{"id":9694,"date":"2024-03-15T06:00:00","date_gmt":"2024-03-15T06:00:00","guid":{"rendered":"https:\/\/www.mojemedunka.cz\/?p=9694"},"modified":"2024-03-13T10:59:15","modified_gmt":"2024-03-13T10:59:15","slug":"o-vzajemnem-souziti-mikroorganismu-a-lidi","status":"publish","type":"post","link":"https:\/\/www.mojemedunka.cz\/index.php\/2024\/03\/15\/o-vzajemnem-souziti-mikroorganismu-a-lidi\/","title":{"rendered":"O vz\u00e1jemn\u00e9m sou\u017eit\u00ed mikroorganism\u016f a lid\u00ed"},"content":{"rendered":"\n

Tak\u00e9 vede va\u0161e prvn\u00ed cesta po n\u00e1vratu dom\u016f do koupelny? Myjete si pe\u010dliv\u011b ruce, abyste si dom\u016f nep\u0159inesli n\u011bco \u0161patn\u00e9ho? Opakujete ne\u00fanavn\u011b d\u011btem i vnou\u010dat\u016fm: \u201eUmyj si ruce!\u201c, \u201eNesahej na to!\u201c, \u201eJe to \u0161pinav\u00e9?\u201c \u010cl\u00e1nek p\u0159ipravial pro Medu\u0148ku p\u0159ed n\u011bkolika lety na\u0161e spolupracovnice, v\u011bdkyn\u011b, badatelka a publicistka<\/strong> prof. RNDr. Anna Struneck\u00e1, DrSc.<\/strong><\/p>\n\n\n\n

<\/p>\n\n\n\n

V\u00a050. letech minul\u00e9ho stolet\u00ed byly na\u0161e p\u0159edstavy o zdrav\u00e9m \u017eivot\u011b zam\u011b\u0159en\u00e9 p\u0159edev\u0161\u00edm na dodr\u017eov\u00e1n\u00ed hygieny. V\u011bd\u011bli jsme, \u017ee mnoho nebezpe\u010dn\u00fdch nemoc\u00ed vyvol\u00e1vaj\u00ed bakterie a viry. B\u00e1li jsme se obrny, tuberkul\u00f3zy, \u017eloutenky, siln\u00fdch pr\u016fjmov\u00fdch onemocn\u011bn\u00ed, ch\u0159ipky, \u010dern\u00e9ho ka\u0161le, ale i kapavky a p\u0159\u00edjice.<\/strong> Po zji\u0161t\u011bn\u00ed, \u017ee p\u0159ed \u010dern\u00fdmi ne\u0161tovicemi, obrnou a tuberkul\u00f3zou n\u00e1s m\u016f\u017ee ochr\u00e1nit v\u010dasn\u00e9 o\u010dkov\u00e1n\u00ed, se za\u010daly vytv\u00e1\u0159et nov\u00e9 vakc\u00edny. L\u00e9ka\u0159i se st\u00e1le u\u010d\u00ed, \u017ee o\u010dkov\u00e1n\u00ed je nej\u00fa\u010dinn\u011bj\u0161\u00ed zp\u016fsob ochrany p\u0159ed infek\u010dn\u00edmi nemocemi zejm\u00e9na d\u011btsk\u00e9ho v\u011bku a stejn\u00e9 p\u0159esv\u011bd\u010den\u00ed m\u00e1 i velk\u00e1 \u010d\u00e1st laick\u00e9 ve\u0159ejnosti.<\/p>\n\n\n\n

I v dne\u0161n\u00ed vysp\u011bl\u00e9 civilizaci hojnosti se \u010dlov\u011bk boj\u00ed ka\u017ed\u00e9 infek\u010dn\u00ed n\u00e1kazy a rad\u011bji vol\u00ed o\u010dkov\u00e1n\u00ed nebo l\u00e9\u010dbu antibiotiky k potla\u010den\u00ed infekce hned v po\u010d\u00e1tku. Matky, kter\u00e9 za\u017eily pl\u00e1\u010d d\u00edt\u011bte s bolav\u00fdm ou\u0161kem, uv\u00edtaj\u00ed s \u00falevou mo\u017enost o\u010dkovat ji\u017e dvoum\u011bs\u00ed\u010dn\u00ed miminko pneumokokovou vakc\u00ednou s nad\u011bj\u00ed, \u017ee ho p\u0159ed touto bolestivou nemoc\u00ed ochr\u00e1n\u00ed. A kolik matek d\u00e1v\u00e1 o\u010dkovat svou dosp\u00edvaj\u00edc\u00ed hol\u010di\u010dku proti rakovin\u011b d\u011blo\u017en\u00edho \u010d\u00edpku vyvolanou sexu\u00e1ln\u011b p\u0159enosn\u00fdmi viry (HPV) s d\u016fv\u011brou, \u017ee ji tak ochr\u00e1n\u00ed p\u0159ed t\u00edmto onemocn\u011bn\u00edm v dosp\u011blosti? Jsou takov\u00e1 rozhodnut\u00ed spr\u00e1vn\u00e1? Chr\u00e1n\u00ed n\u00e1s o\u010dkov\u00e1n\u00ed p\u0159ed infekc\u00ed opravdu spolehliv\u011b? Je povinn\u00e9, p\u0159\u00edpadn\u011b i dal\u0161\u00ed komer\u010dn\u00ed o\u010dkov\u00e1n\u00ed, skute\u010dn\u011b v z\u00e1jmu ochrany zdrav\u00ed? Problematika povinn\u00e9ho a\u00a0plo\u0161n\u00e9ho o\u010dkov\u00e1n\u00ed je v\u00a0sou\u010dasn\u00e9 dob\u011b velmi intenzivn\u011b diskutov\u00e1na u\u00a0n\u00e1s i\u00a0v\u00a0zahrani\u010d\u00ed a\u00a0\u010dten\u00e1\u0159i Medu\u0148ky mohou hledat informace nap\u0159. v\u00a0kn\u00ed\u017ek\u00e1ch MUDr. Ludmily Elekov\u00e9 v\u00a0Knihovni\u010dce Medu\u0148ky <\/em>i\u00a0v\u00a0m\u00fdch kn\u00ed\u017ek\u00e1ch (v\u00edce na www.strunecka.cz<\/a>).
