Tuhinga
Te rangahau patu moroiti mō te kikorangi metilīni: te huakita, te harore, me te whakahohe mā te aho
Ka kite ngā kaipānui tokorua i te kīanga patu moroiti mā te kikorangi metilīni, ā, ka whakaaro rāua ki ngā mea rerekē. Ka whakaaro tētahi ki tētahi wai kikorangi e paihana ana i ngā moroiti ina pā atu. Ka whakaaro tērā atu ki tētahi tukanga e whakangaro ai te waikano me te aho whero i aua moroiti. He wāhanga pono kei ia whakaaro. Kāore tētahi e whakaatu ana i te ariā katoa, ā, ko te whakahanumi i ēnei whakaaro te take e hē ai te nuinga o ngā kerēme ā-ipurangi.
Ko taua rerekētanga te kaupapa o tēnei arotake. He āhua iti te paitini o te kikorangi metilīni i te pōuri, ina rawaka te kukūtanga. Ki te whakamahia te aho whero, ka noho hei matū whakaraerae ki te aho: ka ngongo i tētahi pūaho, ka tae ki tētahi āhua takitoru tauhohe, ā, ka kōkiri i ngā tauhohenga hāoratanga e tūkino ana i ngā whāinga maha i te wā kotahi. He ingoa ake tō taua tikanga whakahohe mā te aho, arā, te maimoatanga patu moroiti mā te aho-whakahohe, ā, he here ake anō ōna. Ehara ko te kukūtanga anake te mea e tautuhi ana i taua tikanga. Mā te roangaru, te horopeta aho, te wā whakawhāngai, te hāora, me te rauropi e whakatau te putanga.
Ngā ariā whakamate e rua
Me whakaaro tuatahi ki te ariā whakamate i te pōuri. He waikano phenothiazinium whai utu tōrunga te kikorangi metilīni. Ka piri ki ngā kahu o ngā moroiti, ka uru ki ngā pūtau i ngā rahinga rerekē, ā, ka whai wāhi ki ngā tauhohenga hāoratanga-whakahekenga me te here. Kāore he pūaho e whai wāhi ana. Ka puta te whakamate, engari ki ngā kukūtanga anake e tino rerekē ana i runga i te rauropi, ā, kāore te tikanga e aro ana ki tētahi whāinga motuhake kotahi.
Ka tāpirihia te aho e te ariā aho-whakahohe. Ka īnaki ngā pūaho whero kei te takiwā o te 630 ki te 680 nm ki te awhe ngongo o te waikano, ā, kei te tata ki te 664 nm te tihi o te waeine rāpoi kotahi. Mā te ngongo e pana te waikano ki tētahi āhua takitahi poto te ora, kātahi ki tētahi āhua takitoru roa ake te ora. Mai i reira, e rua ngā whānau tauhohenga ka whai mai. I te matū Momo I, ka whakawhiti te āhua takitoru i tētahi irahiko ki tētahi matū taketake, ka tīmata ai i ngā ara tuwhena e whai wāhi ai te superoxide me ngā momo hydroxyl. I te matū Momo II, ka whakawhiti pūngao tika ki te hāora kei tōna āhua pūtake, ka hanga ai i te hāora takitahi. Ka taea ēnei e rua te mahi i te wā kotahi, ā, he māmā rawa te kī he matū whakaputa hāora takitahi anake te waikano. Ka whakaatu tika tētahi arotake i te hononga o te hanganga me te mahi o ngā matū phenothiazinium whakaraerae ki te aho i tēnei: i waenga i ngā waikano whai pānga, kāore te paitini nā te aho ki te huakita i whai noa i te nui o te hāora takitahi i puta, nā te mea he rite te hiranga o te ngongo, te wāhi noho, me te whakahekenga ki te āhua leuco kore-mahi ki tō te ahupūngao aho. Ka whakamāramatia te matū aho kei muri i te ture roangaru i te arotake hoa mō te waikano me te aho whero.
