Txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov me nyuam: cov tshuaj tiv thaiv thiab tawm tswv yim

Raws li LEEJ TWG, pneumococci feem ntau ua hauj lawm ntawm tus kab mob kab mob nyob rau hauv tib neeg. Niaj hnub no, txheeb cais yog tias tus kab mob yog qhov ua rau ntawm kev tuag rau 1.2 lab. Cov neeg thoob plaws hauv lub xyoo. Ntawm no naj npawb ntawm cov neeg ntau tshaj 40% cov me nyuam nyob rau hauv 5 lub xyoos ntawm hnub nyoog. Ntawm qhov thiaj li hu zej zog-kis tau mob ntsws, tus xov tooj uas nyob rau hauv Lavxias teb sab ib tug thiab ib tug ib nrab lab ib xyoos, mus txog rau 75% ntawm cov neeg ntawm cov neeg laus pib cov kab mob - pneumococci. Nrog kev xav txog cov me nyuam nyob rau hauv lub hnub nyoog pab pawg neeg ntawm mus txog rau 5 xyoos, muaj ib tug feem pua ntawm cov kev koom tes nyob rau hauv tus txheej txheem ntawm pneumococci nce mus txog 90.

Tag nrho cov me nyuam muaj mob otitis uas ua degrees ntawm heev. Kwv yees li 30-35% ntawm txhua tus neeg mob mob otitis xov xwm nyob rau hauv cov tub ntxhais cov neeg mob yog pib los ntawm pneumococci. Cov kab mob no yog yus muaj los ntawm lawv cov qib high lub ntiajteb txawj nqus txaus nrog lub siab yuav qhov muaj tseeb ntawm perforation ntawm lub nruas ntsej. Feem ntau koj yuav tau hnov los ntawm cov kws txawj txog txoj kev loj hlob orthogene intracranial teeb meem, yuav tau tshem ntawm uas yuav tsum tau nqa tawm nquag txaus tympanostomy. Tus txheej txheem yog ib tug phais pab rau pab ntawm nruab nrab pob ntseg kab noj hniav thiab es ua kom cov hauj lwm ntawm nruab nrab pob ntseg pob txha.

Txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov neeg laus thiab cov me nyuam muaj peev xwm ho txhim kho qhov teeb meem no nrog cov xwm txheej ntawm no initiator.

Tus kab mob pneumococcal: uas yog leej twg?

Tus kab mob Streptococcus pneumoniae yog ib tug ntawm lub Cheebtsam ntawm lub qub microflora ntawm lub Upper pa system ntawm ib tug neeg noj qab nyob. Mus txog rau 70% ntawm cov pejxeem - nws txhawb ntau tshaj ib hom ntawm microorganism. Cov me nyuam, cov theem ntawm lub 'neeg zej zog' yog siab tshaj cov neeg laus. Cov qib siab tshaj plaws ntawm carriage ntawm cov neeg uas nyob, ua hauj lwm thiab loj hlob nyob rau hauv pab pawg (pre-tsev kawm ntawv thiab cov tsev kawm ntawv, ua hauj lwm pab pawg, thiab lwm yam).

Qhov no kab yog muaj li ntawm ib tug polysaccharide capsule hais tias yog muaj peev xwm mus suppress cov kev loj hlob ntawm kev tiv thaiv nyob rau hauv cov me nyuam yau tshaj 2 xyoos. Niaj hnub no, science paub txog lub hav zoov ntawm 84 subtypes ntawm pneumococcus. Nrog rau txoj kev loj hlob ntawm lub era ntawm tshuaj tua kab mob yog heev txawm microbe tus kab mob Streptococcus pneumoniae tau ua ib tug ncaj txhoj puab heev kab mob resistant rau tsoos tshuaj tua kab mob tej tshuaj. Cov theem ntawm kuj mus penicillin yog tam sim no nyob ib ncig ntawm 50%, rau chloramphenicol thiab tetracycline - 30%. Txij li thaum lub penicillin pab pawg neeg ntawm tshuaj tua kab mob yog dav txaus, ces lawv yuav tsis tau ntawm kis kab mob xws li pneumococcus. Txhaj tshuaj tiv thaiv nyob rau hauv xws li mob - tsuas yog txoj kev los yeej muaj tsawg heev losses nyob rau hauv sib ntaus tawm tsam no microorganism. Nws yog ib nqi hais tias tus kab mob feem ntau yog muaj sai heev (feem ntau yog tsis muaj ntau tshaj li 3 hnub), thiab lub sij hawm ua kev tshawb fawb rau lub ntsiab txhais ntawm cov neeg kawm ntawv ntawm rhiab heev rau tej hom tshuaj tua kab mob yog tsis tam sim no.