V\u00a0n\u00e1sleduj\u00edc\u00edch \u0159\u00e1dc\u00edch si uk\u00e1\u017eeme, jak je sou\u017eit\u00ed \u010dlov\u011bka a bakteri\u00ed d\u016fle\u017eit\u00e9 pro udr\u017een\u00ed zdrav\u00ed, a tak\u00e9 chci na p\u0159\u00edkladu n\u00e1vratu spalni\u010dek uk\u00e1zat d\u016fsledky toho, jak \u010dlov\u011bk o\u010dkov\u00e1n\u00edm zasahuje do imunitn\u00edho syst\u00e9mu. Rovn\u011b\u017e je d\u016fle\u017eit\u00e9 v\u011bd\u011bt, jak\u00e9 probl\u00e9my p\u0159in\u00e1\u0161\u00ed \u00fazkostn\u00e1 snaha o hygienu a \u010distotu, co\u017e souvis\u00ed s\u00a0t\u00e9matikou mikrobiomu.<\/strong><\/p>\n\n\n\n

Sou\u017eit\u00ed \u010dlov\u011bka a bakteri\u00ed<\/strong>
Ochranu t\u011bla p\u0159ed infekcemi viry a bakteriemi zaji\u0161\u0165uje imunitn\u00ed syst\u00e9m. Nem\u011bli bychom si v\u0161ak p\u0159edstavovat, \u017ee imunitn\u00ed syst\u00e9m \u010dlov\u011bka okam\u017eit\u011b za\u00fato\u010d\u00ed a zlikviduje ka\u017edou bakterii, kter\u00e1 se objev\u00ed. \u010clov\u011bk m\u00e1 ve sv\u00e9m t\u011ble asi 10x vy\u0161\u0161\u00ed po\u010det bakteri\u00ed, ne\u017e je po\u010det bun\u011bk lidsk\u00e9ho t\u011bla. To, \u017ee bakterie \u017eij\u00ed na k\u016f\u017ei, v na\u0161ich \u00fastech, v nose i u\u0161\u00edch, ve vagin\u011b a p\u0159edev\u0161\u00edm ve st\u0159evech, si zpravidla neuv\u011bdomujeme. Na k\u016f\u017ei pom\u00e1haj\u00ed bakterie vytv\u00e1\u0159et p\u0159irozenou bari\u00e9ru p\u0159ed vniknut\u00edm jin\u00fdch patogen\u016f. Bakterie ve st\u0159evech pom\u00e1haj\u00ed tr\u00e1vit potravu a produkuj\u00ed vitaminy. Od narozen\u00ed jsou tak\u00e9 d\u016fle\u017eitou sou\u010d\u00e1st\u00ed imunitn\u00edho syst\u00e9mu \u010dlov\u011bka.
Sou\u017eit\u00ed organismu s bakteriemi nebo viry a tak\u00e9 jeho obrana v\u016f\u010di nim jsou ovliv\u0148ov\u00e1ny mnoha faktory z prost\u0159ed\u00ed, v\u00fd\u017eivou i genetick\u00fdmi dispozicemi. Jde o velice slo\u017eitou s\u00ed\u0165 vz\u00e1jemn\u011b se ovliv\u0148uj\u00edc\u00edch odpov\u011bd\u00ed. Patogenn\u00ed organismy jsou schopn\u00e9 p\u0159ekonat obrann\u00e9 linie, rozmno\u017eit se v t\u011ble nebo v n\u011bkter\u00e9 jeho \u010d\u00e1sti a vyvolat nemoc, av\u0161ak i v p\u0159\u00edpad\u011b patogen\u016f je b\u011b\u017en\u00e9, \u017ee mnoz\u00ed lid\u00e9 je maj\u00ed ve sv\u00e9m t\u011ble, ani\u017e by onemocn\u011bli.