Ko te hāora takitahi te pūtake o tētahi āhuatanga whai hua. Ka tauhohe ki ngā rāpoi koiora maha i te wā kotahi, nō reira he maha ngā take o te whakaeke, kaua ko te aro ki tētahi whākōkī kotahi, ki tētahi pūmua here rānei. Nā tētahi whakamārama tūāpapa mō te hahau patu moroiti mā te aho-whakahohe i whakaatu koinei te take kāore e nui te hiranga o ngā tauira ātete tikanga noa: kāore tētahi pūmua here penicillin tāpiri, tētahi topoisomerase kua irakētia rānei, e ārai i tētahi pakarutanga o te hāora tauhohe. I mau taua whakaaro i ngā whakamātautau ki te Staphylococcus aureus ātete ki te methicillin me ngā enterococci ātete ki te vancomycin, e whakaaturia ana i te ripanga kei raro. Ehara tēnei i te kī kāore e taea te ātete, engari he rerekē kē tōna mahi. Ka taea tonu e ngā papu pana-waho me ngā parenga ārai-hāoratanga te whakarerekē i te horopeta, otirā i ngā harore.
Te ripanga rauropi me ngā tauira rangahau
Ko tēnei ripanga te wāhanga matua o te tuhinga. He motuhake ia uara ki tōna kawa: he waikano ōrite, engari he horopeta aho, he wā whakawhāngai rerekē, ka rerekē hoki te tau. Kaua e pānui i te MBC, MLC, me te MIC hei mea whakawhiti noa tētahi ki tētahi. I konei, ko te tikanga o te MBC me te MLC, kāore he mea ora e toe ana ina whakatipuria anō, engari ko te MIC e tohu ana i te aukati tupu. Kei ia tāurunga ngā āhuatanga aho.
| Rauropi me te tauira | Putanga i te pōuri | Putanga i te aho | Ngā āhuatanga |
|---|---|---|---|
| S. aureus NCTC 6571, whakatarewa pūtau mānu | MBC 5 uM | MBC 5 uM | Ripanga arotake, aho mā 12 J per cm2 |
| S. aureus NCTC 6571, whakatarewa pūtau mānu | MLC 2.5 uM | MLC 1 uM | Kawa tuatahi o 1997, 1.7 mW per cm2 mō te 1 hāora, tata ki te 6.3 J per cm2, kākano whakatipu tata ki te 10^6 CFU per mL, i pūrongotia i te rangahau taketake mō te whakamate huakita mā te phenothiazinium me te aho |
| MRSA EMRSA-15, pūtau mānu | MBC 80 uM | MBC 20 uM | Ripanga arotake, tata ki te 12 J per cm2, e whā whakareatanga o te whakaraeraetanga |
| MRSA EMRSA-16, pūtau mānu | MBC 40 uM | MBC 10 uM | Ko taua kawa anō o runga |
| E. coli NCTC 9001, pūtau mānu | MBC 500 uM | MBC 100 uM | Ko taua kawa anō, e rima whakareatanga o te whakaraeraetanga |
| P. aeruginosa NCTC 10622, pūtau mānu | MBC 500 uM | MBC 25 uM | Ko taua kawa anō, e rua tekau whakareatanga o te whakaraeraetanga |
| E. faecalis NCTC 775, pūtau mānu | MLC 100 uM | MLC 100 uM | Kawa o 1997 ki te 6.3 J per cm2, kāore he whakapainga mō tēnei riaka me tēnei horopeta |
| E. faecium ātete ki te vancomycin, pūtau mānu | MBC 400 uM | MBC 400 uM | Ripanga arotake, kāore he whakapainga i te waikano pūtake, engari i pai ake ngā pārōnaki kua tāpirihia he rōpū metile, he kaha ake hoki te pana wai, e ai ki te rangahau enterococcus ātete ki te vancomycin |
| Candida albicans, pūtau mānu | MIC i runga ake i te 12.79 ug per mL | MIC 12.79, 6.39, me te 1.59 ug per mL ki te 5, 10, me te 15 J per cm2 | Whakawhāngai tōmua i te pōuri mō te 30 meneti, LED whero 600 ki te 650 nm, ko te tihi kei te 635 nm, e ai ki tētahi rangahau urupare ki te horopeta mō te mahi patu harore a te kikorangi metilīni mā te aho-whakahohe |