Tam sim no rau lo lus nug pneumococcal kuj mus tshuaj tua kab mob yog ua nce tseem ceeb heev, nws yog ua ntau thiab ntau ceev teeb meem.

Yuav ua li cas hom tshuaj tiv thaiv yog siv?

Tam sim no, Russia siv ob hom tshuaj tiv thaiv rau ib txoj kev xws li txhaj tshuaj tiv thaiv tiv thaiv pneumococcal kab mob: polysaccharide thiab conjugated mus protein formulations.

Cov thawj pab pawg neeg (polysaccharide) yog qhov zoo tshaj plaws lub npe hu tshuaj tiv thaiv Pneumo-23 (sanofipaster). Cov tshuaj yog ib tug sib tov ntawm 23 ntawm lim polysaccharide los ntawm serotypes zoo xws li cov nqi. Qhov no pab pawg neeg ntawm serotypes yuav xyuam xim ntaus nqi 90% ntawm cov txiag los ntawm cov ntshav, thiab feem coob ntawm cov kab mob los qhia tau nyob rau hauv lub chaw uas zoo heev ntawm Russia. Tam sim no nyob rau theem ntawm kev cuv npe yog lwm zoo xws li cov tshuaj tiv thaiv - "Pneumovax-23."

Los ntawm daim ntawv ntawm conjugated tshuaj tiv thaiv nyob rau hauv Russia twb officially sau npe thiab yog tam sim no nyob rau hauv kev siv "Prevenar 7". Xya serotypes muaj nyob rau hauv nws cov muaj pes tsawg leeg, ua ke 87% ntawm pneumococcal txiag tau lawm mob cov me nyuam los ntawm lub tebchaws United States thiab lwm yam lub teb chaws. Vim lub fact tias serotipovaya daim duab nyob rau hauv lub tebchaws United States thiab Russia yog suab tib yam, peb tau tias hais tias "Prevenar 7" kuj yuav siv tau nyob rau hauv Lavxias teb sab Federation, raws li zoo raws li nyob rau hauv lub tebchaws United States.

Lub hnub nyoog ntau rau txhaj tshuaj tiv thaiv tiv thaiv pneumococcus

"Pneumo-23" rau txhaj tshuaj tiv thaiv yog tsim los siv ib zaug subcutaneously los yog intramuscularly. Yuav txhaj tshuaj tiv thaiv pib los ntawm 2-hletnego muaj hnub nyoog, ntau npaum - 0.5 ml. Re-txhaj tshuaj tiv thaiv yuav nqa tawm tsis ntxov tshaj li tom qab 3 lub xyoos tom qab kawg txhaj tshuaj.

Txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov me nyuam siv "Prevenar 7" yog tau nrog 2-hmesyachnogo muaj hnub nyoog. Txhaj tshuaj tiv thaiv yog nqa tawm nyob rau hauv thaum uas tig mus nrog cov DTP (nyob rau hauv 3 theem). Revaccination yuav tsum tau ua nyob rau hauv ib tug me nyuam hnub nyoog 1.5 xyoos. Txawm li cas los, qhov no hom ntawm tshuaj tiv thaiv, muaj ntau ntau scenarios ntawm txhaj tshuaj tiv thaiv. Muaj yog cov ntaub ntawv nyob rau hauv cov hauj lwm zoo ntawm txhaj tshuaj tiv thaiv nyob rau hauv 2 theem (tsis pub dhau lub 2nd ib nrab-xyoo), ua raws li los ntawm ib tug koob. Tsis tas li ntawd muaj nyob nrog cov txhaj tshuaj tiv thaiv tswvyim nyob rau hauv 2 theem thaum lub sij hawm thib ob xyoo ntawm lub neej, thiab ib zaug rau ib lub sij hawm ntawm 2 mus rau 5 xyoo.

Cov theem ntawm kev tiv thaiv polysaccharide tshuaj tiv thaiv

High miv nyuas siv zug nyob rau hauv cov kev tiv thaiv ntawm mob ntsws pom ib tug tshuaj tiv thaiv pneumococcal kab mob. Xyuas cov statistical cov tub ceev xwm hais txog 80 rau ib xees kev tiv thaiv. Kws txawj-epidemiologists kom txhaj tshuaj tiv thaiv nrog "Pneumo-23" cov neeg hnub nyoog 18 mus rau 21 xyoos nyob rau hauv loj lub koom haum thiab cov pab pawg (xws li cov tub rog units). Tom qab ib tug tej lub sij hawm ntawm lub sij hawm (2 mus rau 5 lub hlis) tom qab txhaj tshuaj tiv thaiv yeej yuav tau txais ib tug txo nyob rau hauv cov xwm txheej ntawm mob ua pa kab mob nyob rau hauv ntau tshaj li 2-fold npaum li cas, ntsws - txog li 13 lub sij hawm, mob ntsws - tsis tsawg tshaj li 6 lub sij hawm. Nyob rau hauv nyuab mob ntsws, meningitis thiab lwm yam ntaub ntawv ntawm cov pneumococcal kab mob efficiency feem pua yog hom twg los ntawm 56 mus 81.

