{"id":628,"date":"2011-12-06T20:15:48","date_gmt":"2011-12-06T19:15:48","guid":{"rendered":"https:\/\/viscojis.cz\/teens\/2011\/12\/06\/165\/"},"modified":"2025-03-14T14:21:09","modified_gmt":"2025-03-14T13:21:09","slug":"165","status":"publish","type":"post","link":"https:\/\/viscojis.cz\/teens\/165\/","title":{"rendered":"Enterohemoragick\u00e1 E. coli"},"content":{"rendered":"

O \u017eivotu nebezpe\u010dn\u00e9 bakterii, kter\u00e1 zp\u016fsobuje \u201ehamburgerovou nemoc\u201c, a jak se p\u0159ed n\u00ed m\u00e1me chr\u00e1nit.<\/span><\/p>\n

\u00a0<\/p>\n

\"divkaP\u016fvodcem onemocn\u011bn\u00ed je bakterie Escherichia coli<\/em>, kter\u00e1 se b\u011b\u017en\u011b vyskytuje v na\u0161em tr\u00e1vic\u00edm traktu a ve st\u0159evech teplokrevn\u00fdch \u017eivo\u010dich\u016f. Je zn\u00e1mo mnoho kmen\u016f t\u00e9to bakterie, z nich\u017e v\u011bt\u0161ina je ne\u0161kodn\u00e1. N\u011bkter\u00e9 kmeny v\u0161ak mohou zp\u016fsobit z\u00e1va\u017en\u00e1 onemocn\u011bn\u00ed \u0161\u00ed\u0159en\u00e1 prost\u0159ednictv\u00edm potravin. Jedn\u00edm z takov\u00fdchto kmen\u016f jsou EHEC \u2013 enterohemoragick\u00e9 E. coli<\/em>. V USA se pro onemocn\u011bn\u00ed, kter\u00e9 vyvol\u00e1vaj\u00ed, v\u017eil n\u00e1zev \u201ehamburgerov\u00e1 nemoc\u201c, nebo\u0165 pr\u00e1v\u011b hamburgery byly \u010dastou p\u0159\u00ed\u010dinou epidemi\u00ed<\/span> vyvolan\u00fdch enterohemoragick\u00fdmi E. coli<\/em>, konkr\u00e9tn\u011b \u0161lo o s\u00e9rotyp E. coli<\/em> O157:H7, kter\u00fd je epidemiologicky nejv\u00fdznamn\u011bj\u0161\u00ed, ale zdaleka ne jedin\u00fd.<\/p>\n

\u00a0<\/p>\n

Jak se m\u016f\u017eeme nakazit?<\/strong><\/p>\n

Bakterie se dost\u00e1vaj\u00ed do na\u0161eho t\u011bla prost\u0159ednictv\u00edm kontaminovan\u00fdch<\/span> potravin (jejich konzumac\u00ed nebo manipulac\u00ed s\u00a0nimi), nej\u010dast\u011bji ze syrov\u00e9ho \u010di nedostate\u010dn\u011b tepeln\u011b opracovan\u00e9ho masa \u010di masn\u00fdch v\u00fdrobk\u016f, ml\u00e9ka, ze zeleniny (r\u016f\u017ei\u010dkov\u00e1 kapusta, listy sal\u00e1tu), z kontaminovan\u00e9 pitn\u00e9 vody nebo kontaktem s naka\u017een\u00fdmi zv\u00ed\u0159aty.<\/p>\n

N\u00e1kaza se m\u016f\u017ee \u0161\u00ed\u0159it tak\u00e9 kontaktem s\u00a0naka\u017een\u00fdmi lidmi, p\u0159enos z\u00a0osoby na osobu je mo\u017en\u00fd u \u00fazk\u00fdch kontakt\u016f (rodiny, centra p\u00e9\u010de o d\u011bti, mate\u0159sk\u00e9 \u0161kolky, \u0161koly, d\u011btsk\u00e9 domovy a domovy s pe\u010dovatelskou slu\u017ebou, domovy d\u016fchodc\u016f, l\u00e9\u010debny dlouhodob\u011b nemocn\u00fdch atd.). Dosp\u011bl\u00ed vylu\u010duj\u00ed EHEC ve stolici p\u0159ibli\u017en\u011b jeden t\u00fdden, d\u011bti d\u00e9le.<\/p>\n

