Izinsana ezalwa ngaphambi kwesikhathi zinamazinga aphansi e-antibodies, izinto ezisegazini ezisiza ukuvikela ukulwa nokutheleleka. Esikhathini esilandelayo sokukhulelwa, ama-antibodies awela i-placenta ukusuka kumama kuya emntwaneni. Lapho umntwana ezalwa ngaphambi kwesikhathi abalahlekelwa kulesi simiso sokuzivikela omzimba ukukhuliswa kwama-antibodies okuzivikela ngakho-ke, ingozi yabo yokuthuthukisa izifo iphakeme.
Izithasiselo ziyakwazi ukutheleleka ngenxa yokuthi amasosha omzimba asemncane ngakho-ke kunzima ukuba balwe namagciwane ngokwabo. Izifo ezitholakala ku-preemie zingathinta ikhono labo lokuphefumula, zithole isisindo, zingakhuphula ukuhlala esibhedlela futhi zingaholela ezinkingeni eziningi ezingapheli. Kubalulekile ukwazi ukuthi ngezinyathelo ezifanele nolwazi, singakwazi ukuvimbela ezinye zalezi zifo futhi singenza umehluko omkhulu empilweni yonke kanye nomphumela wengane engakafiki .
Ngenxa yokunciphisa amasosha omzimba nokungahlali kahle, umntwana osanda kuzalwa angathuthukisa isifo cishe cishe noma iyiphi ingxenye yomzimba. Okuvamile kakhulu egazini (okuthiwa i-sepsis), emaphashini, ebuchosheni (umkhuhlane) nomgogodla (i-meningitis), isikhumba, noma izinso, isambiso (ukutheleleka kwe-urinary-UTI), noma amathumbu (NEC). Ngemva nje kokubeletha, zonke izingane zithola izinhlobo ezimbili zamagciwane, amanye ama-bacteria angenayo eyingozi.
Amabhaktheriya anempilo asiza ukugcina okulimazayo ekuhloleni. Amabhaktheriya amahle asiza usizo ekugayeni. Ngezinye izikhathi, ngenxa ye-preemie, lesi simiso esiyinkimbinkimbi sinokulinganisela okungenza kube nezinkinga nokutheleleka. Isikhumba yindlela yokuqala yokuzivikela. Ngomntwana ongakabi yisikhathi, isikhumba sishayekile futhi singase sithole izinqubo eziningi zokwelashwa ezifana ne-IV eqala, ukujova, nokuhlolwa kwegazi.
Lokhu kungaba ingosi yezifo zokungena ohlelweni lwezingane ngaphambi kwesikhathi. Ngenxa yokuthi ukutheleleka ngokwayo kungabangela imbangela yokubeletha ngaphambi kwesikhathi, i-preemie kungenzeka ivuliwe futhi ithole ukutheleleka ku-utero uma amabhaktheriya noma igciwane lidluliselwa kusuka egazini likaMama ngokusebenzisa i-placenta kanye nentambo yomntwana kumntwana. Bangakwazi futhi ukuhlakulela izifo kusukela ekuvezweni kwemvelo, ngemuva kwezinsuku noma amasonto ngaphakathi kwe-NICU.
Izifo zibangelwa enye yezinhlobo ezintathu zama-microorganisms; amabhaktheriya, amagciwane, noma isikhunta. Ama-bacteria amancane amangqamuzana angabodwa atholakala emvelweni, esikhumbeni, nasegcekeni lezinsizi (GI). Imithi ebizwa ngokuthi ama-antibiotics isetshenziselwa ukwelapha izifo ezibangelwa amagciwane. I-Ampicillin ne-Gentamicin yizinhlobo ezimbili ze-antibiotic evamile ezisetshenziswa ku-NICU. Ama-virus anempilo encane kunezingqikithi futhi ayengenwa yi-antibiotics. Kukhona imithi etholakalayo ebizwa ngokuthi i-anti-virus esiza ngezinye izinhlobo zama-bacteria okubangela ukutheleleka. Imfucumfucu noma okuvame ukubizwa ngokuthi imvubelo ivame ukutholakala kumapheshana we-GI nasesikhumbeni futhi kungaba yimbangela yezifo ezithile ezisongela igazi. Imithi ebizwa ngokuthi i-antifungals isetshenziselwa ekwelapheni izifo ezifayilini.
Kungaba nzima ukutshela ukuthi i-preemie ihlakulela isifo. Ezinye zezibonakaliso zingabandakanya: isikhumba esibucayi noma esinamafutha, okuhamba kancane kunenhliziyo evamile, izikhathi zokuphefumula (ukuyeka ukuphefumula), nokungakwazi ukugcina ukushisa komzimba okuzinzile; noma ngaphezulu kakhulu noma iphansi kakhulu. Ingane ingaba nezwi elimpofu elimpofu noma libe yi-floppy futhi lingase libe nobunzima ukuhlala liqaphile noma lingase libe yinkinga. Usana lungase lube nenkinga yokubekezelela ukudla kwabo.
