Emkhakheni wemithi yesimanje, ama-antibiotics afakazele ukuthi angenye yentuthuko ebaluleke kakhulu, ehlisa ngokuphawulekayo izinga lokufa elihambisana nezifo ezibangelwa amagciwane. Ikhono labo lokushintsha imiphumela yomtholampilo yezifo ezibangelwa amagciwane liye landisa isikhathi sokuphila seziguli ezingenakubalwa. Ama-antibiotic abalulekile ezinkambisweni zezokwelapha eziyinkimbinkimbi, okuhlanganisa ukuhlinzwa, ukufakwa kokufakelwa, ukufakelwa, kanye nokwelashwa ngamakhemikhali. Kodwa-ke, ukuvela kwamagciwane amelana nama-antibiotic kuye kwaba ukukhathazeka okukhulayo, okunciphisa ukusebenza kahle kwale mithi ngokuhamba kwesikhathi. Izimo zokumelana nama-antibiotic ziye zabhalwa kuzo zonke izigaba zama-antibiotic njengoba kwenzeka ukuguqulwa kwama-microbial. Ingcindezi yokukhetha ekhishwa imishanguzo elwa namagciwane ibe nomthelela ekwandeni kwezinhlobo ezimelana nezifo, okubeke inselele enkulu empilweni yomhlaba wonke.
Ukuze kuliwe nenkinga ecindezelayo yokungazweli ngamagciwane, kubalulekile ukusebenzisa izinqubomgomo ezisebenzayo zokulawula ukutheleleka ezinqanda ukusabalala kwamagciwane angazweli, kanye nokunciphisa ukusetshenziswa kwama-antibiotic. Ngaphezu kwalokho, kunesidingo esiphuthumayo sezinye izindlela zokwelapha. I-Hyperbaric Oxygen Therapy (HBOT) iye yavela njengendlela ethembisayo kulo mongo, okubandakanya ukuphefumula kwe-oksijini engu-100% emazingeni athile okucindezela isikhathi esithile. Njengoba ibekwe njengokwelashwa okuyinhloko noma okuhambisanayo kwezifo, i-HBOT ingase inikeze ithemba elisha ekwelapheni izifo eziyingozi ezibangelwa amagciwane amelana nama-antibiotic.
Lokhu kwelashwa kuya ngokuya kusetshenziswa njengendlela yokwelapha eyinhloko noma ehlukile yezimo ezihlukahlukene, okuhlanganisa ukuvuvukala, ubuthi be-carbon monoxide, amanxeba angapheli, izifo ze-ischemic, kanye nezifo. Ukusetshenziswa komtholampilo kwe-HBOT ekwelashweni kokutheleleka kujulile, kuhlinzeka ngezinzuzo ezibalulekile ezigulini.
Izicelo Zomtholampilo ze-Hyperbaric Oxygen Therapy in Infection
Ubufakazi bamanje busekela ngokuqinile ukusetshenziswa kwe-HBOT, kokubili njengendlela yokwelapha ezimele kanye ne-adjunctive, ethula izinzuzo ezibalulekile ezigulini ezinegciwane. Phakathi ne-HBOT, umfutho wegazi womoya-mpilo we-arterial ungakhuphukela ku-2000 mmHg, futhi umphumela we-gradient ephezulu we-oksijini-tissue ungakhuphula amazinga komoyampilo wezicubu ku-500 mmHg. Imiphumela enjalo ibaluleke kakhulu ekukhuthazeni ukuphulukiswa kwezimpendulo zokuvuvukala kanye nokuphazamiseka kwe-microcirculatory okubonwa ezindaweni ze-ischemic, kanye nokulawula i-compartment syndrome.
I-HBOT nayo ingaba nomthelela ezimeni ezincike kumasosha omzimba. Ucwaningo lubonisa ukuthi i-HBOT ingakwazi ukucindezela i-autoimmune syndromes kanye nezimpendulo zokuzivikela ezibangelwa i-antigen, okusiza ukugcina ukubekezelelana kwe-graft ngokunciphisa ukujikeleza kwama-lymphocyte nama-leukocyte ngenkathi ilungisa izimpendulo zamasosha omzimba. Ngaphezu kwalokho, i-HBOTisekela ukuphulukiswaezilonda zesikhumba ezingapheli ngokuvuselela i-angiogenesis, inqubo ebalulekile yokubuyisela ngcono. Lokhu kwelashwa kuphinde kukhuthaze ukwakheka kwe-collagen matrix, isigaba esibalulekile ekwelapheni kwesilonda.
