Iqembu B streptococcal septicemia yengane esanda kuzalwa

I-septicemia ye-Group B streptococcal (GBS) isifo esibi kakhulu sebhaktheriya esithinta izinsana ezisanda kuzalwa.

I-Septicemia ukutheleleka okusegazini okungahambela ezithweni zomzimba ezahlukahlukene. I-GBS septicemia ibangelwa yigciwane I-Streptococcus agalactiae, okuvame ukubizwa ngeqembu B strep, noma i-GBS.

I-GBS ivame ukutholakala kubantu abadala nasezinganeni ezindala, futhi imvamisa ayibangeli ukutheleleka. Kodwa kungenza izingane ezisanda kuzalwa zigule kakhulu. Kunezindlela ezimbili i-GBS engadluliselwa ngayo enganeni esanda kuzalwa:

• Ingane ingatheleleka ngenkathi idlula emgodini wokuzalwa. Kulokhu, izingane zigula phakathi kokuzalwa nezinsuku eziyisithupha zokuphila (ikakhulukazi emahoreni angama-24 okuqala). Lokhu kubizwa ngokuthi yisifo sokuqala se-GBS.
• Usana nalo lungatheleleka ngemuva kokubeletha ngokuhlangana nabantu abaphethe igciwane le-GBS. Kulesi simo, izimpawu zivela kamuva, lapho ingane inezinsuku ezingu-7 kuya ezinyangeni ezintathu noma ngaphezulu ubudala. Lokhu kubizwa ngokuthi yisifo se-GBS esifike sekwedlule isikhathi.

I-GBS septicemia manje seyivela kancane, ngoba kunezindlela zokuhlola nokwelapha abesifazane abakhulelwe abasengozini.

Lokhu okulandelayo kwandisa ingozi yengane ye-GBS septicemia:

• Ukuzalwa ngaphezu kwamasonto amathathu ngaphambi kosuku olubekiwe (prematurity), ikakhulukazi uma umama eqala ukubeletha (ngaphambi kokubeletha)
• Umama osevele ubelethe ingane ene-GBS sepsis
• Umama onomkhuhlane we-100.4 ° F (38 ° C) noma ngaphezulu ngesikhathi sokubeletha
• Umama oneqembu B streptococcus emathunjini akhe, emathunjini, noma kumchamo
• Ukuqhekeka kolwelwesi (ukuphuka kwamanzi) ngaphezu kwamahora ayi-18 ngaphambi kokubeletha kwengane
• Ukusetshenziswa kokuqashwa kwe-intrauterine fetal (lead lead) ngesikhathi sokubeletha

Ingane ingaba nezimpawu nezimpawu ezilandelayo:

• Ukubukeka okukhathazayo noma okucindezelekile
• Ukubukeka okuluhlaza okwesibhakabhaka (i-cyanosis)
• Ubunzima bokuphefumula, njengokubhakuza kwamakhala, imisindo ebubulelayo, ukuphefumula okusheshayo, nezikhathi ezimfishane ngaphandle kokuphefumula
• Isilinganiso senhliziyo esingajwayelekile noma esingajwayelekile (esheshayo noma esisheshayo)
• Imikhuba emibi
• Ukubukeka okuphaphathekile (i-pallor) ngesikhumba esibandayo
• Ukudla okungafanele
• Izinga lokushisa lomzimba elingazinzile (eliphansi noma eliphakeme)

Ukuthola i-GBS septicemia, ama-GBS bacteria kumele atholakale kusampula yegazi (isiko legazi) elithathwe enganeni esanda kuzalwa egulayo.

Olunye uvivinyo olungenziwa lubandakanya:

• Ukuhlolwa kokuvala igazi - isikhathi seprothrombin (PT) nesikhathi esinqunyelwe se-thromboplastin (PTT)
• Amagesi egazi (ukubona ukuthi ingane idinga usizo ngokuphefumula)
• Qedela ukubalwa kwegazi
• Isiko le-CSF (ukuhlola i-meningitis)
• Isiko lomchamo
• I-X-ray yesifuba

Ingane inikezwa ama-antibiotic ngomthambo (IV).