| C. albicans YEM14 me te mea whakaputa nui i ngā papu pana-waho, whakamate CFU | Kāore e hāngai ana | Tata ki te 5 log te whakamate i te riaka pūtake, tata ki te kore te whakamate i te mea whakaputa nui i te CDR1/CDR2 | Waikano 100 uM, whakawhāngai 30 meneti, 660 nm ki te 60 J per cm2, e ai ki tētahi rangahau mō ngā pānga o ngā papu pana-waho ki te whakamate mā te kikorangi metilīni me te aho |
| Ngā weu harore Trichophyton rubrum me ngā pua | Kāore e hāngai ana | MIC o ngā weu harore tata ki te 6.3 ug per mL, o ngā pua tata ki te 2.0 ug per mL; mō te aukati CFU katoa, i hiahiatia te 5 ug per mL me te 100 J per cm2 mō ngā weu harore, engari te 1.25 ug per mL me te 40 J per cm2 mō ngā pua | Kawa aho-whakahohe 635 nm, e ai ki tētahi rangahau mō te whakaraeraetanga i ngā wāhanga whanaketanga o ngā harore kiri |
| Kiriata koiora pakari o ngā momo 33 i raro i te pae niho, pūrere Calgary, rā 6 | MB anake, neke atu i te 80 ōrau te hekenga o te tatau katoa | MB me te LED 660 nm, tata ki te 55 ōrau te hekenga o te mahi pākia, kāore he whakarerekētanga whānui o te hanganga hapori | Waikano 0.01 ōrau (100 ug per mL), 660 nm ki te tata ki te 330 mW per cm2 mō te 5 meneti, whakatipu kore-hāora, e ai ki tētahi rangahau ā-taiwhanga mō te kiriata koiora ā-waha maha-momo |
E toru ngā tauira e kitea mārama ana. Tuatahi, ka mate ngā staphylococci Gram-tōrunga ki ngā taumata micromolar iti, engari i te pōuri ka hiahia ngā huakita rākau Gram-tōraro ki te tata ki te kotahi rau whakareatanga o te waikano, nā te mea ka herea te urunga e te kiriuhi o waho o ngā Gram-tōraro. Ka whakaiti te aho i te āputa, engari kāore e whakakore. Tuarua, he tūturu te mahi patu harore a te kikorangi metilīni, engari ka herea ki ngā āhuatanga: ka tino piki te whakamate i te Candida mā te kikorangi metilīni i te pikinga o te horopeta aho, ā, ka taea e tētahi panonitanga āhua kotahi, pērā i te whakaputa nui i ngā papu pana-waho, te whakakore i te whakamate 5 log i te horopeta ōrite. Tuatoru, he rerekē te whanonga o te kiriata koiora pakari i tō ngā whakatarewa pūtau; koinei te horopaki o te rārangi kiriata koiora ā-waha.
Te huakita: ngā wāhi e tino āwhina ai te aho, me ngā wāhi kāore e āwhina
Ko ngā staphylococci te tauira whakaraerae. Ahakoa ngā uara o te ripanga arotake mō te MRSA urutā, ina whakamahia te aho, kei te taumata ōrite, kei raro rānei i te uara whakataurite vancomycin. I pai ake anō ngā pārōnaki kua tāpirihia ngā rōpū metile e rua, nā te mea i whakapiki te tāpiri metile i te rata ki te ngako me te putanga hāora takitahi, me te ātete hoki ki te whakahekenga ki te āhua leuco. He mea nui taua taipitopito matū: e whakaatu ana he hua te whakamate nō te kawe matū me te ahupūngao aho, ehara nō te ahupūngao aho anake.
Ka whakaaturia e ngā rauropi Gram-tōraro te wāhanga kawe matū. I hiahiatia e te Pseudomonas te 500 uM i te pōuri me te 25 uM i te aho, arā, e rua tekau whakareatanga te whakapainga, engari kei runga rawa tonu te uara whai aho i te awhe o ngā staphylococci. Mā te utu tōrunga e āwhina te waikano ki te whakatata ki te kiriuhi o waho, engari ko te kuhu tonu te here. He nui ake te whakarerekētanga o ēnei tau mā te hanganga ranunga, te wā whakawhāngai, me te kōwhiringa pārōnaki i tō te whakamahi anō i taua waikano ki tētahi horopeta teitei ake.