Kufanele kuqashelwe ngokukhethekile izifo ezithile, ikakhulukazi izifo ezijulile futhi okunzima ukuzelapha njenge-necrotizing fasciitis, i-osteomyelitis, izifo ezingapheli zezicubu ezithambile, kanye ne-endocarditis ethathelwanayo. Esinye sezicelo zomtholampilo ezivame kakhulu ze-HBOT ukutheleleka kwezicubu ezithambile zesikhumba kanye ne-osteomyelitis ehlotshaniswa namazinga omoya-mpilo aphansi avame ukubangelwa amagciwane anaerobic noma amelana.
1. Izifo Zezinyawo Zesifo Sikashukela
Unyawo lwesifo sikashukelaizilonda ziyinkimbinkimbi edlangile ezigulini ezinesifo sikashukela, ezithinta kufika ku-25% walesi sibalo. Ukutheleleka kuvame ukuvela kulezi zilonda (okuhlanganisa u-40% -80% wezigameko) futhi kuholela ekwandeni kokugula nokufa. Izifo zonyawo lwesifo sikashukela (i-DFIs) ngokuvamile zihlanganisa izifo ze-polymicrobial ezinezinhlobonhlobo ze-anaerobic bacterial pathogens ezihlonziwe. Izici ezahlukahlukene, kufaka phakathi ukungasebenzi kahle kwe-fibroblast, izinkinga zokwakheka kwe-collagen, izindlela zokuzivikela kumaselula, kanye nomsebenzi we-phagocyte, kungavimbela ukuphulukiswa kwesilonda ezigulini ezinesifo sikashukela. Ucwaningo oluningana lukhombe ukuhanjiswa komoya-mpilo esikhumbeni njengento eyingozi enkulu yokunqunywa kwezitho ezihlobene nama-DFI.
Njengenye yezinketho zamanje zokwelashwa kwe-DFI, I-HBOT ibike ukuthi ithuthukisa kakhulu amazinga okuphulukiswa kwezilonda ezinyaweni zesifo sikashukela, kamuva yehlisa isidingo sokunqunywa kwezitho kanye nokungenelela kokuhlinzwa okuyinkimbinkimbi. Akugcini nje ngokunciphisa isidingo sezinqubo ezidinga izinsiza, njengokuhlinzwa kwe-flap kanye nokuxhunyelelwa kwesikhumba, kodwa futhi kuveza izindleko eziphansi kanye nemiphumela engemihle emincane uma kuqhathaniswa nezinketho zokuhlinzwa. Ucwaningo olwenziwa u-Chen et al. kubonise ukuthi izikhathi ezingaphezu kwe-10 ze-HBOT ziholele ekuthuthukisweni okungama-78.3% kumazinga okuphulukiswa kwesilonda ezigulini ezinesifo sikashukela.
2. I-Necrotizing Soft Tissue Infections
Izifo zezicubu ezithambile ze-Necrotizing (NSTIs) zivame ukuba yi-polymicrobial, ngokuvamile ezivela ekuhlanganiseni amagciwane e-aerobic kanye ne-anaerobic bacteria futhi ngokuvamile ahlotshaniswa nokukhiqizwa kwegesi. Nakuba ama-NSTI eyivelakancane uma kuqhathaniswa, aveza izinga eliphezulu lokufa ngenxa yokuthuthuka kwawo ngokushesha. Ukuxilongwa kanye nokwelashwa okufika ngesikhathi futhi okufanele kuyisihluthulelo sokuzuza imiphumela emihle, futhi i-HBOT iye yatuswa njengendlela yokwengeza yokulawula ama-NSTI. Nakuba kusasele umbango ophathelene nokusetshenziswa kwe-HBOT kuma-NSTI ngenxa yokuntuleka kwezifundo ezilawulwayo,ubufakazi buphakamisa ukuthi kungase kuhlotshaniswe namazinga okusinda athuthukisiwe kanye nokulondolozwa kwezitho ezigulini ze-NSTI.. Ucwaningo lokubuyisela emuva lubonise ukwehla okukhulu kwamazinga okufa phakathi kweziguli ze-NSTI ezithola i-HBOT.
