He aha te kahurangi metilīni e whakamahia ai hei waikano tauaro mō te whakawaikano ātete-waikawa

Ka tirohia e tētahi kaitoi taiwhanga tētahi pani hūpē whai muri i te raupapa whakawaikano katoa. Ka kitea mārire ngā huakita rākau whero i runga i te papamuri kahurangi, ā, ka tukuna te pūrongo e kī ana kua kitea he huakita rākau ātete-waikawa. I te rā i muri mai, ka whakaatu tētahi atu kiriata i te papamuri kahurangi ōrite, kāore he huakita rākau whero, ā, ka pūrongotia he tōraro mō te mate kohi. Ko tētahi o ēnei pūrongo e kī ana i tētahi mea kāore e tautokona e te kiriata, ā, ehara tērā i te pūrongo tuatahi.

Ko te pūtake o te pōhēhē he pōhēhē ki te ariā. I whakaarotia e te kaitoi ko te waikano kahurangi tētahi wāhanga o te matū kimi huakita, me te mea nei he āwhina tā te kahurangi metilīni ki te kimi i ngā huakita maikō. Kāore he āwhina pērā. Kia pā atu te kahurangi metilīni ki te kiriata, kua oti kē te whakamātautau. He whakakara noa tā te waikano i te papamuri kia taea ai te pānui te hua. Ka whakamārama tēnei tuhinga i te take o te kahurangi metilīni i te whakawaikano ātete-waikawa, he aha i kahurangi ai, kaua ko tētahi atu tae, me ngā whakatau e tika ana kia puta i te whero i runga i te kahurangi.

Te whakautu poto

He whakamātautau wehewehe te whakawaikano ātete-waikawa e hangaia ana i runga i ngā ariā e toru. Ka kōkuhutia te fuksini karapō, te waikano matua, ki ia pūtau, tae atu ki ngā huakita maikō whai kiri āhua ware pi. Ka tangohia e te waikawa-waipiro, te kai tango tae, te waikano whero i ngā pūtau noa, engari kāore e taea te tango i taua waikano i ngā pūtau ātete-waikawa. Kātahi ka whakakara te kahurangi metilīni, te waikano tauaro, i ngā mea katoa i tangohia ai te tae, kia kahurangi ai ngā pūtau kāore e ātete-waikawa, ngā pūtau o te rauropi manaaki, me ngā toenga, ā, ka noho whero tonu ngā huakita rākau ātete-waikawa. Mā te waikano tauaro te rerekētanga tae e whakarato. Kāore ōna wāhi i te mahi matū e ātete-waikawa ai tētahi pūtau.

Te mahi a ia hipanga

E whakaatu ana te hoahoa i raro nei i te wehenga o ngā mahi. Pānuitia mai i te taha mauī ki te taha matau hei tukanga, ā, pānuitia te pae o raro hei whakamaharatanga he rerekē te pātai a ia whānau whakawaikano.

Ko te kuhu te mahi tuatahi. Ka ātete ngā huakita maikō ki ngā waikano wairewa noa nā te mea he tino pana-wai tō rātou kiri ārai, nō reira ka akiakina te kuhu e te kawa. I te tikanga Ziehl-Neelsen, ka kōkiritia e te wera me te mamaoa te fuksini karapō whai fenōra mā te pakitara āhua ware pi. I te tikanga makariri Kinyoun, ka whakakapia te wera ki tētahi ranunga waikano matua kaha noa atu, ā, ka tāpirihia he matū whakaiti mānukanuka mata ki ētahi putanga whakarerekē kāore e whakamahi wera. E tuhi ana ngā kawa whakawaikano ātete-waikawa a te American Society for Microbiology i ngā ranunga e rua hei whakataurite, ā, he nui te rerekētanga o te kukū: tata ki te 0.3 g fuksini pāpāhua mō ia 100 mL i te tikanga whakawera, ki te 4 g pea i te tikanga makariri.