Ko ngā enterococci te tauira whakatūpato. I raro i ngā kawa tawhito, kāore rawa te E. faecalis i whai painga i te aho, ā, i hiahiatia e te E. faecium ātete ki te vancomycin tētahi rāpoi kē, kaua ko te aho nui ake. E hē ana te pānui a te tangata e whakahua ana i tētahi MBC kikorangi metilīni kotahi hei uara pūmau whānui mō te patu huakita. Kāore he uara pūmau pēnā. He uara anake e motuhake ana ki te riaka, te reo whakatipu, te kākano whakatipu, te wā whakawhāngai, te roangaru, me te pūngao aho mō ia horahanga. Kei te aratohu whakamāori ānau whakamate te whakamārama mō te pānui i aua uara me te kore e whakapohehe i a koe anō.
Te harore: he whakaraerae, engari mā te wāhanga whanaketanga me ngā papu e whakatau
He rerekē te raruraru ngongo o ngā pakitara harore, he glucan, he mannan, he chitin ō roto, i tō ngā huakita, ā, he parenga hohe anō tō ngā harore. Ko te putanga pana-waho o te Candida i runga ake te tauira tino mārama: he waikano ōrite, he aho ōrite, he reo whakatipu ōrite, engari i ora te mea whakaputa nui i ngā papu, i te mea i ngaro te tata ki te 99.999 ōrau o ngā waeine hanga koroni o te riaka pūtake. Ka tāpirihia e ngā harore kiri tētahi āhuatanga whanaketanga. He tino māmā ake te whakamate i ngā pua i ngā weu harore, nō reira ka taea e tētahi kawa te whakakore i ngā pua, engari ka waiho tonu i ngā kongakonga weu harore e ora ana i taua horopeta anō.
Koia te take me whai ngā pūrongo patu harore mō te kikorangi metilīni i ngā here aho ōrite ki ērā o ngā pūrongo huakita. I ngā rangahau haumanu aho-whakahohe mō ngā maikuku me te kiri, i honoa te waikano 1 ki te 2 ōrau ki te aho whero kua inea, me ngā pūngao aho mō ia horahanga kua tautuhia me te aroturuki whai muri. I wehewehea hoki te āhua haumanu i te whakakorenga harore. Ka arotakengia aua whakamātautau i te whakarāpopototanga taunakitanga aho-whakahohe mō ngā harore maikuku me te kiri. Mā te pani waikano waimeha ki tētahi wāhi pāngia i te aho o te rūma e puta anō ai te tae, engari ka mahue te tukanga.
Te arowhai kiriata koiora: he tauira ā-waha 33 momo
Me aro ki te rangahau kiriata koiora ā-waha maha-momo o 2024, nā te mea ka whakamātau i te āhuatanga uaua, kaua i te mea māmā. E toru tekau mā toru ngā momo ā-waha, tae atu ki te Porphyromonas gingivalis, Tannerella forsythia, Aggregatibacter actinomycetemcomitans, Fusobacterium, me ngā streptococci ā-waha, i tipu kore-hāora hei kiriata koiora pakari i te rā 6. Ko te maimoatanga he waikano 0.01 ōrau me te LED 660 nm mō te 5 meneti, ki te kaha aho teitei. I tino whakaheke te waikano anake me te aho anake i ngā tatau katoa, ā, nā te huinga i whakaheke te mahi pākia ki te tata ki te haurua, engari kāore te hanganga o te hapori i rerekē, kāore hoki te kiriata koiora i whakakorengia katoatia ōna moroiti.
He pānga tūturu tērā, he here pono hoki tōna. E tautoko ana i te maimoatanga aho-whakahohe hei āpiti ā-rohe i roto i tētahi kōhao pae niho kua horoia, ehara hei wai horoi waha e maimoa takitahi ana i te periodontitis kua tautohua. Mā konei tātou e tae ai ki te āputa whānui.