1.3 Ukutheleleka Kwendawo Yokuhlinza
Ama-SSI angahlukaniswa ngokusekelwe endaweni ye-anatomical yokutheleleka futhi angavela emagciwaneni ahlukahlukene, okuhlanganisa kokubili amagciwane e-aerobic kanye ne-anaerobic. Naphezu kwentuthuko ezindleleni zokulawula ukutheleleka, okufana namasu okubulala inzalo, ukusetshenziswa kwemithi elwa namagciwane, nokuthuthukiswa kwezinqubo zokuhlinza, ama-SSI ahlala eyinkinga eqhubekayo.
Ukubuyekezwa okukodwa okubalulekile kuphenye ukusebenza kahle kwe-HBOT ekuvimbeleni ama-SSI ajulile ekuhlinzeni kwe-neuromuscular scoliosis. I-HBOT yangaphambi kokuhlinzwa ingase yehlise kakhulu izehlakalo zama-SSI futhi yenze lula ukuphulukiswa kwesilonda. Lokhu kwelashwa okungahlaseli kudala indawo lapho amazinga e-oksijini ezicutshini zesilonda ephakanyiswa, okuye kwahlotshaniswa nesenzo sokubulala i-oxidative ngokumelene namagciwane. Ukwengeza, ibhekana namazinga egazi ehlisiwe nawomoya-mpilo afaka isandla ekuthuthukisweni kwama-SSI. Ngale kwamanye amasu okulawula ukutheleleka, i-HBOT inconyelwe ikakhulukazi ukuhlinzwa okungcolile okufana nezinqubo ze-colorectal.
1.4 Ukushiswa
Ukusha ukulimala okubangelwa ukushisa okukhulu, amandla kagesi, amakhemikhali, noma imisebe futhi kungadala izinga eliphezulu lokugula nokufa. I-HBOT inenzuzo ekwelapheni ukusha ngokwandisa amazinga omoya-mpilo ezicutshini ezilimele. Ngenkathi izifundo zezilwane nezomtholampilo zinikeza imiphumela exubile mayelanaukusebenza kwe-HBOT ekwelapheni kokushiswa, ucwaningo oluhilela iziguli ezishile ze-125 lubonise ukuthi i-HBOT ayizange ibonise umthelela omkhulu emazingeni okufa noma inani lokuhlinzwa okwenziwa kodwa yehlisa isikhathi sokuphulukisa esijwayelekile (izinsuku ze-19.7 uma kuqhathaniswa nezinsuku ze-43.8). Ukuhlanganisa i-HBOT nokuphathwa kokusha okuphelele kungalawula ngempumelelo i-sepsis ezigulini ezishile, okuholela ezikhathini zokuphulukisa ezifushane kanye nezidingo ezincishisiwe zoketshezi. Kodwa-ke, ucwaningo olubanzi oluqhubekayo luyadingeka ukuze kuqinisekiswe indima ye-HBOT ekulawuleni ukusha okukhulu.
1.5 I-Osteomyelitis
I-Osteomyelitis ukutheleleka kwethambo noma umnkantsha ngokuvamile okubangelwa amagciwane amagciwane. Ukwelapha i-osteomyelitis kungaba inselele ngenxa yokungatholakali kahle kwegazi emathanjeni kanye nokungena okulinganiselwe kwemithi elwa namagciwane emnkantsheni. I-osteomyelitis engapheli ibonakala ngama-pathogens aphikelelayo, ukuvuvukala okuncane, nokwakheka kwezicubu ze-necrotic. I-Refractory osteomyelitis ibhekisela ezifweni ezingapheli zamathambo eziqhubekayo noma eziphindaphindayo naphezu kokwelashwa okufanele.
