{"id":13326,"date":"2011-10-10T06:10:53","date_gmt":"2011-10-10T06:10:53","guid":{"rendered":"http:\/\/chanhkien.org\/?p=13326"},"modified":"2012-05-28T07:00:28","modified_gmt":"2012-05-28T07:00:28","slug":"suy-ngam-ve-hien-tuong-vi-khuan-khang-thuoc","status":"publish","type":"post","link":"https:\/\/chanhkien.org\/2011\/10\/suy-ngam-ve-hien-tuong-vi-khuan-khang-thuoc.html","title":{"rendered":"Suy ng\u1eabm v\u1ec1 hi\u1ec7n t\u01b0\u1ee3ng vi khu\u1ea9n kh\u00e1ng thu\u1ed1c"},"content":{"rendered":"<p><strong>[Chanhkien.org]<\/strong> Ph&aacute;t minh ra thu&#7889;c kh&aacute;ng sinh l&agrave; m&#7897;t trong nh&#7919;ng &#273;&#7897;t ph&aacute; l&#7899;n c&#7911;a y h&#7885;c hi&#7879;n &#273;&#7841;i. Nh&#7901; &#273;&oacute;, r&#7845;t nhi&#7873;u c&#259;n b&#7879;nh nhi&#7877;m tr&ugrave;ng &#273;&atilde; tr&#7903; n&ecirc;n c&oacute; th&#7875; ki&#7875;m so&aacute;t &#273;&#432;&#7907;c m&#7897;t c&aacute;ch h&#7919;u hi&#7879;u. Tuy nhi&ecirc;n, s&#7921; gia t&#259;ng trong ti&#7871;p th&#7883; v&agrave; s&#7917; d&#7909;ng thu&#7889;c kh&aacute;ng sinh &#273;&atilde; khi&#7871;n hi&#7879;n t&#432;&#7907;ng vi khu&#7849;n kh&aacute;ng thu&#7889;c tr&#7903; th&agrave;nh m&#7897;t v&#7845;n &#273;&#7873; nghi&ecirc;m tr&#7885;ng trong y h&#7885;c hi&#7879;n &#273;&#7841;i. T&#7889;c &#273;&#7897; ph&aacute;t tri&#7875;n c&#7911;a c&aacute;c lo&#7841;i thu&#7889;c kh&aacute;ng vi khu&#7849;n m&#7899;i c&#361;ng kh&ocirc;ng th&#7875; b&#7855;t k&#7883;p s&#7913;c c&#259;ng c&#7911;a vi khu&#7849;n kh&aacute;ng thu&#7889;c. R&#7845;t nhi&#7873;u nh&agrave; khoa h&#7885;c &#273;&atilde; b&#7855;t &#273;&#7847;u lo l&#7855;ng v&#7873; n&oacute;, v&agrave; h&#7885; r&#7845;t n&#7895; l&#7921;c t&igrave;m c&aacute;ch gi&#7843;i quy&#7871;t v&#7845;n &#273;&#7873; nan gi&#7843;i n&agrave;y.<\/p>\n<p>Trong qu&aacute; tr&igrave;nh &#273;i&#7873;u tr&#7883; c&aacute;c c&#259;n b&#7879;nh nhi&#7877;m tr&ugrave;ng, t&ocirc;i &#273;&atilde; quan s&aacute;t m&#7897;t hi&#7879;n t&#432;&#7907;ng ph&#7893; bi&#7871;n x&#7843;y ra trong r&#7845;t nhi&#7873;u tr&#432;&#7901;ng h&#7907;p &#273;&#432;&#7907;c b&aacute;o c&aacute;o. &#272;&oacute; l&agrave; c&aacute;c b&#7879;nh nh&acirc;n b&#7883; nhi&#7877;m vi khu&#7849;n kh&aacute;ng thu&#7889;c kh&aacute;ng sinh th&#432;&#7901;ng c&oacute; di&#7877;n bi&#7871;n b&#7879;nh nghi&ecirc;m tr&#7885;ng h&#417;n. C&aacute;c b&#7879;nh nh&acirc;n n&agrave;y th&#432;&#7901;ng c&oacute; ti&#7873;n s&#7917; s&#7917; d&#7909;ng li&ecirc;n ti&#7871;p thu&#7889;c kh&aacute;ng sinh v&agrave; c&#361;ng c&oacute; r&#7845;t nhi&#7873;u