Iqela le-streptococcal septicemia yosana olusanda kuzalwa

I-septicemia yeqela B le-streptococcal (GBS) sisifo esosulelayo esibi esichaphazela iintsana ezisandul 'ukuzalwa.

I-Septicemia sisifo egazini esinokuhamba siye kumalungu omzimba ahlukeneyo. I-GBS septicemia ibangelwa yintsholongwane IStreptococcus agalactiae, ebizwa ngokuba liqela B, okanye i-GBS.

I-GBS ifunyanwa kubantu abadala nakubantwana abadala, kwaye ayisoloko ibangela usulelo. Kodwa inokwenza abantwana abasandul 'ukuzalwa bagule kakhulu. Zimbini iindlela apho i-GBS inokugqithiselwa kusana olusandul 'ukuzalwa:

• Usana lunokosuleleka ngelixa luhamba kumjelo wokuzalwa. Kule meko, abantwana bayagula phakathi kokuzalwa kunye neentsuku ezi-6 zobomi (amaxesha amaninzi kwiiyure ezingama-24 zokuqala). Oku kubizwa ngokuba sisifo sokuqala se-GBS.
• Usana lusenokosulelwa emva kokubeleka ngokudibana nabantu abaphethe intsholongwane ye-GBS. Kule meko, iimpawu ziyavela kamva, xa umntwana eneentsuku ezisi-7 ukuya kwiinyanga ezi-3 okanye nangaphezulu ubudala. Oku kubizwa ngokuba sisifo se-GBS esifike emva kwexesha.

I-GBS septicemia ngoku yenzeka ngokufuthi, kuba zikhona iindlela zokujonga nokunyanga abafazi abakhulelweyo abasemngciphekweni.

Olu lulandelayo lonyusa umngcipheko wosana kwi-GBS septicemia:

• Ukuzalwa ngaphezulu kweeveki ezi-3 ngaphambi komhla omiselweyo (prematurity), ngakumbi xa umama esiya kubeleka kwangoko (kwangaphambi kokubeleka)
• Umama osele ebeleke umntwana one-GBS sepsis
• Umama onomkhuhlane we-100.4 ° F (38 ° C) okanye ngaphezulu ngexesha lokubeleka
• Umama oneqela B le-streptococcus kwindawo yakhe yesisu, yokuzala, okanye yokuchama
• Ukuqhekeka kwenwebu (ikhefu lamanzi) ngaphezulu kweeyure ezili-18 ngaphambi kokuba umntwana abeleke
• Ukusetyenziswa kokubekwa kweliso lomntwana ngaphakathi (ukukhokela entlonzeni) ngexesha lomsebenzi

Usana lunokuba nayo nayiphi na imiqondiso okanye iimpawu ezilandelayo:

• Inkxalabo okanye uxinzelelo
• Ukubonakala okuluhlaza okwesibhakabhaka (cyanosis)
• Ubunzima bokuphefumla, njengokubhabha kwamakhala, ingxolo yokugruma, ukuphefumla ngokukhawuleza, kunye namaxesha amafutshane ngaphandle kokuphefumla
• Engaqhelekanga okanye engaqhelekanga (ngokukhawuleza okanye ngokukhawuleza) inqanaba lentliziyo
• Ukuhamba
• Ukubonakala kwepale (pallor) ngolusu olubandayo
• Ukutya okungalunganga
• Ubushushu bomzimba obungazinzanga (obuphantsi okanye obuphezulu)

Ukufumanisa i-GBS septicemia, ii-bacteria ze-GBS kufuneka zifumaneke kwisampulu yegazi (inkcubeko yegazi) ethathwe kusana olusandul 'ukuzalwa.

Olunye uvavanyo olunokwenziwa lunokubandakanya:

• Uvavanyo lwe-clotting test-ixesha leprothrombin (PT) kunye nexesha le-thromboplastin (PTT)
• Iigesi zegazi (ukubona ukuba umntwana ufuna uncedo ngokuphefumla)
• Gcwalisa ubalo lwegazi
• Inkcubeko ye-CSF (ukujonga i-meningitis)
• Inkcubeko umchamo
• X-ray esifubeni

Usana lunikwa ii-antibiotics ngomthambo (IV).