Cov theem ntawm cov hauj lwm zoo ntawm ib txoj kev xws li txhaj tshuaj tiv thaiv tiv thaiv pneumococcus, muaj feem xyuam rau cov muaj hnub nyoog ntawm vaccinees. Nyob rau hauv lub hnub nyoog pab pawg neeg mus rau 55 xyoo, cov duab yog 93%, los ntawm 55 mus rau 64 xyoo lub efficiency poob mus rau 88%. Cov theem ntawm kev tiv thaiv tiv thaiv pneumococcus nyob rau hauv lub hnub nyoog ntawm 65 xyoo mus 74 - 80%, 75 xyoos ntawm hnub nyoog - 67%.

Rau cov neeg mob kev txom nyem los ntawm cov hlab plawv tus thiab broncho-pulmonary kab mob, cov theem ntawm kev tiv thaiv nrog polysaccharide tshuaj tiv thaiv (tshwj xeeb yog "pneumo-23") yog kwv yees li 69% (raws li nyob rau hauv kev noj qab nyob tib neeg). Qhia ib tug high degree ntawm efficiency ntawm xws li ib tug tshuaj tiv thaiv thaum siv nyob rau hauv cov me nyuam pab pawg. Zoo kawm qhia tau hais tias "Pneumo-23" nyob rau hauv ua ke nrog nrog kab mob khaub thuas tshuaj tiv thaiv.

Hais txog lwm yam tshuaj tiv thaiv siv nyob rau hauv Lavxias teb sab - "Pneumovax-23" - yuav tau hais tias nws cov miv nyuas siv zug rau cov neeg uas muaj mob ntshav qab zib yog 84%, nrog ischemia - 73%. Rau cov neeg mob kev txom nyem los ntawm lub plawv tsis ua hauj lwm, qhov no feem pua yog 69, nrog distressed ntsws thiab mob ntsws nqias - 65 rau cov txiv neej nyob rau hauv lub hnub nyoog pab pawg neeg tshaj 65 xyoo ntawm cov hauj lwm zoo ntawm cov tshuaj nyhav mus rau 75%.

Cov theem ntawm kev tiv thaiv conjugate tshuaj tiv thaiv

Nrog rau kev siv ntawm conjugate tshuaj tiv thaiv txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov me nyuam pom ib tug high degree ntawm efficiency. Significantly txo tsis tau tsuas yog lub xov tooj ntawm lub tsev kho mob thiaj nkag tau mus ntawm cov me nyuam nrog mob ntsws ntawm tej keeb kwm, tab sis kuj cov zaus ntawm pw mus ntsib mus rau tus kws kho mob. Ho paub qhov teeb meem no morbidity pneumococcal meningitis.

Pneumococci yog haum resistant rau penicillin. "Prevenar-23" yog tau los tiv thaiv tiv thaiv kab mob los nrog intermediate thiab siab stability yog 80-100%. Nyob rau hauv tas li ntawd, qhov no tshuaj tiv thaiv nrog high efficiency ua ke nrog ib tug kev faib ua feem ntawm qhov kab mob npaws.

Raws li lub ntiaj teb Health Organization, txoj kev siv cov conjugate vaccine rau ib txoj kev xws li ib tug txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov me nyuam (tag nrho cov nyob rau hauv 72 lub teb chaws tsim nyob ib ncig ntawm lub ntiaj teb no), muaj peev xwm tiv thaiv kom txhob mus txog 407.000 cov neeg tuag txhua xyoo.