Zaj\u00edmav\u00fdm p\u0159\u00edkladem mikrob\u016f, kter\u00e9 osidluj\u00ed lidsk\u00e9 t\u011blo a nemus\u00ed mu \u0161kodit, jsou bacily tuberkul\u00f3zy, Mycobacterium tuberculosis<\/em>. Odhaduje se, \u017ee v sou\u010dasn\u00e9 dob\u011b infikuj\u00ed n\u011bco mezi 1\u20132 miliardami lid\u00ed na zem\u011bkouli a v\u011bt\u0161ina z nich si toho v\u016fbec nen\u00ed v\u011bdoma. Pokud v\u0161ak u takov\u00e9ho \u010dlov\u011bka dojde k oslaben\u00ed imunitn\u00edho syst\u00e9mu, t\u0159eba v\u00a0d\u016fsledku l\u00e9\u010den\u00ed nebo infek\u010dn\u00ed n\u00e1kazy, jemn\u00e1 rovnov\u00e1ha mezi imunitn\u00edm syst\u00e9mem a bakteri\u00ed se vych\u00fdl\u00ed, bakterie se m\u016f\u017ee za\u010d\u00edt mno\u017eit zcela nekontrolovateln\u00fdm zp\u016fsobem, a\u017e vznikne v\u00e1\u017en\u00e1 nemoc. O smutn\u00fdch zji\u0161t\u011bn\u00edch p\u0159\u00edtomnosti skryt\u00fdch patogenn\u00edch vir\u016f ve vakc\u00edn\u00e1ch proti d\u011btsk\u00fdm nemocem p\u00ed\u0161u v\u00a0na\u0161\u00ed kn\u00ed\u017ece Varovn\u00e9 sign\u00e1ly o\u010dkov\u00e1n\u00ed<\/em>. Epidemiologov\u00e9 dnes bohu\u017eel zji\u0161\u0165uj\u00ed, \u017ee patogenn\u00ed mikroorganismy mohou p\u0159en\u00e1\u0161et i o\u010dkovan\u00e9 d\u011bti, jako je tomu nap\u0159\u00edklad u \u010dern\u00e9ho ka\u0161le.<\/p>\n\n\n\n

Mikrobiom<\/strong>
Zji\u0161t\u011bn\u00ed, \u017ee v\u00a0tr\u00e1vic\u00edm traktu \u010dlov\u011bka \u017eije asi 10 miliard bakteri\u00e1ln\u00edch bun\u011bk, jejich\u017e po\u010det gen\u016f je stokr\u00e1t v\u011bt\u0161\u00ed, ne\u017e je po\u010det gen\u016f na\u0161eho t\u011bla, vyvolalo zm\u011bnu v n\u00e1zoru, \u017ee je t\u0159eba usmrtit ka\u017ed\u00e9ho mikroba, kter\u00fd se objev\u00ed v lidsk\u00e9m t\u011ble. Intenzivn\u00ed v\u00fdzkum sv\u011bta mikrob\u016f (mikrobiomu) dnes prob\u00edh\u00e1 na des\u00edtk\u00e1ch pracovi\u0161\u0165 ve sv\u011bt\u011b.
Prvn\u00ed \u201en\u00e1kazu\u201c t\u011bmito bakteriemi d\u00edt\u011b spolkne od matky p\u0159i porodu. D\u011bti, kter\u00e9 p\u0159ijdou na sv\u011bt c\u00edsa\u0159sk\u00fdm \u0159ezem, proto m\u016f\u017eou m\u00edt probl\u00e9my s os\u00eddlen\u00edm st\u0159eva a spr\u00e1vn\u00fdm fungov\u00e1n\u00edm mikrobiomu. Nezastupitelnou \u00falohu v rozvoji mikrobiomu sehr\u00e1v\u00e1 tak\u00e9 kojen\u00ed mate\u0159sk\u00fdm ml\u00e9kem. Miliardy bakteri\u00ed n\u00e1m pom\u00e1haj\u00ed tr\u00e1vit, posilovat imunitu a vyr\u00e1b\u011bt r\u016fzn\u00e9 vitaminy i molekuly, kter\u00e9 ovliv\u0148uj\u00ed dokonce i \u010dinnost mozku.
St\u0159evn\u00ed mikrobiom ka\u017ed\u00e9ho z\u00a0n\u00e1s je stejn\u011b jedine\u010dn\u00fd jako otisky prst\u016f. Prom\u00edtaj\u00ed se do n\u011bj v\u0161echny negativn\u00ed vlivy, kter\u00fdm jsme b\u011bhem \u017eivota vystavili na\u0161i tr\u00e1vic\u00ed soustavu, jako je nap\u0159\u00edklad u\u017e\u00edv\u00e1n\u00ed antibiotik, l\u00e9\u010div a \u00e9\u010dek z\u00a0potravin. Ve strav\u011b by proto m\u011blo b\u00fdt dostatek vl\u00e1kniny, m\u011bla by zahrnovat fermentovan\u00e9 ml\u00e9\u010dn\u00e9 v\u00fdrobky a kva\u0161enou zeleninu s obsahem probiotick\u00fdch mikroorganism\u016f. M\u00edsto kupov\u00e1n\u00ed hojn\u011b nab\u00edzen\u00fdch drah\u00fdch dopl\u0148k\u016f stravy s\u00a0obsahem probiotik by se v\u00a0ka\u017ed\u00e9 dom\u00e1cnosti m\u011bla zav\u00e9st fermentace zeleniny, kter\u00e1 obsahuje velk\u00e9 mno\u017estv\u00ed u\u017eite\u010dn\u00fdch mikroorganism\u016f, a nav\u00edc \u0161et\u0159\u00ed na\u0161i pen\u011b\u017eenku.
