| Sažetak | Salmonele su gram-negativne bakterije, fakultativno anaerobni, pokretni štapići i pripadaju porodici Enterobacteriaceae te su crijevne zarazne bolesti. Na temelju somatskog O antigena, flagelarnog H antigena i površinskog Vi antigena salmonele se mogu razvrstati u više od 2500 serotipova. Iz epidemioloških i kliničkih razloga salmonele se razvrstavaju u dvije skupine te jednu čine Salmonella typhi i Salmonella paratyphi (A, B i C), uzročnici trbušnog tifusa i paratifusa. Sve ostale salmonele se kolektivno nazivaju netifusne salmonele i najčešći su uzroci bakterijskih dijareja te su u Hrvatskoj na drugome mjestu. Salmoneloze su u današnje doba u porastu u cijelome svijetu i predstavljaju svugdje značajan problem javnog zdravstva i kliničke medicine. Putevi prijenosa salmonela su putem hrane, kontakta sa životinjama te prijenos s čovjeka na čovjeka. Čovjek se može zaraziti ako konzumira inficirana jaja, meso, ribe, mlijeko, voće te povrće. Salmonela se prenosi feko-oralnim putem. Salmonele dugo egzistiraju izvan domaćina i otporne su na vanjske uvjete. Simptomi salmoneloze su proljev, mučnina, povraćanje, bolovi u trbuhu te vrućica. Simptomi se javljaju 12-72 sata od konzumiranja kontaminirane hrane te bolest uglavnom traje 4 do 7 dana. Dijagnoza salmoneloze se postavlja bakteriološkom pretragom te se za tu pretragu uzima uzorak stolice. Uzeti treba i uzorke hrane koja je sumnjiva, briseve posuda i radnih ploha u objektu s kojim je povezana infekcija. Kod liječenja bakterije Salmonella bitno je što prije nadoknaditi izgubljenu tekućinu i elektrolite parenteralnim putem ili per os. Liječenje antibioticima se ne preporučuje jer može dovesti do produljenog kliconoštva, a primjenjuje se samo kod rizičnih bolesnika i u onih s teškim oblikom bolesti. Antimikrobni lijekovi izbora su ciprofloksacin, levofloksacin i ceftriakson. Gastrointestinalne infekcije prouzročene salmonelom su dijareja, mučnina, povraćanje te bolovi u abdomenu. Liječenje se sastoji od rehidracije, medikamentozne terapije te dijetalne prehrane. Uloga medicinske sestre/tehničara je higijena ruku, izolacija pacijenta, edukacija, psihološka podrška bolesniku te prevencija. Njega bolesnika sastoji se od ublažavanja boli, smještaja bolesnika u udoban položaj, primjene propisanih analgetika, antiemetika, antidijaroika, antipiretika, ublažavanja strahova, poticanju bolesnika da pije tekućinu, primjene intravenske nadoknade tekućine te sprječavanje dehidracije. Bolesnicima treba omogućiti mirnu okolinu, ugodne mikroklimatske uvjete u sobi, privatnost, higijenu ruku, laganu prehranu te primjenjivati tehnike relaksacije. Prevencija se temelji na pravilnom čuvanju namirnica, dobroj termičkoj obradi hrane, izbjegavanju konzumiranja namirnica sumnjiva podrijetla te pranje ruku. |
| Sažetak (engleski) | Salmonella are gram negative bacteria; optionally anaerobic, they are moveable sticks which belong to the Enterobacteriaceae family, thus being intestinal infectious diseases. On the basis of the somatic O antigen, flagellar H antigen and surfice Vi antigen, salmonella can be classified in more than 2500 serotypes. For epidemiological and clinical reasons, salmonella are divided in two groups, the former consisting of Salmonella typhi and Salmonella paratyphi (A, B and C) and the latter consisting of typhoid fever and paratyphoid agents. All the other salmonella are found under the common name of non-typhoidal salmonella; in most cases, they cause bacterial diarrhoea and hold the second position in Croatia. Nowadays, salmonelloses have been appearing more and more frequently all over the world and therefore present a considerable problem regarding public health and clinical medicine. Salmonella are transmitted by food, contacts with animals and there is also human-to-human transmission. People get infected if they consume infected eggs, meat, fish, milk, fruit and vegetables. Salmonella is transmitted feco-orally. They can long exist outside the host and are resistant to external conditions. Salmonellosis symptoms are diarrhoea, nausea, vomiting, stomach pains and fever. The symptoms appear 12-72 hours since the consumption of infected food and the disease lasts 4-7 days. The disease is diagnosed on the basis of bacteriological examination for which a faecal sample is needed. We should also examine the samples of possibly infected food, as well as take the swabs of vessels and working surfaces connected to the infection. As for treating a Salmonella bacterium, it is essential to replace the lost liquid and electrolytes parenterally, i. e. per os. The treatment with antibiotics is not recommended since it could lead to a prolongued germ-carrying, although it is used with high-risk patients or those who suffer from a severe form of the disease. The antimicrobial drugs to be chosen are ciprofloxacin, levofloxacin and cetriaxone. The gastrointestinal infections caused by salmonella are diarrhoea, nausea, vomiting and abdominal pains. The treatment includes rehydration, drug therapy and dietary nutrition. The activities of a nurse/a medical technician comprise hand hygiene, isolation of a patient, education, psychological support to a patient and prevention. The patient care includes pain relief, putting a patient into a comfortable position, treating a patient with prescribed pain relievers, antiemetics, antidiarrheals, antipyretics, easing the patient's fears, motivating the patient to drink liquid, applying the intravenous liquid replacement and preventing dehydration. Patients sholud be provided with peaceful environment, cosy microclimatic room conditions, privacy, hand hygiene, light diet and instructions about how to relax. Prevention is based on appropriate food storage, appropriate thermal food processing, avoiding to consume food of dubious origin and washing hands. |