Tau tshua rau txhaj tshuaj tiv thaiv

Txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal tshwj xeeb muaj cai ua nyob rau hauv txhua lub sij hawm ntawm lub xyoo thiab ua ke nrog lwm yam tshuaj tiv thaiv (ib tug kos yog ua tau tsuas yog rau koob tshuaj BCG lawm). Nyob rau thawj coj ntawm ob hom tshuaj tiv thaiv tiv thaiv tej yam pneumococci tau lus teb los ntawm tib neeg lub cev. Nyob rau hauv "Pneumo-23" nyob rau hauv ib tug neeg cov neeg mob tej zaum yuav tshwm sim hauv zos cov tshuaj tiv thaiv nyob rau hauv daim ntawv ntawm cov tawv nqaij liab, mob. Cov kev siv ntawm lub tshuaj tiv thaiv no feem ntau yog tsis muaj zog thiab yuav kav mus txog 48 teev. Txhaj tshuaj tiv thaiv tiv thaiv pneumococcal tus me nyuam (xyuas ntawm kev noj qab nyob neeg ua hauj lwm thiab cov niam txiv nyob rau hauv daim ntawv cog lus nyob rau hauv no taw tes) nyob rau hauv tej rooj plaub (tsis yog feem ntau) yuav ua rau ib tug pob, mob nyob rau hauv cov pob qij txha.

Muaj mob qhov twg cov neeg mob uas idiopathic thrombocytopenic purpura (nyob rau hauv ib tug nyob ntsiag to theem) tom qab ib lub sij hawm ntawm los ntawm 2 mus rau 14 hnub, tsim recurrences extending mus txog 2 lub lis piam. Nws yog heev tsawg hnov txog anaphylactic lub xeev.

Qhov tshuaj tiv thaiv "Prevenar" yog yus muaj los ntawm ib tug zoo me nyuam txoj kev tolerability. Xws li ib tug tshuaj tiv thaiv pneumococcal kab mob mob (peb yuav sib tham txog tej yam teeb meem loj), raws li ib tug txoj cai, tsis ua. Txawm li cas los, feem ntau heev manifested raws li hauv zos tshua txob taus, pw tsis taus, laus lossis puas liab liab thiab o, nce nyob rau hauv lub cev kub rau 38 C. Ib tug me me muaj pes tsawg tus ntawm cov me nyuam (5%), qhov kub thiab txias yuav sawv saum toj no 39˚ C.

Puas muaj tej contraindications rau txhaj tshuaj tiv thaiv tiv thaiv pneumococcus?

Tej kev los yog tshwj xeeb contraindications rau txhaj tshuaj tiv thaiv tsis yog rau ib yam ntawm cov tshuaj tiv thaiv, tsuas yog hais tias cov tshuaj tiv thaiv rau qhov tshuaj tiv thaiv pneumococcal kab mob nyob rau hauv lub yav dhau los lub sij hawm. Muaj ib co tswv yim pom zoo nyob rau kev siv ntawm Immunology "Pneumo-23" yog tsis tsawg tshaj li 10 hnub ua ntej ib lub chav kawm ntawm immunosuppressive txoj kev kho pib. Tsis ua raws li cov lus qhia no tej zaum yuav txhawb ib tug txo nyob rau hauv antibody theem.

Txhaj tshuaj tiv thaiv ntawm cev xeeb tub cov poj niam noj qab haus huv neeg ua hauj lwm muaj cai tsuas yog nyob rau hauv lub kawg peb lub hlis. Txawm li cas los, tshwj tsis yog tias tsim nyog kiag li, nws yog pom zoo kom txhob txoj kev ua no.

Cov xwm txheej ntawm cov kab mob pneumococcal: ib pab pawg neeg ntawm kev pheej hmoo

Txoj kev ntawm ib tug txheej txheem xws li ib tug txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal? teeb meem rau tej pab pawg ntawm cov neeg muaj peev xwm ua rau ntau tshaj nws tus cwj pwm. Kws txawj pom zoo kom tas txhaj tshuaj tiv thaiv cov neeg uas muaj hnub nyoog ntawm 65. Nyob rau hauv ib co teb chaws uas tsim, txhaj tshuaj tiv thaiv ntawm no muaj hnub nyoog pab pawg neeg mus rau lub nyob qib yuav tsum tau cov txheej txheem.

Yuav tsum tau txhaj tshuaj tiv thaiv pneumococcal tsis muaj zog txaus, sickly thiab yuav raug pw tsev kho mob ntawm cov neeg uas muaj mob ntshav qab zib, mob ntsws, tsis muaj peev xwm nyob rau hauv mob thiab ua pa ua si, cov hauj lwm ntawm lub siab.

Xav tau ib tug txhaj tshuaj tiv thaiv tiv thaiv pneumococcus (paramedics xyuas - pov thawj ntawm) cov neeg uas muaj tsis muaj zog txaus tiv thaiv kab mob systems. Ntawm no yuav raug cov neeg mob uas muaj undergone phais rau qhov kev tshem tawm ntawm tus po, kev txom nyem los ntawm nephrotic syndrome, sickle-cell anemia. Tsis tas li ntawd, qhov no pab pawg neeg no muaj xws li cov neeg uas tau raug to txha caj kua.