Amanye amanyathelo onyango anokubandakanya:

• Uncedo lokuphefumla (inkxaso yokuphefumla)
• Ulwelo olunikwa ngomthambo
• Amayeza okubuyisa umothuko
• Amayeza okanye iinkqubo zokulungisa iingxaki zokunqanda igazi
• Unyango lweoksijini

Unyango olubizwa ngokuba yi-membrane ye-membrane oxygenation (ECMO) inokusetyenziswa kwiimeko ezinzima kakhulu. I-ECMO ibandakanya ukusebenzisa impompo ukuhambisa igazi ngemiphunga yokufakelwa ibuyele kwigazi lomntwana.

Esi sifo sinokusongela ubomi ngaphandle kwonyango olukhawulezileyo.

Iingxaki ezinokubakho zibandakanya:

• Ukusasazwa kwe-intravascular coagulation (DIC): Ukuphazamiseka okunzulu apho iiproteni ezilawula ukujiya kwegazi zisebenza ngokungaqhelekanga.
• Hypoglycemia, okanye iswekile esezantsi yegazi.
• I-Meningitis: Ukudumba (ukudumba) kweembumba ezigubungele ingqondo kunye nentambo yomqolo ebangelwa lusulelo.

Esi sifo sihlala sifunyaniswa emva nje kokuzalwa, rhoqo ngelixa umntwana usesesibhedlele.

Nangona kunjalo, ukuba usana olusandul 'ukuzalwa ekhaya olubonisa iimpawu zale meko, funa uncedo olukhawulezileyo lwezonyango okanye utsalele inombolo yongxamiseko yendawo (enje nge-911).

Abazali kufuneka bajonge iimpawu kwiiveki zokuqala ezi-6 zosana lwabo. Amanqanaba okuqala esi sifo anokuvelisa iimpawu ekunzima ukuzibona.

Ukunceda ukunciphisa umngcipheko we-GBS, abasetyhini abakhulelweyo kufuneka bavavanyelwe iibhaktheriya kwiiveki ezingama-35 ukuya kwezi-37 zokukhulelwa kwabo. Ukuba ibhaktheriya ifunyenwe, abafazi banikwa i-antibiotics ngomthambo ngexesha lokubeleka. Ukuba umama uya kusebenza ngaphambi kwexesha ngaphambi kweeveki ezingama-37 kwaye iziphumo zovavanyo ze-GBS azifumaneki, kufuneka anyangwe ngeyeza lokubulala iintsholongwane.

Iintsana ezisemngciphekweni omkhulu zivavanyelwa usulelo lwe-GBS. Banokufumana amayeza okubulala iintsholongwane ngomthambo ngeeyure zokuqala ezingama-30 ukuya kuma-48 zobomi de kufumaneke iziphumo zovavanyo. Akufunekanga baphindiselwe ekhaya ukusuka esibhedlele phambi kweeyure ezingama-48.

Kuzo zonke iimeko, ukuhlamba izandla ngokufanelekileyo ngabongi, abantwana kunye nabazali banokunceda ukuthintela ukusasazeka kwebhaktheriya emva kokuba usana luzelwe.

Ukuxilongwa kwangoko kunokunceda ukunciphisa umngcipheko weengxaki ezithile.

Uluhlu lweqela B; I-GBS; I-sepsis engakhulelwa; I-sepsis ye-neonatal-ukubetha

Amaziko oLawulo lweNtsholongwane kunye noThintelo lwewebhusayithi. Uluhlu lweqela B (GBS). www.cdc.gov/groupbstrep/clinicians/clinical-overview.html. Ukuhlaziywa ngoMeyi 29, 2018. Kufikeleleke ngoDisemba 10, 2018.

Edwards MS, Nizet V, Baker CJ. Usulelo lweqela B lwe-streptococcal. Ku: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, ii-eds. Izifo ezosulelayo zosana olungekazalwa kunye nosana olusandul 'ukuzalwa u-Remington noKlein. Ngomhla we-8. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 12.

Lachenauer CS, Wessels UMnu. I-streptococcus yeqela B. Ku: Kliegman RM, Stanton BF, St Geme JW, Schor NF, ii-eds. Incwadi kaNelson yeNcwadi yePediatrics. Umhla we-20. IPhiladelphia, PA: Elsevier; I-2016: isahluko 184.