V\u00a0posledn\u00ed dob\u011b se ve sv\u011bt\u011b i u n\u00e1s tak\u00e9 velmi rychle roz\u0161\u00ed\u0159ila tzv. fek\u00e1ln\u00ed transplantace. Transplantace stolice je z\u00e1krok, p\u0159i kter\u00e9m doch\u00e1z\u00ed k\u00a0odb\u011bru stolice od p\u0159edem vytipovan\u00e9ho a vy\u0161et\u0159en\u00e9ho d\u00e1rce. Odebran\u00e1 stolice je pot\u00e9 sm\u00edch\u00e1na s\u00a0fyziologick\u00fdm roztokem a n\u00e1sledn\u011b je vpravena do tlust\u00e9ho st\u0159eva pacienta. Fek\u00e1ln\u00ed transplantace je velmi dob\u0159e funguj\u00edc\u00ed l\u00e9\u010dbou u pacient\u016f, kte\u0159\u00ed trp\u00ed opakuj\u00edc\u00edmi se z\u00e1n\u011bty st\u0159ev, kter\u00e9 zp\u016fsobuje st\u0159evn\u00ed bakt\u00e9rie zn\u00e1m\u00e1 pod n\u00e1zvem Clostridium difficile<\/em>. Klinick\u00e9 studie ukazuj\u00ed, \u017ee do budoucna by se tato metoda mohla dob\u0159e uplatnit i p\u0159i l\u00e9\u010db\u011b syndromu dr\u00e1\u017ediv\u00e9ho tra\u010dn\u00edku, ulcer\u00f3zn\u00ed kolitidy, autoimunitn\u00edch onemocn\u011bn\u00ed, chronick\u00e9ho \u00fanavov\u00e9ho syndromu, celiakie, obezity, potravinov\u00fdch alergi\u00ed, revmatoidn\u00ed artritidy, cukrovky a mo\u017en\u00e1 i Parkinsonovy nemoci. M\u00e1te u\u017e sv\u00e9ho zdrav\u00e9ho d\u00e1rce?<\/p>\n\n\n\n

Co n\u00e1m ukazuje pades\u00e1tilet\u00e1 historie o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m?<\/strong>
Na po\u010d\u00e1tku 60. let minul\u00e9ho stolet\u00ed popisovali epidemiologov\u00e9 spalni\u010dky jako st\u0159edn\u011b v\u00e1\u017enou d\u011btskou infekci o\u00a0kr\u00e1tk\u00e9m trv\u00e1n\u00ed a\u00a0n\u00edzk\u00e9 \u00famrtnosti. L\u00e9ka\u0159i v\u011bd\u011bli, \u017ee \u017eeny, kter\u00e9 prod\u011blaly spalni\u010dky jako d\u011bti, pasivn\u011b p\u0159en\u00e1\u0161ely protil\u00e1tky proti vir\u016fm spalni\u010dek v\u00a0pr\u016fb\u011bhu t\u011bhotenstv\u00ed na vyv\u00edjej\u00edc\u00ed se plod. Novorozenci byli chr\u00e1n\u011bni v\u00a0pr\u016fb\u011bhu prvn\u00edho roku \u017eivota (a\u00a0mo\u017en\u00e1 i\u00a0d\u00e9le). Spalni\u010dky byly obvykle nemoc\u00ed \u0161koln\u00edch d\u011bt\u00ed. Jejich prod\u011bl\u00e1n\u00ed poskytlo ka\u017ed\u00e9mu dlouhodobou imunitu a imunita rodi\u010d\u016f byla op\u011btovn\u011b posilov\u00e1na kontaktem s\u00a0viry od jejich nemocn\u00fdch d\u011bt\u00ed.
V\u00a0sou\u010dasn\u00e9 dob\u011b je v\u011bt\u0161ina matek proti spalni\u010dk\u00e1m ji\u017e o\u010dkov\u00e1na, a tak v\u00a0porovn\u00e1n\u00ed s t\u00edm, jak\u00e9 by to bylo, kdyby spalni\u010dky prod\u011blaly, maj\u00ed protil\u00e1tek nedostatek. Jejich d\u011bti pak v\u016f\u010di spalni\u010dk\u00e1m imunitu nemaj\u00ed. Vypl\u00fdv\u00e1 z\u00a0toho, \u017ee o\u010dkov\u00e1n\u00ed vakc\u00ednou MMR (spalni\u010dky, p\u0159\u00edu\u0161nice a zard\u011bnky) zaveden\u00e9 v\u00a060. letech zp\u016fsobilo, \u017ee dne\u0161n\u00ed novorozenci a\u00a0kojenci jsou n\u00e1chyln\u00ed k\u00a0n\u00e1kaze spalni\u010dek od nejrann\u011bj\u0161\u00edho v\u011bku. Objevuj\u00ed se i epidemie p\u0159\u00edu\u0161nic u adolescent\u016f.
Plo\u0161n\u00e9 o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m prov\u00e1d\u011bn\u00e9 v\u00a0dob\u011b, kdy byla je\u0161t\u011b velk\u00e1 \u010d\u00e1st osob st\u0159edn\u00edho a vy\u0161\u0161\u00edho v\u011bku chr\u00e1n\u011bn\u00e1 celo\u017eivotn\u00ed imunitou po p\u0159irozen\u011b prod\u011blan\u00e9m onemocn\u011bn\u00ed, vedlo ve spole\u010dnosti k ukon\u010den\u00ed cirkulace p\u016fvodn\u00edho divok\u00e9ho viru spalni\u010dek. O\u010dkov\u00e1n\u00ed tak\u00e9 p\u016fvodn\u00ed virus p\u0159inutilo k\u00a0mnoha mutac\u00edm. Cirkuluj\u00edc\u00ed viry genotyp\u016f D4, D6, D7, a\u00a0B3, proti kter\u00fdm imunizace o\u010dkov\u00e1n\u00edm nechr\u00e1n\u00ed, zp\u016fsobuj\u00ed dnes onemocn\u011bn\u00ed u\u00a0dosp\u011bl\u00fdch.
Vypuknut\u00ed spalni\u010dek v\u00a0EU a v USA v\u00a0sou\u010dasn\u00e9 dob\u011b vyvol\u00e1v\u00e1 siln\u00e9 reakce m\u00e9di\u00ed a\u00a0vakcinolog\u016f. V\u00a0b\u0159eznu 2019 bylo v\u00a0EU s\u00a0populac\u00ed 512 milion\u016f ob\u010dan\u016f zaznamen\u00e1no asi 2 000 p\u0159\u00edpad\u016f spalni\u010dek. V\u00a0USA s\u00a0populac\u00ed 328 milion\u016f ob\u010dan\u016f to v\u00a0kv\u011btnu 2019 bylo 839 p\u0159\u00edpad\u016f. Po letech, kdy v\u00fdskyt spalni\u010dek v\u00a0\u010cR nep\u0159esahoval 10\u201320 p\u0159\u00edpad\u016f ro\u010dn\u011b, bylo od za\u010d\u00e1tku roku 2018 a\u017e do 13. 12. 2019 jenom v\u00a0Praze evidov\u00e1no\u00a0290 p\u0159\u00edpad\u016f! <\/strong>Hygienici doporu\u010duj\u00ed o\u010dkov\u00e1n\u00ed, l\u00e9ka\u0159i se nech\u00e1vaj\u00ed p\u0159eo\u010dkovat, av\u0161ak spalni\u010dky se zastavit neda\u0159\u00ed.
