal sepsis - strep

Malo Othandizira Kuteteza ndi Kuteteza tsamba lawebusayiti. Gulu la gulu B (GBS). www.cdc.gov/groupbstrep/clinicians/clinical-overview.html. Idasinthidwa pa Meyi 29, 2018. Idapezeka pa Disembala 10, 2018.

Edwards MS, Nizet V, Baker CJ. Matenda a streptococcal a Gulu B. Mu: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, olemba. Matenda Opatsirana a mwana wosabadwayo ndi mwana wakhanda a Remington ndi Klein. 8th ed. Philadelphia, PA: Elsevier Saunders; 2016: chap 12.

Lachenauer CS, Wessels MR. Streptococcus Gulu B. Mu: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, olemba. Nelson Textbook of Pediatrics. Wolemba 20th. Philadelphia, PA: Elsevier; 2016: chap 184.