Kunezinye izivivinyo ezivamile ezenziwa eNICU lapho umntwana ebonisa izimpawu zokutheleleka. Lezi zivivinyo zingase zenziwe njalo ukuze zikhishwe noma yikuphi ukungahle kwenzeke inkinga ekhona.
Igazi lingase libhekwe ukuhlola inani le-white white cell. Inhloso eyinhloko yamaseli e-White (WBC) emzimbeni ukulwa nezifo. Inani eliphakeme kunejwayelekile noma eliphansi kune-WBC count liwukukhathazeka ukuthi umntwana angase athuthukise noma une-infection. Uhlobo lwe-WBC olubizwa ngokuthi i-neutrophil lwenziwa emzimbeni ngokuphendula ukuvuvukala nokutheleleka. I-neutrophils yi-WBCs engakafiki futhi uma isifo sisekhona, umzimba uzokhulula masinyane amangqamuzana afanele ukusiza ukulwa nezincane ezincane ezihlasela. Olunye uhlolo lwegazi oluthiwa yi-CRP noma i-C-isenzo se-protein esisebenzayo singenziwa. Iprotheyini e-C esebenzayo yinto ekhishwa ngumzimba ngokuphendula ukuvuvukala. I-CRP ephakeme ingase ikhombise ukuthi kukhona ukutheleleka. Umkhuba wegazi yi-test eyenziwa ukuzama nokukhula i-microorganism engase ibe khona egazini. Lokhu kuhlolwa kwenziwa ukuze kubone ukuthi yikuphi ukugula okungenzeka kube khona futhi kuzosiza ukunquma ukuthi imiphi imithi elwa namagciwane efanelekile ukuphatha ukutheleleka.
I-X-ray yesifuba yisifo sokuhlola ukubona amaphaphu ukucacisa ukuthi kungenzeka yini ukuthi kube nesifo sofuba njengesifo sofuba. Umshini wokugaya umgogodla noma ukugwedwa kwe-lumbar (LP) kungenye ukuhlolwa okungase kwenziwe ukuze kuhlolwe i-meningitis. Ku-LP, inani elincane le-cerebral fluid umgogodla (oketshezi olujikeleza ubuchopho kanye nentambo yomgogodla) kususwa futhi kuhlolwe ukuba khona kokutheleleka.
Uma kukhona ubufakazi bokutheleleka, umntwana angaphathwa ngama-antibiotic, ama-flu flu, i-oksijeni, noma ngisho ne-ventilation yemishini ngokuya ngobukhulu bezimpawu kanye ne-microorganism ngokwayo. Nakuba ezinye izifo zingase zibe yingozi kakhulu, iningi lizophendula kahle ngama-antibiotic. Ngaphambi kwalokho usana luphathwa, kungcono ukulwa nokutheleleka ngempumelelo.
Isivikelo somzimba sokuzivikela komntwana osengaphambi kwesikhathi sizoqhubeka sikhula ngaphambi kwezinyanga ezimbalwa zokuphila futhi singasebenzi kanye neyesikhathi esisha esibelethayo ngakho-ke sibabeka engozini enkulu yokuthola izifo, ikakhulukazi amagciwane. Ukuvikela i-preemie yakho ngenkathi ku-NICU futhi emva kokukhipha kubalulekile kakhulu. Ukugeza izandla kanye nokusetshenziswa kwe-sanitizer yezandla yizinto ezimbili ezibaluleke kakhulu ongayenza futhi ukhuthaze abanye abazovakashela noma abazungeze i-preemie yakho ukwenza okufanayo. Nciphisa inani lezivakashi futhi ugcine labo abangenazo izimpawu zokubandayo, ukukhwehlela noma ukutheleleka. Ukugula okulula kumazingane asebekhulile nakubantu abadala kungaba yinto engathà sina ngisho nokubulala ingane engakafiki.
Imithombo
Stoll et al. Ukuqala kokuqala kwe-neonatal: isisindo se-B streptococcal nesifo se-E. coli siyaqhubeka. Izingane zokwelapha. 2011: 127: 817-826.
URennie JM (2005) I- Roberton's Textbook of Neonatology , eNgilandi, uChurchill Livingstone, p1017
UKaufman D, i-Fairchild KD. I-microbiology emitholampilo ye-sepsis ye-bacterial and fungal ezincane ezincane kakhulu zokubeletha. I-Clin Microbiol Rev. Jul 2004; 17 (3): 638-80.
Lopez Sastre, JB, uCoto Cotallo, D., noFernandez Colomer, B. (2002). Ukuthungathwa kwe-neonatal kwesiqalo se-nosocomial: isifundo se-epidemiological esivela ku "Grupo de Hospitales Castrillo". J Perinat Med, 30 (2), 149-157