Vysok\u00fd po\u010det onemocn\u011bn\u00ed spalni\u010dkami je hl\u00e1\u0161en\u00fd ze <\/strong>170 zem\u00ed sv\u011bta, zejm\u00e9na rozvojov\u00fdch, kde je i vysok\u00e1 \u00famrtnost podvy\u017eiven\u00fdch d\u011bt\u00ed. <\/strong>Varovn\u00fd prst p\u0159edstavitel\u016f WHO a\u00a0vakcinolog\u016f v\u00a0USA a v EU v\u0161ak ukazuje na \u201eantivaxxery\u201c, odp\u016frce o\u010dkov\u00e1n\u00ed, kte\u0159\u00ed nedali sv\u00e9 d\u011bti o\u010dkovat vakc\u00ednou MMR. Podobn\u00e9 n\u00e1zory se \u0161\u00ed\u0159\u00ed i\u00a0v\u00a0\u010cR. MUDr. Milan Kubek, <\/em>prezident\u00a0\u010cesk\u00e9 l\u00e9ka\u0159sk\u00e9 komory nap\u0159\u00edklad prohl\u00e1sil: \u201eSpalni\u010dky se u n\u00e1s \u0161\u00ed\u0159\u00ed proto, \u017ee n\u011bkte\u0159\u00ed blbe\u010dkov\u00e9 \u2013 rodi\u010de d\u011bt\u00ed je nedali o\u010dkovat<\/em>.\u201c
Po\u010det d\u011bt\u00ed, kter\u00e9 nejsou o\u010dkovan\u00e9 proti spalni\u010dk\u00e1m, byl v\u00a0\u010cR do roku 2017 1-3 %. Proto pouze 1-3 % d\u011bt\u00ed (dnes maxim\u00e1ln\u011b 3-4 %) jsou skute\u010dn\u011b rizikov\u00e1 z d\u016fvodu odm\u00edtnut\u00ed o\u010dkov\u00e1n\u00ed sv\u00fdmi rodi\u010di. \u00dadaje o n\u00edzk\u00e9 proo\u010dkovanosti d\u011bt\u00ed proti spalni\u010dk\u00e1m, kter\u00e9 se dnes u\u00a0n\u00e1s uv\u00e1d\u011bj\u00ed v\u00a0rozmez\u00ed 93-83,5 %, jsou tedy zav\u00e1d\u011bj\u00edc\u00ed. Vyjad\u0159uj\u00ed, kolik d\u011bt\u00ed nedostalo v\u00a0z\u00e1konn\u00e9m term\u00ednu ob\u011b d\u00e1vky MMR vakc\u00edny. V roce 2018 bylo v\u00a0\u010cR posunuto doporu\u010den\u00ed pod\u00e1vat druhou d\u00e1vku vakc\u00edny MMR ze 24 m\u011bs\u00edc\u016f na 5. rok v\u011bku d\u00edt\u011bte. V\u011bt\u0161ina z\u00a0d\u011bt\u00ed, ozna\u010den\u00fdch dnes t\u00edmto trikov\u00fdm zp\u016fsobem za neproo\u010dkovan\u00e9, jsou d\u011bti imunologicky chr\u00e1n\u011bn\u00e9 jednou d\u00e1vkou MMR vakc\u00edny nebo dokonce ob\u011bma d\u00e1vkami, pouze jsou doo\u010dkovan\u00e9 o n\u011bco pozd\u011bji. Takov\u00e9 d\u011bti se na sou\u010dasn\u00fdch epidemi\u00edch spalni\u010dek pod\u00edlet v\u016fbec nemohou a rozhodn\u011b nepat\u0159\u00ed mezi jejich p\u0159\u00ed\u010diny.
V\u011bdci zjistili, \u017ee imunita navozen\u00e1 o\u010dkov\u00e1n\u00edm vyvane mnohem rychleji ne\u017e imunita vyvolan\u00e1 onemocn\u011bn\u00edm spalni\u010dkami. V\u00a0n\u011bkter\u00fdch p\u0159\u00edpadech je tak\u00e9 \u00a0\u00a0hladina protil\u00e1tek mnohem ni\u017e\u0161\u00ed. Kanadsk\u00e1 studie uk\u00e1zala, \u017ee 92 % t\u0159\u00edm\u011bs\u00ed\u010dn\u00edch a\u00a0100 % \u0161estim\u011bs\u00ed\u010dn\u00edch kojenc\u016f m\u00e1 ni\u017e\u0161\u00ed hladinu protil\u00e1tek, ne\u017e by bylo t\u0159eba k\u00a0jejich ochran\u011b. Sv\u011bd\u010d\u00ed to o\u00a0tom, \u017ee vakc\u00edna MMR nen\u00ed schopn\u00e1 navodit dostate\u010dn\u00fd titr protil\u00e1tek u\u00a0o\u010dkovan\u00fdch matek, kter\u00fd by mohl ochr\u00e1nit jejich\u00a0kojence po prvn\u00ed rok \u017eivota p\u0159ed n\u00e1kazou spalni\u010dkami. Takto mal\u00e9 d\u011bti se o\u010dkovat vakc\u00ednou MMR nemohou a po propuknut\u00ed nemoci maj\u00ed vy\u0161\u0161\u00ed riziko \u00famrtnosti.