Enterohemoragick\u00e9 E. coli<\/em> jsou vysoce infek\u010dn\u00ed \u2013 k vyvol\u00e1n\u00ed infekce sta\u010d\u00ed velmi n\u00edzk\u00e1 d\u00e1vka a p\u0159edev\u0161\u00edm jejich p\u0159\u00edtomnost na \u010derstv\u00e9 zem\u011bd\u011blsk\u00e9 produkci ur\u010den\u00e9 ke konzumaci za syrova je velmi nebezpe\u010dn\u00e1.<\/p>\n

\u00a0<\/p>\n

Jak se m\u016f\u017eeme chr\u00e1nit?<\/strong><\/p>\n

Z\u00a0potravin bakterie odstran\u00edme d\u016fkladn\u00fdm tepeln\u00fdm o\u0161et\u0159en\u00edm (va\u0159en\u00ed pokrm\u016f, pasterace ml\u00e9ka apod.) teplotami nad 70 \u00b0C ve v\u0161ech \u010d\u00e1stech tepeln\u011b zpracov\u00e1van\u00e9 potraviny.<\/p>\n

Krom\u011b tepeln\u00e9 \u00fapravy je d\u016fle\u017eit\u00e9 dodr\u017eovat hygienick\u00e9 z\u00e1sady \u2013 pe\u010dliv\u00e9 myt\u00ed rukou p\u0159ed a b\u011bhem p\u0159\u00edpravy pokrm\u016f, zejm\u00e9na po manipulaci s\u00a0\u010derstvou zeleninou nebo syrov\u00fdm masem a po kontaktu s dom\u00e1c\u00edmi mazl\u00ed\u010dky a\u00a0hospod\u00e1\u0159sk\u00fdmi zv\u00ed\u0159aty.<\/p>\n

D\u016fle\u017eit\u00e9 je kvalitn\u00ed om\u00fdv\u00e1n\u00ed zeleniny a ovoce p\u0159ed konzumac\u00ed a zamezen\u00ed k\u0159\u00ed\u017eov\u00e9 kontaminace<\/a>.<\/p>\n

\u00a0<\/p>\n

Inkuba\u010dn\u00ed doba<\/strong><\/p>\n

Onemocn\u011bn\u00ed vznikne asi 3\u20138 dn\u00ed pot\u00e9, co dojde k n\u00e1kaze.<\/p>\n

\u00a0<\/p>\n

Jak se nemoc projevuje?<\/strong><\/p>\n

Enterohemoragick\u00e9 E. coli<\/em> mohou zp\u016fsobit z\u00e1va\u017en\u00e1 onemocn\u011bn\u00ed. N\u011bkdy jsou to \u201epouze\u201c k\u0159e\u010de v\u00a0b\u0159i\u0161e a pr\u016fjmy, kter\u00e9 v\u0161ak mohou p\u0159ej\u00edt do t\u011b\u017ek\u00fdch krv\u00e1civ\u00fdch pr\u016fjm\u016f napodobuj\u00edc\u00edch \u00faplavici (shigel\u00f3zu). M\u016f\u017ee se objevit hore\u010dka a zvracen\u00ed.<\/p>\n

V\u011bt\u0161ina posti\u017een\u00fdch se zotav\u00ed do 10 dn\u016f, ale u mal\u00e9 \u010d\u00e1sti z nich (asi 10 %), p\u0159ev\u00e1\u017en\u011b se jedn\u00e1 o mal\u00e9 d\u011bti, star\u0161\u00ed a oslaben\u00e9 jedince, m\u016f\u017ee vy\u00fastit do \u017eivota ohro\u017euj\u00edc\u00ed nemoci \u2013 hemolyticko-uremick\u00e9ho syndromu (HUS). Jedn\u00e1 se o akutn\u00ed selh\u00e1n\u00ed ledvin spojen\u00e9 s hemolytickou an\u00e9mi\u00ed a\/nebo trombocytopeni\u00ed. Asi u 25 % t\u011bch, kte\u0159\u00ed p\u0159e\u017eij\u00ed hemolyticko-uremick\u00fd syndrom, m\u016f\u017ee doj\u00edt k neurologick\u00fdm komplikac\u00edm (epileptick\u00e9 z\u00e1chvaty, mozkov\u00e1 mrtvice a koma).<\/p>\n