Ko te wehewehe te mahi tuarua. Ko te waikawa-waipiro, ko te tikanga he 3 mL waikawa haumāota kukū i roto i te 97 mL waihā 95 ōrau, ka horoi atu i te waikano whero i ia pūtau kāore tōna pakitara e tuku ātete motuhake. Ka pupuri ngā pūtau whai kiri ārai ngako maikō tōtika i te waikano. Koinei te hipanga e whakawhirinaki ai te tikanga katoa, ā, koinei hoki te hipanga e tino pāngia ana e te āhua o te mahi, e kōrerotia ana i raro nei.

Ko te whakaputa tauaro te mahi whakamutunga. Kei te kiriata ināianei ngā pūtau ātete-waikawa whero i runga i tētahi papamuri o ngā pūtau kua tangohia te waikano, kua tata kore tae. Ka whakahokia e te kahurangi metilīni 0.3 ōrau w/v te kitea o taua papamuri ki tētahi tae e tino rerekē ana i te whero. He poto te whakawaikano tauaro, ko te tikanga he 20 ki te 30 hēkona i te tikanga whakawera, ā, tae atu ki ētahi meneti i ētahi putanga o te tikanga makariri. Ka whakawhirinaki te roanga ki te kawa, ehara i te āhuatanga o te waikano ake.

He aha tēnei waikano, ā, he aha i kahurangi ai

He waikano pāpāhua katote tōrunga te kahurangi metilīni, arā, he whana tōrunga tō tōna katote whai tae, ā, ka herea ki ngā mata whai whana tōraro o ngā huakita kua tangohia te tae, ngā pūtau o te rauropi manaaki, me ngā toenga. E whakamārama ana te Pukapuka Mātai Huakita a OpenStax i tēnei arorau whana hei mātāpono whānui mō ngā waikano pāpāhua. Engari ehara te kahurangi metilīni i te mea ahurei ā-matū i konei. He waikano pāpāhua anō te waiorete karaihe me te safaranini. He kōwhiringa ā-whatu tēnei, ehara i te kōwhiringa ā-matū.

Me whai papamuri tauaro ngā huakita rākau whero, ā, ko te kahurangi te tae e tino tauaro ana ki te whero mō te mātai karu whārahi āpure-mārama. Kāore te safaranini e pai hei waikano tauaro nā te mea he tata rawa tōna tae whakamutunga māwhero-whero ki te fuksini karapō e mau tonu ana, ka ngaro ai te rerekētanga i hangaia e te tukanga. Ka puta he papamuri waiorete pōuri i te waiorete karaihe, ka whakataetae ai ki ngā huakita rākau whero angiangi mō te aro o te kaitirotiro. Ko te taunakitanga kaha rawa he mahi whakaputa tauaro tēnei, kaua ko te mahi matū, ko te whakakapi: ka whakamahia ngā waikano tauaro kākāriki pērā i te kākāriki malakaite me te kākāriki pīataata i ētahi kawa mātai kararehe me ētahi kawa whakarerekē, ā, ka mahi tonu te whakamātautau, nā te mea he ōrite te mahi a tētahi tae e tino rerekē ana.

E rua ngā hua ā-mahi o tēnei. Tuatahi, kāore te tohutaka paerewa e tohu ana kia whakarerekētia te pH; kaua e whakapoauau i tēnei wairewa noa 0.3 ōrau ki ngā ranunga kawakore pērā i te kahurangi metilīni a Loeffler, nō tētahi atu ariā whakawaikano. Tuarua, he kino te nui rawa o te waikano. E whakatūpato mārika ana ngā tuhinga mātai kiko ka taea e tētahi papamuri kahurangi tino mātotoru te huna i ngā huakita rākau tokoiti, nō reira ko te waiho i te waikano ki runga i te kiriata mō te wā roa ake i tā te kawa e whakaae ai ka whakaiti noa i te mārama o te pānui, kāore he painga.