Nam\u00edsto obvi\u0148ov\u00e1n\u00ed odp\u016frc\u016f o\u010dkov\u00e1n\u00ed je tedy \u010das zodpov\u011bdn\u011b zhodnotit d\u016fsledky o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m. Patrn\u011b ji\u017e p\u0159ed jeho zah\u00e1jen\u00edm v\u00a060. letech 20. stolet\u00ed m\u011bla b\u00fdt polo\u017eena ot\u00e1zka, zda je o\u010dkov\u00e1n\u00ed vakc\u00ednou MMR v\u016fbec vhodn\u00e9.\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0<\/p>\n\n\n\n

Snaha o p\u0159\u00edli\u0161nou \u010distotu m\u016f\u017ee \u0161kodit<\/strong>
Bakterie a jejich spory i viry jsou v\u0161ude kolem n\u00e1s, na v\u0161ech p\u0159edm\u011btech, ve vzduchu i na na\u0161ich ruk\u00e1ch. Pokud je n\u00e1\u0161 imunitn\u00ed syst\u00e9m zdrav\u00fd, dok\u00e1\u017ee jim odol\u00e1vat. Je-li v\u0161ak imunitn\u00ed syst\u00e9m oslaben\u00fd, vyvol\u00e1v\u00e1 p\u0159emno\u017een\u00ed patogenn\u00ed bakterie nebo viru nemoc. Uv\u011bdomili jste si n\u011bkdy, \u017ee p\u0159i usilovn\u00e9 snaze o o\u010distu sv\u00e9ho t\u011bla a cel\u00e9 dom\u00e1cnosti m\u016f\u017eete navodit zna\u010dn\u011b nebezpe\u010dnou situaci pro zdrav\u00ed cel\u00e9 rodiny a m\u016f\u017eete zp\u016fsobit prav\u00fd opak toho, o\u010d usilujete?
D\u00edt\u011b, kter\u00e9 vyr\u016fst\u00e1 v\u00a0dom\u00e1cnosti prosycen\u00e9 antibakteri\u00e1ln\u00edmi m\u00fddly a dezinfek\u010dn\u00edmi prost\u0159edky, dost\u00e1v\u00e1 antibiotika a je \u00fazkostliv\u011b chr\u00e1n\u011bno p\u0159ed p\u0159irozenou \u201e\u0161p\u00ednou\u201c, viry a bakteriemi, toti\u017e nen\u00ed schopn\u00e9 vytvo\u0159it si p\u0159irozenou ochranu p\u0159ed nemocemi a tak\u00e9 se st\u00e1v\u00e1 n\u00e1chyln\u00e9 v\u016f\u010di nemocem v\u00a0pozd\u011bj\u0161\u00edm v\u011bku.
V\u00a0posledn\u00ed dob\u011b se diskutuje o tom, \u017ee p\u0159ehnan\u00e1 p\u00e9\u010de o hygienu je p\u0159\u00ed\u010dinou mnoha alergi\u00ed a poruch imunitn\u00edho syst\u00e9mu. Prosp\u011b\u0161n\u00e9 bakterie, kter\u00e9 \u017eij\u00ed na na\u0161\u00ed k\u016f\u017ei i ve vlasech, se tak\u00e9 po\u0161kozuj\u00ed \u010dast\u00fdm myt\u00edm. V\u011bdci zji\u0161\u0165uj\u00ed, \u017ee dezinfek\u010dn\u00ed \u010dinidla ve z\u0159ed\u011bn\u00e9 form\u011b mohou mnohdy bakterie pos\u00edlit a stimulovat vznik rezistentn\u00edch kmen\u016f. K\u00a0tomu doch\u00e1z\u00ed i v\u00a0dom\u00e1cnostech.
Nejlep\u0161\u00edmi a ne\u0161kodn\u00fdmi prost\u0159edky pro udr\u017eov\u00e1n\u00ed \u010distoty t\u011bla jsou m\u00fddlo a voda<\/strong>. Pro \u00faklid kuchyn\u011b, prk\u00e9nek a koupelen je vhodn\u00fd 3% peroxid vod\u00edku a ocet. Ka\u017edou z\u00a0t\u011bchto tekutin bychom m\u011bli m\u00edt ve zvl\u00e1\u0161tn\u00ed n\u00e1dob\u011b s\u00a0rozpra\u0161ova\u010dem, nejprve povrch post\u0159\u00edkat peroxidem vod\u00edku a pot\u00e9 octem. \u00a0Peroxid vod\u00edku je v\u00a0porovn\u00e1n\u00ed s r\u016fzn\u00fdmi dezinfek\u010dn\u00edmi a b\u011bl\u00edc\u00edmi p\u0159\u00edpravky s\u00a0chlorem bezpe\u010dn\u011bj\u0161\u00ed. Tak\u00e9 soda je skv\u011bl\u00fd \u010dist\u00edc\u00ed prost\u0159edek. Sm\u00edch\u00e1me-li ji s\u00a0jable\u010dn\u00fdm octem, vznikne bublav\u00e1 sm\u011bs, kter\u00e1 dob\u0159e vy\u010dist\u00ed odpady v\u00a0kuchy\u0148sk\u00e9 v\u00fdlevce i v\u00a0koupeln\u011b. Po 15 minut\u00e1ch p\u016fsoben\u00ed prolijeme v\u00fdlevku horkou vodou.
Ocet m\u016f\u017eeme pou\u017e\u00edt k\u00a0vy\u010di\u0161t\u011bn\u00ed prakticky \u010dehokoliv v\u00a0dom\u00e1cnosti.<\/strong> Jestli\u017ee ho sm\u00edch\u00e1me s\u00a0trochou tekut\u00e9ho m\u00fddla, levandulov\u00fdm olejem a vodou, m\u016f\u017eeme s\u00a0takovou sm\u011bs\u00ed um\u00fdvat dve\u0159e, okna, kuchyn\u011b i koupelny. Jsou to prost\u0159edky, kter\u00e9 jsou zdrav\u00ed ne\u0161kodn\u00e9, a nav\u00edc jsou levn\u00e9.