Ezinye izindlela zokwelashwa zingafaka:

• Usizo lokuphefumula (ukwesekwa kokuphefumula)
• Uketshezi olunikezwa ngomthambo
• Imithi yokuguqula ukwethuka
• Imithi noma izinqubo zokulungisa izinkinga zokuvala igazi
• Ukwelashwa kwe-oxygen

Ukwelashwa okubizwa nge-extracorporeal membrane oxygenation (ECMO) kungasetshenziswa ezimweni ezinzima kakhulu. I-ECMO ifaka phakathi ukusebenzisa iphampu ukuhambisa igazi ngamaphaphu okufakelwa abuyele egazini lengane.

Lesi sifo singasongela impilo yakho ngaphandle kokwelashwa ngokushesha.

Izinkinga ezingaba khona zifaka:

• Kusatshalaliswe i-intravascular coagulation (i-DIC): Isifo esibi lapho amaprotheni alawula ukujiya kwegazi asebenza ngokungajwayelekile.
• I-Hypoglycemia, noma ushukela wegazi ophansi.
• I-Meningitis: Ukuvuvukala (ukuvuvukala) kwezingqimba ezimboze ubuchopho nentambo yomgogodla obangelwa ukutheleleka.

Lesi sifo sivame ukutholakala ngemuva nje kokuzalwa, kaningi ngenkathi ingane isesibhedlela.

Kodwa-ke, uma usana olusanda kuzalwa ekhaya olukhombisa izimpawu zalesi simo, funa usizo oluphuthumayo lwezokwelapha noma ushayele inombolo yendawo ephuthumayo (njenge-911).

Abazali kufanele babheke izimpawu emasontweni ayisithupha okuqala engane yabo. Izigaba zokuqala zalesi sifo zingaveza izimpawu okunzima ukuzibona.

Ukusiza ukunciphisa ubungozi be-GBS, abesifazane abakhulelwe kufanele bahlolelwe amagciwane emasontweni angama-35 kuye kwangama-37 ekukhulelweni kwabo. Uma amagciwane etholakala, abesifazane banikezwa ama-antibiotic ngomthambo ngesikhathi sokubeletha. Uma umama ebeletha ngaphambi kwesikhathi ngaphambi kwamasonto angama-37 futhi imiphumela yokuhlolwa kwe-GBS ingatholakali, kufanele alashwe ngama-antibiotic.

Izinsana ezisengozini enkulu zihlolelwa ukutheleleka nge-GBS. Bangathola ama-antibiotic ngomthambo phakathi namahora okuqala angama-30 kuye kwangama-48 okuphila kuze kutholakale imiphumela yokuhlolwa. Akufanele baphindiselwe ekhaya besuka esibhedlela ngaphambi kwamahora angama-48 ubudala.

Kuzo zonke izimo, ukugeza izandla ngokufanele ngabanakekeli bezinkulisa, izivakashi nabazali kungasiza ekuvimbeleni ukusabalala kwamagciwane ngemuva kokuzalwa kosana.

Ukuxilongwa kusenesikhathi kungasiza ekunciphiseni ubungozi bezinye izinkinga.

Ukusakaza kweqembu B; I-GBS; I-sepsis engakazalwa; I-sepsis ye-neonatal - ukusakaza

Izikhungo Zokulawulwa Nokuvimbelwa Kwezifo iwebhusayithi. Ukusakaza kweqembu B (GBS). www.cdc.gov/groupbstrep/clinicians/clinical-overview.html. Kubuyekezwe uMeyi 29, 2018. Kufinyelelwe kuDisemba 10, 2018.

U-Edwards MS, uNizet V, uBaker CJ. Ukutheleleka kwe-streptococcal yeqembu B. Ku: Wilson CB, Nizet V, Maldonado YA, Remington JS, Klein JO, abahleli. Izifo Ezithathelwanayo ze-Remington ne-Klein ze-Fetus ne-Baby Newborn. Umhlaka 8. IPhiladelphia, PA: Elsevier Saunders; 2016: isahluko 12.

ULachenauer CS, uWessels MR. I-streptococcus yeqembu B. Ku: Kliegman RM, Stanton BF, St Geme JW, Schor NF, ama-eds. Incwadi kaNelson Yezingane. Umhla ka-20. IPhiladelphia, PA: Elsevier; 2016: isahluko 184.