I-HBOT ikhonjiswe ukuthi ithuthukisa kakhulu amazinga e-oksijini emathanjeni athintekile. Uchungechunge lwamacala amaningi kanye nezifundo zeqoqo zibonisa ukuthi i-HBOT ithuthukisa imiphumela yomtholampilo ezigulini ze-osteomyelitis. Kubonakala kusebenza ngezindlela ezihlukahlukene, okuhlanganisa ukuqinisa umsebenzi we-metabolic, ukucindezela amagciwane amagciwane, ukuthuthukisa imiphumela yama-antibiotic, ukunciphisa ukuvuvukala, nokukhuthaza ukuphulukiswa.izinqubo. I-Post-HBOT, i-60% kuya ku-85% yeziguli ezine-osteomyelitis engapheli, ephikisanayo zibonisa izimpawu zokucindezelwa kokutheleleka.
1.6 Izifo zefungal
Emhlabeni jikelele, abantu abangaphezu kwezigidi ezintathu bahlushwa izifo zesikhunta ezingalapheki noma ezihlaselayo, okuholela ekufeni kwabantu abangaphezu kuka-600,000 ngonyaka. Imiphumela yokwelashwa kwezifo zokukhunta ivamise ukuba sengozini ngenxa yezinto ezifana nokushintsha kwesimo sokuzivikela ezifweni, izifo eziwumsuka, kanye nezici ze-pathogen virulence. I-HBOT isiba inketho yokwelapha ekhangayo ezifweni ezinzima zesikhunta ngenxa yokuphepha kwayo kanye nemvelo engahlaseli. Ucwaningo lubonisa ukuthi i-HBOT ingasebenza ngempumelelo ekulweni nesikhunta esifana ne-Aspergillus ne-Mycobacterium tuberculosis.
I-HBOT ikhuthaza imiphumela ye-antifungal ngokuvimbela ukwakheka kwe-biofilm ye-Aspergillus, ngokukhula okusebenzayo okuphawulwe ezinhlobonhlobo ezingenalo izakhi zofuzo ze-superoxide dismutase (SOD). Izimo ze-hypoxic ngesikhathi sokutheleleka kwesikhunta zibeka izinselele ekulethweni kwezidakamizwa ze-antifungal, okwenza amazinga e-oksijini akhuphukayo avela ku-HBOT abe ukungenelela okungase kube nenzuzo, nakuba ucwaningo olwengeziwe lufanelekile.
I-Antimicrobial Properties ye-HBOT
Imvelo ye-hyperoxic edalwe yi-HBOT iqala izinguquko zomzimba kanye ne-biochemical evuselela izakhiwo ze-antibacterial, ikwenze kube ukwelapha okuhambisanayo okuphumelelayo kokutheleleka. I-HBOT ibonisa imiphumela emangalisayo ngokumelene namabhaktheriya e-aerobic kanye namagciwane e-anaerobic ikakhulukazi ngokusebenzisa izindlela ezifana nokusebenza okuqondile kwe-bactericidal, ukuthuthukiswa kwezimpendulo zokuzivikela komzimba, kanye nemiphumela ye-synergistic ngama-ejenti athile alwa namagciwane.
2.1 Imithelela Eqondile Ye-Antibacterial ye-HBOT
Umphumela oqondile we-antibacterial we-HBOT ubangelwa kakhulu isizukulwane sezinhlobo ze-oxygen esebenzayo (i-ROS), ehlanganisa i-superoxide anions, i-hydrogen peroxide, i-hydroxyl radicals, nama-hydroxyl ions-konke avela ngesikhathi sokushintshwa kwamaselula.
Ukusebenzisana phakathi kwe-O₂ nezingxenye zamaselula kubalulekile ekuqondeni ukuthi i-ROS yakha kanjani ngaphakathi kwamaseli. Ngaphansi kwezimo ezithile ezibizwa ngokuthi ukucindezeleka kwe-oxidative, ibhalansi phakathi kokwakheka kwe-ROS nokuwohloka kwayo kuyaphazamiseka, okuholela emazingeni aphakeme e-ROS kumaseli. Ukukhiqizwa kwe-superoxide (O₂⁻) kwenziwa i-superoxide dismutase, okuthi kamuva iguqule i-O₂⁻ ibe i-hydrogen peroxide (H₂O₂). Lokhu kuguqulwa kuthuthukiswa nakakhulu ukusabela kwe-Fenton, eyenza i-Fe²⁺ ikhiqize ama-hydroxyl radicals (·OH) ne-Fe³⁺, ngaleyo ndlela iqalise ukulandelana kwe-redox eyingozi yokwakheka kwe-ROS nokulimala kweselula.