\u00a0<\/p>\n

Jak se nemoc l\u00e9\u010d\u00ed?<\/strong><\/p>\n

D\u016fraz je kladen na d\u016fkladn\u00e9 zavodn\u011bn\u00ed organizmu a l\u00e9\u010dbu komplikac\u00ed, pokud k\u00a0nim dojde \u2013 zejm\u00e9na hemolyticko-uremick\u00fd syndrom. V nejz\u00e1va\u017en\u011bj\u0161\u00edch p\u0159\u00edpadech se prov\u00e1d\u00ed dial\u00fdza p\u0159i selh\u00e1v\u00e1n\u00ed ledvin.<\/p>\n

\u00a0<\/p>\n

Rozs\u00e1hl\u00e1 epidemie<\/span> v N\u011bmecku<\/strong><\/p>\n

Ke druh\u00e9 nejv\u011bt\u0161\u00ed epidemii<\/span> co do po\u010dtu posti\u017een\u00fdch osob do\u0161lo ned\u00e1vno v\u00a0N\u011bmecku (kv\u011bten 2011). Bylo posti\u017eeno p\u0159es 4000 osob a n\u00e1kaza si vy\u017e\u00e1dala n\u011bkolik des\u00edtek ob\u011bt\u00ed na \u017eivotech. N\u011bmeck\u00e1 epidemie<\/span> byla vyvolan\u00e1 pom\u011brn\u011b vz\u00e1cn\u00fdm, ale ne nov\u00fdm s\u00e9rotypem E. coli<\/em> O104:H4.<\/p>\n

Ve srovn\u00e1n\u00ed s\u00a0p\u0159edchoz\u00edmi epidemiemi, byla tato epidemie<\/span> v\u00fdjime\u010dn\u00e1, co se t\u00fd\u010de posti\u017een\u00fdch a pr\u016fb\u011bhu onemocn\u011bn\u00ed. Dosavadn\u00ed epidemie<\/span> b\u011b\u017en\u011b obsahovaly asi 10 % p\u0159\u00edpad\u016f s t\u011b\u017ek\u00fdm pr\u016fb\u011bhem onemocn\u011bn\u00ed (HUS), v\u00a0t\u00e9to epidemii<\/span> ale bylo posti\u017eeno hemolyticko-uremick\u00fdm syndromem t\u00e9m\u011b\u0159 25 % osob, nav\u00edc se jednalo p\u0159ev\u00e1\u017en\u011b o \u017eeny star\u0161\u00ed 20 let (obvykle jsou posti\u017eeny mal\u00e9 d\u011bti a star\u0161\u00ed \u010di oslaben\u00ed jedinci).
Podle Evropsk\u00e9ho \u00fa\u0159adu pro bezpe\u010dnost potravin (EFSA) n\u00e1kazu zp\u016fsobila kontaminovan\u00e1 semena\u00a0p\u00edskavice poch\u00e1zej\u00edc\u00ed z\u00a0Egypta, z nich\u017e byly v\u00a0N\u011bmecku vyp\u011bstov\u00e1ny kl\u00ed\u010dky (v\u00fdhonky) ur\u010den\u00e9 ke konzumaci. To je tak\u00e9 z\u0159ejm\u011b d\u016fvod, pro\u010d byly posti\u017eeny zejm\u00e9na \u017eeny ve st\u0159edn\u00edm v\u011bku, kter\u00e9 up\u0159ednost\u0148uj\u00ed zdravou v\u00fd\u017eivu.<\/p>\n

\u00a0<\/p>\n

\u00a0<\/strong><\/p>\n

Pou\u017eit\u00e1 literatura<\/strong><\/em><\/span><\/p>\n

Marejkov\u00e1 M., Roh\u00e1\u010dov\u00e1 H., Reisingerov\u00e1 M., Petr\u00e1\u0161 P. Velk\u00e1 n\u011bmeck\u00e1 epidemie<\/span> vyvolan\u00e1 shigatoxigenn\u00edm kmenem Escherichia coli O104:H4 a jeden importovan\u00fd p\u0159\u00edpad v \u010cesk\u00e9 republice. Zpr\u00e1vy z\u00a0centra epidemiologie a mikrobiologie (SZ\u00da, Praha) 2011; 20(5): 170-173.<\/em><\/span>
Enterohaemorrhagic Escherichia coli<\/a> (EHEC), WHO Fact sheet N\u00b0125, kv\u011bten 2005.<\/em><\/span><\/p>\n

\u00a0<\/p>\n

\u00a0<\/p>\n