c&#259;n b&#7879;nh kh&aacute;c [1-3]. &#272;i&#7873;u n&agrave;y khi&#7871;n ng&#432;&#7901;i ta c&#7843;m th&#7845;y nhi&#7877;m tr&ugrave;ng b&#7903;i vi khu&#7849;n kh&aacute;ng thu&#7889;c l&agrave; &ldquo;d&#7919; d&#7897;i h&#417;n&rdquo;. T&#7841;i sao? &#272;&oacute; l&agrave; b&#7903;i v&igrave; vi khu&#7849;n kh&aacute;ng thu&#7889;c &#273;&#7897;c h&#417;n? R&#7845;t nhi&#7873;u th&iacute; nghi&#7879;m l&acirc;m s&agrave;ng v&agrave; ki&#7875;m nghi&#7879;m &#273;&#7897;c t&iacute;nh &#273;&atilde; cho th&#7845;y g&#7847;n nh&#432; kh&ocirc;ng c&oacute; kh&aacute;c bi&#7879;t gi&#7919;a s&#7913;c c&#259;ng kh&aacute;ng c&#7921; v&agrave; nh&#7841;y c&#7843;m gi&#7919;a ch&uacute;ng [4,5]. V&#7853;y th&igrave; ch&uacute;ng ta l&yacute; gi&#7843;i hi&#7879;n t&#432;&#7907;ng n&agrave;y nh&#432; th&#7871; n&agrave;o?<\/p>\n<p>Hi&#7875;u bi&#7871;t c&#7911;a t&ocirc;i v&#7873; hi&#7879;n t&#432;&#7907;ng ngh&#7883;ch l&yacute; n&agrave;y &#273;&#7871;n t&#7915; <a class=\"lar-automated-link\" href=\"https:\/\/chanhkien.org\/chu-giai-tu-vung#phap_luan_dai_phap\" rel=\"nofollow\" target=\"_blank\">Ph&aacute;p Lu&acirc;n &#272;&#7841;i Ph&aacute;p<\/a>, m&agrave; cho t&ocirc;i bi&#7871;t r&#7857;ng nguy&ecirc;n nh&acirc;n th&#7921;c s&#7921; c&#7911;a b&#7879;nh t&#7853;t l&agrave; &lsquo;nghi&#7879;p&rsquo; [6,7]. &lsquo;Nghi&#7879;p&rsquo; l&agrave; v&#7853;t ch&#7845;t m&agrave;u &#273;en t&#7891;n t&#7841;i trong m&#7897;t kh&ocirc;ng gian th&acirc;m s&acirc;u h&#417;n, nh&#432;ng bi&#7875;u hi&#7879;n c&#7911;a n&oacute; &#7903; kh&ocirc;ng gian n&agrave;y l&agrave; vi khu&#7849;n hay virus. Kh&aacute;ng sinh c&oacute; th&#7875; ti&ecirc;u di&#7879;t vi khu&#7849;n v&agrave; virus &#7903; kh&ocirc;ng gian n&agrave;y, nh&#432;ng n&oacute; kh&ocirc;ng th&#7875; ti&ecirc;u tr&#7915; &lsquo;nghi&#7879;p&rsquo; &#7903; kh&ocirc;ng gian kh&aacute;c. K&#7871;t qu&#7843; l&agrave; sau khi kh&aacute;ng sinh tr&#7883; b&#7879;nh nhi&#7877;m tr&ugrave;ng r&#7891;i, th&igrave; &lsquo;nghi&#7879;p&rsquo; s&#7869; t&iacute;ch t&#7909; l&#7841;i trong c&#417; th&#7875;. N&#7871;u nhi&#7877;m b&#7879;nh l&#7841;i, qu&aacute; tr&igrave;nh ph&aacute;t b&#7879;nh s&#7869; nghi&ecirc;m tr&#7885;ng h&#417;n r&#7845;t nhi&#7873;u. &#272;i&#7873;u &#273;&oacute; c&oacute; ngh&#297;a l&agrave; s&#7921; ph&aacute;t b&#7879;nh n&#7863;ng nh&#7845;t v&agrave; x&#7845;u nh&#7845;t l&agrave; &#273;&#7871;n t&#7915; &lsquo;nghi&#7879;p&rsquo; trong c&#417; th&#7875;, ch&#7913; kh&ocirc;ng ph&#7843;i vi khu&#7849;n. N&#7871;u ch&uacute;ng ta c&oacute; th&#7875; thay &#273;&#7893;i &#273;&#7889;i t&#432;&#7907;ng nghi&ecirc;n c&#7913;u b&#7879;nh nhi&#7877;m tr&ugrave;ng, t&#7915; nh&acirc;n t&#7889; b&ecirc;n ngo&agrave;i, t&#7913;c vi khu&#7849;n v&agrave; virus sang nh&acirc;n t&#7889; b&ecirc;n trong, t&#7913;c &lsquo;nghi&#7879;p&rsquo;, th&igrave; ch&uacute;ng ta s&#7869; c&oacute; m&#7897;t hi&#7875;u bi&#7871;t ho&agrave;n to&agrave;n m&#7899;i v&#7873; b&#7879;nh t&#7853;t v&agrave; tr&#7883; b&#7879;nh.<\/p>\n<p><strong>Tham kh&#7843;o:<\/strong><\/p>\n<p>1. Lentino JR etc 1985 A comparison of pneumonia caused by gentamicin, methicillin-resistant and gentamicin, methicillin-senstive Staphylococcus aureus: epidemiologic and clinical studies. Infect Control Jul;6(7):267-72.<\/p>\n<p>2. Rello J etc 1994 Ventilator-associated pneumonia by Staphylococcus aureus. Comparison of methicillin-resistant and methicillin-sensitve episodes. Am J Respir Crit Care Med Dec;150(6 Pt 1):1545-9.<\/p>\n<p>3. Selvey La etc 2000 Nosocomial methicillin-resistant Staphylococcus aureus bacteremia:is it any worse than nosocomial methicillin-senstive Staphylococcus aureus bacteremia? Infect Control Hosp Epidemiol Oct;21(10):645-8.<\/p>\n<p>4. Mizobuchi S etc 1994 Comparison of the virulence of methicillin-resistant and methicillin-sensitive Staphylococcus aureus. Microbiol Immunol 38(8):599-605.<\/p>\n<p>5. Marty L etc 1993 Resistance to methicillin and virulence of Staphylococcus aureus strains in bacteriemic cancer patients. Intensive Care Med 19(5):285-9.<\/p>\n<p>6. L&yacute; H&#7891;ng Ch&iacute;, &ldquo;<a href=\"http:\/\/phapluan.org\/book\/zfl_html\/index.html\">Chuy&#7875;n Ph&aacute;p Lu&acirc;n<\/a>&rdquo;.<\/p>\n<p>7. L&yacute; H&#7891;ng Ch&iacute;, &ldquo;<a href=\"http:\/\/phapluan.org\/book\/jjyz_html\/index.html\">Tinh T&#7845;n Y&#7871;u Ch&#7881;<\/a>&rdquo;.<\/p>\n<p>D&#7883;ch t&#7915;:<\/p>\n<p><a href=\"http:\/\/pureinsight.org\/node\/143\">http:\/\/pureinsight.org\/node\/143<\/a><\/p>\n\n\n","protected":false},"excerpt":{"rendered":"<p>Ph\u00e1t minh ra thu\u1ed1c kh\u00e1ng sinh l\u00e0 m\u1ed9t trong nh\u1eefng \u0111\u1ed9t ph\u00e1 l\u1edbn c\u1ee7a y h\u1ecdc hi\u1ec7n \u0111\u1ea1i.<\/p>\n","protected":false},"author":10,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_sitemap_exclude":false,"_sitemap_priority":"","_sitemap_frequency":"","ngg_post_thumbnail":0,"footnotes":""},"categories":[80],"tags":[],"class_list":["post-13326","post","type-post","status-publish","format-standard","hentry","category-khoa-hoc-khac"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.8 - 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