Imiphumela enobuthi ye-ROS iqondise ezingxenyeni ezibalulekile zamaselula njenge-DNA, i-RNA, amaprotheni, nama-lipids. Ngokuphawulekayo, i-DNA iyimpokophelo eyinhloko ye-H₂O₂-mediated cytotoxicity, njengoba iphazamisa izakhiwo ze-deoxyribose futhi ilimaza ukwakheka kwesisekelo. Umonakalo ongokomzimba odalwe yi-ROS udlulela esakhiweni se-helix se-DNA, okungenzeka kube umphumela we-lipid peroxidation eqalwa yi-ROS. Lokhu kugcizelela imiphumela emibi yamazinga e-ROS aphakeme ngaphakathi kwamasistimu ebhayoloji.
Isenzo se-Antimicrobial se-ROS
I-ROS idlala indima ebalulekile ekuvimbeleni ukukhula kwamagciwane, njengoba kuboniswa ngesizukulwane se-ROS esenziwe yi-HBOT. Imiphumela yobuthi ye-ROS iqondise ngokuqondile izakhi zamaselula njenge-DNA, amaprotheni, nama-lipids. Ukugxila okuphezulu kwezinhlobo ze-oxygen esebenzayo kungalimaza ngokuqondile i-lipids, okuholela ku-lipid peroxidation. Le nqubo ibeka engcupheni ubuqotho bolwelwesi lwamaseli futhi, ngenxa yalokho, ukusebenza kwama-membrane-associated receptors kanye namaprotheni.
Ngaphezu kwalokho, amaprotheni, nawo ayizinjongo ezibalulekile zamangqamuzana e-ROS, abhekana noshintsho oluthile lwe-oxidative ezinsalela ezihlukahlukene ze-amino acid njenge-cysteine, i-methionine, i-tyrosine, i-phenylalanine, ne-tryptophan. Ngokwesibonelo, i-HBOT iboniswe ukuthi yenza izinguquko ze-oxidative kumaprotheni amaningana ku-E. coli, okuhlanganisa i-elongation factor G kanye ne-DnaK, ngaleyo ndlela kuthinte ukusebenza kwawo kwamaselula.
Ukuthuthukisa Ukungavikeleki Nge-HBOT
Izakhiwo zokulwa nokuvuvukala ze-HBOTkubhaliwe, okufakazela ukuthi kubalulekile ekudambiseni ukulimala kwezicubu kanye nokucindezela ukuqhubeka kokutheleleka. I-HBOT ithinta kakhulu ukuvezwa kwama-cytokines nezinye izilawuli ezivuthayo, ezithonya impendulo yokuzivikela komzimba. Amasistimu okuhlola ahlukahlukene abone izinguquko ezihlukene ekukhulumeni kwezakhi zofuzo kanye nokukhiqizwa kwamaprotheni ngemva kwe-HBOT, okungenzeka ukuthi ilawule noma yehlise izici zokukhula nama-cytokines.
Ngesikhathi senqubo ye-HBOT, amazinga e-O₂ anda aqala uhla lwezimpendulo zamaselula, njengokucindezela ukukhululwa kwabalamuli abavuvukalayo kanye nokukhuthaza i-lymphocyte ne-neutrophil apoptosis. Ngokuhlangene, lezi zenzo zithuthukisa izindlela zokulwa namagciwane zamasosha omzimba, ngaleyo ndlela zisize ukuphulukiswa kwezifo.
Ngaphezu kwalokho, ucwaningo lubonisa ukuthi amazinga e-O₂ akhuphuka ngesikhathi se-HBOT anganciphisa ukubonakaliswa kwama-cytokines ane-pro-inflammatory, kuhlanganise ne-interferon-gamma (IFN-γ), i-interleukin-1 (IL-1), ne-interleukin-6 (IL-6). Lezi zinguquko zihlanganisa nokwehlisa isilinganiso se-CD4:CD8 T cell kanye nokushintshanisa amanye ama-soluble receptors, ekugcineni kukhuphule amazinga e-interleukin-10 (IL-10), okubalulekile ekulweni nokuvuvukala kanye nokukhuthaza ukuphulukiswa.