Nezapom\u00ednejme na to, \u017ee tak\u00e9 slune\u010dn\u00ed z\u00e1\u0159en\u00ed je t\u00edm nejlep\u0161\u00edm dezinfek\u010dn\u00edm prost\u0159edkem. M\u011bli bychom co nejv\u00edc vyu\u017e\u00edvat mo\u017enost su\u0161en\u00ed pr\u00e1dla na slunci, jeho\u017e v\u016fn\u011b ur\u010dit\u011b p\u0159ed\u010d\u00ed v\u0161echny um\u011bl\u00e9 aviv\u00e1\u017ee.<\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"

Tak\u00e9 vede va\u0161e prvn\u00ed cesta po n\u00e1vratu dom\u016f do koupelny? Myjete si pe\u010dliv\u011b ruce, abyste si dom\u016f nep\u0159inesli n\u011bco \u0161patn\u00e9ho? Opakujete ne\u00fanavn\u011b d\u011btem i vnou\u010dat\u016fm: \u201eUmyj si ruce!\u201c, \u201eNesahej na to!\u201c, \u201eJe to \u0161pinav\u00e9?\u201c \u010cl\u00e1nek p\u0159ipravial pro Medu\u0148ku p\u0159ed n\u011bkolika lety na\u0161e spolupracovnice, v\u011bdkyn\u011b, badatelka a publicistka prof. RNDr. Anna Struneck\u00e1, DrSc. V\u00a050. letech minul\u00e9ho stolet\u00ed byly na\u0161e p\u0159edstavy o zdrav\u00e9m \u017eivot\u011b zam\u011b\u0159en\u00e9 p\u0159edev\u0161\u00edm na dodr\u017eov\u00e1n\u00ed hygieny. V\u011bd\u011bli jsme, \u017ee mnoho nebezpe\u010dn\u00fdch nemoc\u00ed vyvol\u00e1vaj\u00ed bakterie a viry. B\u00e1li jsme se obrny, tuberkul\u00f3zy, \u017eloutenky, siln\u00fdch pr\u016fjmov\u00fdch onemocn\u011bn\u00ed, ch\u0159ipky, \u010dern\u00e9ho ka\u0161le, ale i kapavky a p\u0159\u00edjice. Po zji\u0161t\u011bn\u00ed, \u017ee p\u0159ed \u010dern\u00fdmi ne\u0161tovicemi, obrnou a tuberkul\u00f3zou n\u00e1s m\u016f\u017ee ochr\u00e1nit v\u010dasn\u00e9 o\u010dkov\u00e1n\u00ed, se za\u010daly vytv\u00e1\u0159et nov\u00e9 vakc\u00edny. L\u00e9ka\u0159i se st\u00e1le u\u010d\u00ed, \u017ee o\u010dkov\u00e1n\u00ed je nej\u00fa\u010dinn\u011bj\u0161\u00ed zp\u016fsob ochrany p\u0159ed infek\u010dn\u00edmi nemocemi zejm\u00e9na d\u011btsk\u00e9ho v\u011bku a stejn\u00e9 p\u0159esv\u011bd\u010den\u00ed m\u00e1 i velk\u00e1 \u010d\u00e1st laick\u00e9 ve\u0159ejnosti. I v dne\u0161n\u00ed vysp\u011bl\u00e9 civilizaci hojnosti se \u010dlov\u011bk boj\u00ed ka\u017ed\u00e9 infek\u010dn\u00ed n\u00e1kazy a rad\u011bji vol\u00ed o\u010dkov\u00e1n\u00ed nebo l\u00e9\u010dbu antibiotiky k potla\u010den\u00ed infekce hned v po\u010d\u00e1tku. Matky, kter\u00e9 za\u017eily pl\u00e1\u010d d\u00edt\u011bte s bolav\u00fdm ou\u0161kem, uv\u00edtaj\u00ed s \u00falevou mo\u017enost o\u010dkovat ji\u017e dvoum\u011bs\u00ed\u010dn\u00ed miminko pneumokokovou vakc\u00ednou s nad\u011bj\u00ed, \u017ee ho p\u0159ed touto bolestivou nemoc\u00ed ochr\u00e1n\u00ed. A kolik matek d\u00e1v\u00e1 o\u010dkovat svou dosp\u00edvaj\u00edc\u00ed hol\u010di\u010dku proti rakovin\u011b d\u011blo\u017en\u00edho \u010d\u00edpku vyvolanou sexu\u00e1ln\u011b p\u0159enosn\u00fdmi viry (HPV) s d\u016fv\u011brou, \u017ee ji tak ochr\u00e1n\u00ed p\u0159ed t\u00edmto onemocn\u011bn\u00edm v dosp\u011blosti? Jsou takov\u00e1 rozhodnut\u00ed spr\u00e1vn\u00e1? Chr\u00e1n\u00ed n\u00e1s o\u010dkov\u00e1n\u00ed p\u0159ed infekc\u00ed opravdu spolehliv\u011b? Je povinn\u00e9, p\u0159\u00edpadn\u011b i dal\u0161\u00ed komer\u010dn\u00ed o\u010dkov\u00e1n\u00ed, skute\u010dn\u011b v z\u00e1jmu ochrany zdrav\u00ed? Problematika povinn\u00e9ho a\u00a0plo\u0161n\u00e9ho o\u010dkov\u00e1n\u00ed je v\u00a0sou\u010dasn\u00e9 dob\u011b velmi intenzivn\u011b diskutov\u00e1na u\u00a0n\u00e1s i\u00a0v\u00a0zahrani\u010d\u00ed a\u00a0\u010dten\u00e1\u0159i Medu\u0148ky mohou hledat informace nap\u0159. v\u00a0kn\u00ed\u017ek\u00e1ch MUDr. Ludmily Elekov\u00e9 v\u00a0Knihovni\u010dce