Thiab, ntawm chav kawm, tsis txhob hnov qab txog cov loj hlob rau tiam. Txhaj tshuaj pom zoo sickly cov me nyuam (xws li cov neeg raug tus kab mob tus kab mob ntsws), mus txog rau hauv ib pawg loj loj (tim, kindergarten, tsev kawm ntawv). C. 2-hletnego hnub nyoog podiatrists qhia kom txhaj tshuaj hluas cov neeg mob kev txom nyem liquorrhea, asplenic, tsis muaj peev xwm ntawm complement cheebtsam uas tau dhau mus lawm txoj kev ntawm cochlear implant.

Txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal rau cov me nyuam muaj peev xwm txo tau cov kev siv ntawm cov kab mob thiab txo tau lub neej los ntawm no txaus ntshai microorganism.

Raws li kws kho mob, cov neeg mob, cov niam txiv

Tswv yim pediatricians, kev kho mob cov tub txawg nyob rau hauv ntau lwm teb ntawm cov tshuaj nyob rau hauv lo lus nug no unequivocally - txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal (xws li xyuas txog twg sab ntawm zoo tib yam townsfolk yog heev tsis meej xwm) - yog yuav tsum tau. Cov kws kho mob xav txog qhov no txoj kev tiv thaiv uas zoo tshaj plaws nyob rau hauv sib ntaus tawm tsam loj cov kab mob sib txawv heev etymology. Nws yog ib txwm yooj yim dua thiab tsawg kim los mus tiv thaiv tus kab mob no dua li noj tshuaj (ntau tshaj ib tug, thiab feem ntau ob peb los yog feem ntau inoffensive) los tswj thiab feem ntau kab mob thiab qhov zoo thiab cov teeb meem.

Cov niam txiv cov menyuam yaus muaj zog tswv yim rau txhaj tshuaj tiv thaiv tiv thaiv pneumococcus yog tsis ib txwm resonate. Ib tug yooj yim txiv neej, tsis yog ib tug kws kho mob, ua tsaug rau media "tseeb paub" hais tias kab mob los ntawm pneumococcus yog heev ntau yam, thiab seb qhov tshuaj tiv thaiv yuav tiv thaiv ib tug me nyuam, uas yog pom zoo los ntawm cov kws kho mob - lub loj lo lus nug. Txawm hais tias feem coob ntawm cov niam txiv tseem yuav mloog mus rau lub tswv yim ntawm ib tug kws thiab mus txhaj tshuaj tiv thaiv.

Los ntawm lub sij hawm rau lub sij hawm koj yuav hnov hais tias txhaj tshuaj tiv thaiv tiv thaiv tus kab mob pneumococcal, teeb meem ntawm uas muaj nyob rau hauv raising qhov kub thiab txias tsis zoo - tus me nyuam yog tseem muaj mob. Nyob rau hauv xws li mob nws yog tsim nyog them sai sai mus rau tus siv ntawm tus kab mob. Yog hais tias tus me nyuam yog hnoos, nws muaj ib tug kub mus txog 38 degrees, thiab nws yog muaj mob 7 hnub - qhov no yog to taub. Yog tsis muaj txhaj tshuaj tiv thaiv txim yuav muaj ntau zuj zus, bronchitis, mob ntsws, pw tsev kho mob, muaj ntau yam tshuaj yog tsis tau qhov uas yooj yim, thiab tsawg kawg yog 21 hnub ntawm kev kho mob.

Summing li

Tus kab mob pneumococcal ua nyob ib ncig ntawm lub ntiaj teb no rau txoj kev loj hlob ntawm mob ua pa kab mob, obstructive tus kab mob ntsws, thiab lwm yam Thiab niaj hnub no, nyob rau hauv lub niaj hnub high-tech muaj hnub nyoog, cov lub neej no tus nqi ntawm no microorganism yog siab txaus. Yog li ntawd, ib feem ntawm cov niam txiv txhaj tshuaj tiv thaiv tiv thaiv pneumococcus tus me nyuam (cov tswv yim - tsis zoo ntawm cov ntaub ntawv uas yuav tsum tau ua nyob rau hauv xws li mob) - qhov no yog ib lub sij hawm los mus tiv thaiv nws tus me nyuam, los mus tiv thaiv cov kev loj hlob ntawm loj cov kab mob nyob rau hauv far-fetched, tsis txhob muaj nyob rau hauv nws tus kheej tsis muaj pov thawj, pretexts.