Te matū o te pakitara e taea ai te whakamātautau

Kei te kiri ārai o te huakita maikō te take e wehewehe ai te waikawa-waipiro. Ko tōna uho hanga ko te matatini maikōrira-arapinokaratana-peptidokaraikana: he peptidokaraikana e hono ana ki te arapinokaratana, ā, kei ngā pito o waho ngā waikawa maikōriki mekameka roa rawa, e hanga ana i tētahi kiriuhi maikō o waho whai ngako nui, he tino iti hoki tōna uruhanga. E whakamārama ana te arotake o te kiriuhi o waho o te huakita maikō i tēnei hanganga. Ka mahi te ārai ki ngā ahunga e rua. Ka ātete ki te kuhu o te waikano, nā reira me whai wera, me whai waikano matua kaha ake rānei hei kōkuhu, ā, ka ātete hoki ki te tangohanga o te waikano, nā reira kāore e taea e te waikawa-waipiro te tango i te fuksini karapō ina kua uru ki roto. Kāore tēnei kiri ārai i ngā huakita noa, ā, ka ngaro tō rātou waikano. Nō reira, he pai ake te mārama ki te ātete-waikawa hei āhuatanga o tētahi ārai ngako, kaua ko te here ā-matū o te fuksini ki te waikawa maikōriki.

Ka whakamārama hoki tēnei mahi matū i tētahi pātai noa: he ngoikore, he uaua hoki ki te matapae te whakawaikano o ngā huakita maikō mā te tikanga Gram, ā, i ētahi wā ka kitea he āhua pirepire koma, he āhua kēhua kore tae rānei. Ka whakawhāitihia e tō rātou pakitara pana-wai te kuhu o te waiorete karaihe. Ehara te whakawaikano ātete-waikawa i te whakawaikano Gram kua whakarerekētia. He mātāpono wehewehe kē, e hangaia ana i runga i tētahi āhuatanga kē o te pakitara, pērā i tā te whakataurite i te whakawaikano māmā me te whakawaikano Gram e whakaatu ana mō ērā atu tikanga e rua.

E toru ngā tikanga, e toru ngā pātai

Mō te whānau whānui ake o ngā tikanga huakita waikano-kotahi, tirohia te mahere whakawaikano mō te mātai karu whārahi.

Ngā mea kāore e taea te whakaū mā te whero i runga i te kahurangi

Ko te tikanga o ngā huakita rākau whero, i mau tonu i ngā rauropi te fuksini karapō ahakoa te waikawa-waipiro. E hāngai ana taua kitenga ki a Mycobacterium tuberculosis, engari e kī mārika ana ngā aratohu CDC mō te tātaritanga mate kohi he ātete-waikawa anō ētahi atu huakita maikō, nō reira me whai whakatipu huakita me te whakamātautau waikawa karihi hei tautuhi i te momo, kaua ko te tae.

Ka whakaemi ngā hapa ā-mahi ki ngā horoinga e rua. Ki te iti rawa te tango tae, ka waiho whero ngā mea o te papamuri, ka hua ai he pānuitanga tōrunga hē. Ki te nui rawa te tango tae, ka tangohia te waikano matua kāore i tino mau, ka hua ai he pānuitanga tōraro hē. Ki te kaha rawa te whakapā o te waikano tauaro, ka hunaia ngā huakita rākau tokoiti i te kahurangi. Ka tāpiri hoki ngā pani mātotoru, ngā tauhohenga kua tau mai hei totoka, me te wai horoi kua whakapokea i ō rātou ake āhua horihori.

Ahakoa te tika o te mahi, ka herea te tairongo e te nui o ngā rauropi. Me whai tata ki te 5,000 ki te 10,000 huakita rākau mō ia ritamano o te hūpē te mātai pani mā te karu whārahi tuku iho, ā, i whakatauria e ngā arotake taunakitanga CDC tawhito te tairongo o te pani ki te 45 ki te 80 ōrau pea i ngā kēhi mate pūkahukahu i whakaūngia mā te whakatipu huakita. Nō reira, kāore rawa tētahi pani tōraro e whakakore i te tūponotanga o te mate kohi. Kei ngā aratohu CDC o nāianei te whakatipu huakita hei hoa mō ia pani, ā, e taunaki ana kia whakamātauria te whakarahi waikawa karihi ki tētahi tauira pūnaha hā, neke atu rānei, ina whakaarohia te mate kohi pūkahukahu, ā, ka whakarerekētia te whakahaere i runga i te hua.