Imisebenzi ye-antimicrobial ye-HBOT ihlanganiswe nezinqubo zebhayoloji eziyinkimbinkimbi. Kokubili i-superoxide kanye nengcindezi ephakeme kuye kwabikwa ukuthi ikhuthaza ngokungaguquki umsebenzi we-antibacterial we-HBOT kanye ne-neutrophil apoptosis. Kulandela i-HBOT, ukuphakama okuphawulekayo kumazinga omoya-mpilo kuthuthukisa amandla okubulala amagciwane ama-neutrophils, ingxenye ebalulekile yokusabela komzimba. Ngaphezu kwalokho, i-HBOT icindezela ukunamathela kwe-neutrophil, okuxhunyaniswa nokusebenzisana kwe-β-integrins kuma-neutrophils ane-intercellular adhesion molecules (ICAM) kumaseli endothelial. I-HBOT ivimbela umsebenzi we-neutrophil β-2 integrin (Mac-1, CD11b/CD18) ngenqubo ye-nitric oxide (NO)-mediated, enomthelela ekufudukeni kwe-neutrophils endaweni yokutheleleka.
Ukuhlelwa kabusha okunembile kwe-cytoskeleton kuyadingeka ukuze ama-neutrophils akwazi ukwenza i-phagocytize ngempumelelo amagciwane. I-S-nitrosylation ye-actin iboniswe ukuthi ivuse i-actin polymerization, engase ibe lula umsebenzi we-phagocytic wama-neutrophils ngemva kokwelashwa kwangaphambili kwe-HBOT. Ngaphezu kwalokho, i-HBOT ikhuthaza i-apoptosis emigqeni yeseli T yomuntu ngokusebenzisa izindlela ze-mitochondrial, ngokufa kwe-lymphocyte esheshayo ngemva kwe-HBOT kubikwa. Ukuvimbela i-caspase-9-ngaphandle kokuthinta i-caspase-8-kubonise imiphumela ye-immunomodulatory ye-HBOT.
I-Synergistic Effects ye-HBOT enama-ejenti e-Antimicrobial
Ezinhlelweni zomtholampilo, i-HBOT ivamise ukusetshenziswa kanye nama-antibiotics ukulwa nezifo ngempumelelo. Isimo se-hyperoxic esifinyelelwe ngesikhathi se-HBOT singathonya ukusebenza kahle kwama-antibiotic athile. Ucwaningo luphakamisa ukuthi izidakamizwa ezithile ezibulala amagciwane, njenge-β-lactam, i-fluoroquinolones, nama-aminoglycosides, azisebenzi nje kuphela ngezinqubo ezingokwemvelo kodwa futhi zithembele kancane ku-aerobic metabolism yamagciwane. Ngakho-ke, ukuba khona komoyampilo kanye nezici ze-metabolic zamagciwane kubalulekile lapho kuhlolwa imiphumela yokwelapha yama-antibiotic.
Ubufakazi obubalulekile bukhombisile ukuthi amazinga aphansi komoyampilo angakhuphula ukumelana kwe-Pseudomonas aeruginosa ku-piperacillin/tazobactam nokuthi indawo komoyampilo ephansi nayo inomthelela ekwandeni kokumelana kwe-Enterobacter cloacae ku-azithromycin. Ngakolunye uhlangothi, izimo ezithile ze-hypoxic zingase zithuthukise ukuzwela kwebhaktheriya kuma-antibiotic e-tetracycline. I-HBOT isebenza njengendlela yokwelapha esebenzayo yokwengeza ngokufaka i-aerobic metabolism kanye ne-reoxygenating izicubu ezinegciwane le-hypoxic, kamuva ikhulise ukuzwela kwamagciwane kuma-antibiotics.