He aha te whakamate ā-taiwhanga e kore ai e ōrite ki te maimoatanga
I te whakamātautau MBC o ngā pūtau mānu, ka pāngia ngā pūtau ōrite e te waikano ōrite me te aho ōrite i roto i tētahi reo whakatipu whai hāora. Kāore tētahi wāhi pāngia e tuku i aua āhuatanga. Ka whakaroa te kupenga i te urunga, ka whakamanawanui ngā āhua rite ki ngā pūtau manawaroa i te hāoratanga, ka ngongo te toto me te wai rere i te aho, ka waiho e te hanga o te kiko he wāhi taumarumaru, ā, ka whakaiti ngā kōhao iti-hāora i te mahi matū Momo II, nā te mea e hiahiatia ana te hāora rāpoi hei whakaputa i te hāora takitahi. Ka tāpirihia e ngā whakapokenga whakauru ngā momo e rerekē ana te ngongo me te whakaraeraetanga, nō reira kāore tētahi uara riaka tohutoro kotahi e āhei ki te whakaatu i te wāhi katoa.
Ka whakamārama te tauira ā-waha i taua āputa. Ko te whakaheke i te Porphyromonas, i ngā streptococci rānei, i roto i tētahi rīhi, ko te pehi rānei i tētahi kiriata koiora kua whakatipuria kia heke ki te haurua, kāore e whakaū ana ka maimoa tētahi wai horoi kikorangi i te periodontitis, ka whakaora i tētahi whakapokenga o roto i te niho, ka whakakore rānei i te huakita i roto i te toto. E whakawhirinaki ana te tiaki haumanu i ngā kiko tautoko niho ki te wawahi ā-tinana me te tango i te kiriata koiora, me te whakahaere i te hanga o te kōhao pae niho. E rangahautia ana te maimoatanga whai aho hei āpiti ā-rohe. Kāore he hononga pūmau i waenga i te kukūtanga waikano e whakamate ana i roto i tētahi kōhao whakamātautau me te kukūtanga ka tae ki ngā huakita i raro i te pae niho, ā, ehara te aho o te rūma i te horopeta 660 nm. Mā tētahi mātanga haumanu e whakahaere ngā here horopeta, haumaru, me ngā pāhekoheko mō te whakamahinga ā-waha, e ai ki te tohutoro haumaru me ngā pāhekoheko.
Ngā mea kāore e whakaaturia ana e ēnei taunakitanga
Ehara tēnei i te kerēme mō te whakakore moroiti ā-whare. Ka whakamahi ngā ripanga patu huakita i ngā riaka, ngā reo whakatipu, ngā wā pānga, ngā awhe aho, me ngā pūngao aho mō ia horahanga kua tautuhia. Kāore aua ripanga e kōrero mō ngā mata kīhini, mō ngā wā pānga e hiahiatia ana i roto i te paru matū waro, mō ngā paerewa ā-ture whakakore moroiti rānei.
Ehara hoki i te whakakapi mō ngā paturopi e mahi ana puta noa i te tinana. E hiahiatia ana e te mahi aho-whakahohe tikanga noa te waikano, te aho kua ngongohia, me te hāora ki te wāhi kotahi i te wā kotahi. Kāore te aho e tae ki ngā wāhi hōhonu, ki ngā wāhi marara rānei, pēnei i te rongoā kua horomia e tae ana ki te toto. Ka whakatakotoria tēnei huarahi e ngā tuhinga rangahau mō te whakapokenga ā-rohe ka taea te toro atu, hei āpiti rānei, pērā tonu i tā Wainwright whakatakoto i te whakakore moroiti ā-rohe mai i te tīmatanga.
He whāiti ake te whakarāpopototanga tōkeke, engari he mea whakamere tonu. He āhua iti te mahi patu moroiti a te kikorangi metilīni i te pōuri, ā, ka whakatuwhera te aho whero i tētahi pānga aho-whakahohe nui ake mō ngā huakita me ngā harore maha. He nui ngā ōwehenga aho ki te pōuri, pērā i te 500 ki te 25 uM mō te Pseudomonas me te 80 ki te 20 uM mō te MRSA urutā, me ngā korenga whai hua e whakaako ana i roto i ngā enterococci me te Candida whai kaha pana-waho. He rite te mana whakahaere o te kawe matū, te whaiaroaro o te kiriata koiora, me te hāora ki tō te kukūtanga waikano kua tohua, i te whakawhiti ki te whakamahinga. Kia kitea tonutia aua āhuatanga, ka whai tikanga ngā tau. Ki te tangohia, ka kore he tikanga.