Me whai kawa kua whakamanahia ngā mahi ā-taiwhanga

Kāore ngā whakamārama whakaako, tae atu ki tēnei tuhinga, e whakamana ana i ngā mahi haumanu. Mō te mahi ā-taiwhanga, whāia te tukanga whakahaere paerewa kua manatoko o te taiwhanga, e hāngai ana ki ngā tuhinga CDC, APHL, CLSI rānei o nāianei; e whakaatu ana te tohutoro CDC mō te whakawaikano ātete-waikawa kei tōna pūranga Stacks i te āhua o te tautuhi tauhohenga me ngā pānuitanga e aua tukanga. Me whai ārai haumaru te mahi ki ngā tauira mate kohi: ka whakaritea ngā pani ki roto i tētahi kāpata haumaru koiora nā te mea ka puta he korakora rangi me te paratī i te whakaritenga, ā, e kī ana ngā aratohu haumaru taiwhanga CDC ahakoa ngā pani kua whakamaua mā te wera, tērā pea kei roto tonu he huakita rākau mate kohi ora, ā, me whakahaere tonu hei mea poke. He whakamaharatanga whai hua te tāurunga o te Puna Whakaahua Hauora Tūmatanui CDC mō tētahi pani fuksini-karapō me te kahurangi metilīni i tirohia mō M. leprae ki te whānuitanga o tēnei tikanga i tua atu i te mate kohi: ka whai hua taua tauaro whero i runga i te kahurangi i ngā wāhi katoa e rapua ana ngā rauropi ātete-waikawa, ā, ko tētahi pānuitanga tōraro āta mahia he hua e tika ana kia tuhia.

Te pānui i te kiriata kua oti

Ka kitea te painga o te waikano tauaro i te tirotiro tuatahi. I a ia e matawai ana ki te whārahinga iti, ka whakamahi tuatahi te kaitirotiro karu whārahi i te papamuri kahurangi hei aromatawai i te kounga o te pani: he tohatoha pūtau ōrite, he pūtau tōtika o te rauropi manaaki hei arotahi, kāore he totoka tau mai mātotoru. Kātahi ka tōia te karu e ngā mea whero e whakapaetia ana, nā te mea kāore he mea atu i runga i te kiriata e whero ana. Ka mahia te whakaū mā te rumaki-hinu, e whakaatu ai ngā huakita rākau tūturu i ngā āhua rākau angiangi e tūmanakohia ana, i ētahi wā he paku kōpiko, he āhua pirepire rānei, kaua ko ngā toenga waikano ōrite.

Ka whakatakoto hoki te whakawaikano papamuri i te reo o te pūrongo. Ka pūrongotia te kiriata whai huakita rākau whero hei mea kua kitea he huakita rākau ātete-waikawa, ā, he maha ngā wā ka tāpirihia he kōeke āhua ine-rahinga e ai ki te tauine o te taiwhanga. Ka pūrongotia te kiriata kāore he rauropi whero hei mea kāore he huakita rākau ātete-waikawa i kitea, kaua rawa hei mea tōraro mō te mate kohi. He mea nui te rerekētanga, nā te mea ka whakaū te papamuri kahurangi i te mahi tika o te waikano, i te kuhu o te waikano tauaro ki ngā pūtau, me te rawaka o ngā āhuatanga whatu, engari kāore he kōrero mō ngā rauropi kei raro i te paepae kitenga. Ko tētahi āpure kahurangi kāore he rauropi whero he hua whaimana mō te kiriata, ehara i te whakatau mō te tūroro.

Kia maumahara ki te wehenga o ngā mahi, ka māmā te tuhi i ngā pūrongo. Ka kitea e te fuksini karapō ngā mea e whakapaetia ana. Ka whakahaere te waikawa-waipiro i te whakamātautau. He whakamārama noa tā te kahurangi metilīni i te whakautu: i mau tonu i te whero te waikano ahakoa te waikawa, i ngaro i te kahurangi. Ko ngā mea katoa atu, arā, te momo, te nui o ngā rauropi, me te tikanga haumanu, ka ahu mai i ngā mahi kei tua atu i te kiriata.