Ocwaningweni lwangaphambi komtholampilo, inhlanganisela ye-HBOT—enikezwa kabili ngosuku amahora angu-8 ku-280 kPa—kanye ne-tobramycin (20 mg/kg/ngosuku) yehlise kakhulu imithwalo yamagciwane ku-Staphylococcus aureus endocarditis ethathelwanayo. Lokhu kubonisa amandla e-HBOT njengokwelashwa okusizayo. Uphenyo olwengeziwe luveze ukuthi ngaphansi kwengcindezi engu-37°C kanye ne-3 ATA amahora angu-5, i-HBOT yathuthukisa ngokuphawulekayo imiphumela ye-imipenem ngokumelene ne-Pseudomonas aeruginosa enegciwane le-macrophage. Ukwengeza, indlela ehlanganisiwe ye-HBOT ne-cephalolin itholakale iphumelela kakhulu ekwelapheni i-Staphylococcus aureus osteomyelitis kumamodeli ezilwane uma kuqhathaniswa ne-cephalolin yodwa.
I-HBOT futhi inyusa kakhulu isenzo se-bactericidal se-ciprofloxacin ngokumelene ne-Pseudomonas aeruginosa biofilms, ikakhulukazi kulandela imizuzu engama-90 yokuchayeka. Lokhu kuthuthukiswa kudalwe ekwakhekeni kwezinhlobo ze-oxygen esebenzayo (i-ROS) futhi kukhombisa ukuzwela okuphakeme kuma-mutant anesici se-peroxidase.
Kumamodeli e-pleuritis ebangelwa i-Staphylococcus aureus (MRSA) engamelana ne-methicillin (MRSA), umphumela wokusebenzisana we-vancomycin, i-teicoplanin, ne-linezolid ene-HBOT ubonise ukusebenza kahle okukhuphuke kakhulu ngokumelene ne-MRSA. I-Metronidazole, isibulala-magciwane esisetshenziswa kakhulu ekwelapheni izifo ezinzima ze-anaerobic kanye ne-polymicrobial ezifana ne-diabetesic foot infections (DFIs) kanye ne-surgical site infections (SSIs), ibonise ukusebenza kahle kwe-antimicrobial ngaphansi kwezimo ze-anaerobic. Ucwaningo lwesikhathi esizayo luqinisekisiwe ukuhlola imiphumela ye-synergistic antibacterial ye-HBOT ehlanganiswe ne-metronidazole kokubili kuzilungiselelo ze-vivo kanye ne-in vitro.
I-Antimicrobial Efficacy ye-HBOT Kumagciwane Angazweli
Ngokuziphendukela kwemvelo kanye nokusabalala kwezinhlobo ezingazweli, ama-antibiotic endabuko ngokuvamile alahlekelwa amandla awo ngokuhamba kwesikhathi. Ngaphezu kwalokho, i-HBOT ingase ibonakale ibalulekile ekwelapheni nasekuvimbeleni izifo ezibangelwa amagciwane amelana nemithi eminingi, esebenza njengesu elibalulekile lapho ukwelashwa kwama-antibiotic kwehluleka. Ucwaningo oluningi lubike imiphumela ebalulekile yokubulala amagciwane ye-HBOT kumagciwane amelana ngokomtholampilo. Isibonelo, iseshini ye-HBOT yemizuzu engama-90 ku-ATM emi-2 yehlise kakhulu ukukhula kwe-MRSA. Ukwengeza, kumamodeli wesilinganiso, i-HBOT ithuthukise imiphumela ye-antibacterial ye-antibiotic ehlukahlukene ngokumelene nezifo ze-MRSA. Imibiko iqinisekisile ukuthi i-HBOT iyasebenza ekwelapheni i-osteomyelitis ebangelwa i-Klebsiella pneumoniae ekhiqiza i-OXA-48 ngaphandle kwesidingo semithi elwa namagciwane.
Ngamafuphi, ukwelashwa kwe-oxygen ye-hyperbaric kumelela indlela ehlangene yokulawula ukutheleleka, okuthuthukisa impendulo yokuzivikela komzimba ngenkathi futhi kukhulisa ukusebenza kahle kwama-antimicrobial akhona. Ngocwaningo olubanzi nentuthuko, inamandla okunciphisa imiphumela yokungazweli kwama-antibiotic, inikeza ithemba empini eqhubekayo yokulwa nokutheleleka ngamagciwane.
Isikhathi sokuthumela: Feb-28-2025