Medu\u0148ky i\u00a0v\u00a0m\u00fdch kn\u00ed\u017ek\u00e1ch (v\u00edce na www.strunecka.cz).V\u00a0n\u00e1sleduj\u00edc\u00edch \u0159\u00e1dc\u00edch si uk\u00e1\u017eeme, jak je sou\u017eit\u00ed \u010dlov\u011bka a bakteri\u00ed d\u016fle\u017eit\u00e9 pro udr\u017een\u00ed zdrav\u00ed, a tak\u00e9 chci na p\u0159\u00edkladu n\u00e1vratu spalni\u010dek uk\u00e1zat d\u016fsledky toho, jak \u010dlov\u011bk o\u010dkov\u00e1n\u00edm zasahuje do imunitn\u00edho syst\u00e9mu. Rovn\u011b\u017e je d\u016fle\u017eit\u00e9 v\u011bd\u011bt, jak\u00e9 probl\u00e9my p\u0159in\u00e1\u0161\u00ed \u00fazkostn\u00e1 snaha o hygienu a \u010distotu, co\u017e souvis\u00ed s\u00a0t\u00e9matikou mikrobiomu. Sou\u017eit\u00ed \u010dlov\u011bka a bakteri\u00edOchranu t\u011bla p\u0159ed infekcemi viry a bakteriemi zaji\u0161\u0165uje imunitn\u00ed syst\u00e9m. Nem\u011bli bychom si v\u0161ak p\u0159edstavovat, \u017ee imunitn\u00ed syst\u00e9m \u010dlov\u011bka okam\u017eit\u011b za\u00fato\u010d\u00ed a zlikviduje ka\u017edou bakterii, kter\u00e1 se objev\u00ed. \u010clov\u011bk m\u00e1 ve sv\u00e9m t\u011ble asi 10x vy\u0161\u0161\u00ed po\u010det bakteri\u00ed, ne\u017e je po\u010det bun\u011bk lidsk\u00e9ho t\u011bla. To, \u017ee bakterie \u017eij\u00ed na k\u016f\u017ei, v na\u0161ich \u00fastech, v nose i u\u0161\u00edch, ve vagin\u011b a p\u0159edev\u0161\u00edm ve st\u0159evech, si zpravidla neuv\u011bdomujeme. Na k\u016f\u017ei pom\u00e1haj\u00ed bakterie vytv\u00e1\u0159et p\u0159irozenou bari\u00e9ru p\u0159ed vniknut\u00edm jin\u00fdch patogen\u016f. Bakterie ve st\u0159evech pom\u00e1haj\u00ed tr\u00e1vit potravu a produkuj\u00ed vitaminy. Od narozen\u00ed jsou tak\u00e9 d\u016fle\u017eitou sou\u010d\u00e1st\u00ed imunitn\u00edho syst\u00e9mu \u010dlov\u011bka.Sou\u017eit\u00ed organismu s bakteriemi nebo viry a tak\u00e9 jeho obrana v\u016f\u010di nim jsou ovliv\u0148ov\u00e1ny mnoha faktory z prost\u0159ed\u00ed, v\u00fd\u017eivou i genetick\u00fdmi dispozicemi. Jde o velice slo\u017eitou s\u00ed\u0165 vz\u00e1jemn\u011b se ovliv\u0148uj\u00edc\u00edch odpov\u011bd\u00ed. Patogenn\u00ed organismy jsou schopn\u00e9 p\u0159ekonat obrann\u00e9 linie, rozmno\u017eit se v t\u011ble nebo v n\u011bkter\u00e9 jeho \u010d\u00e1sti a vyvolat nemoc, av\u0161ak i v p\u0159\u00edpad\u011b patogen\u016f je b\u011b\u017en\u00e9, \u017ee mnoz\u00ed lid\u00e9 je maj\u00ed ve sv\u00e9m t\u011ble, ani\u017e by onemocn\u011bli.Zaj\u00edmav\u00fdm p\u0159\u00edkladem mikrob\u016f, kter\u00e9 osidluj\u00ed lidsk\u00e9 t\u011blo a nemus\u00ed mu \u0161kodit, jsou bacily tuberkul\u00f3zy, Mycobacterium tuberculosis. Odhaduje se, \u017ee v sou\u010dasn\u00e9 dob\u011b infikuj\u00ed n\u011bco mezi 1\u20132 miliardami lid\u00ed na zem\u011bkouli a v\u011bt\u0161ina z nich si toho v\u016fbec nen\u00ed v\u011bdoma. Pokud v\u0161ak u takov\u00e9ho \u010dlov\u011bka dojde k oslaben\u00ed imunitn\u00edho syst\u00e9mu, t\u0159eba v\u00a0d\u016fsledku l\u00e9\u010den\u00ed nebo infek\u010dn\u00ed n\u00e1kazy, jemn\u00e1 rovnov\u00e1ha mezi imunitn\u00edm syst\u00e9mem a bakteri\u00ed se vych\u00fdl\u00ed, bakterie se m\u016f\u017ee za\u010d\u00edt mno\u017eit zcela nekontrolovateln\u00fdm zp\u016fsobem, a\u017e vznikne v\u00e1\u017en\u00e1 nemoc. O smutn\u00fdch zji\u0161t\u011bn\u00edch p\u0159\u00edtomnosti skryt\u00fdch patogenn\u00edch vir\u016f ve vakc\u00edn\u00e1ch proti d\u011btsk\u00fdm nemocem p\u00ed\u0161u v\u00a0na\u0161\u00ed kn\u00ed\u017ece Varovn\u00e9 sign\u00e1ly o\u010dkov\u00e1n\u00ed. Epidemiologov\u00e9 dnes bohu\u017eel zji\u0161\u0165uj\u00ed, \u017ee patogenn\u00ed mikroorganismy mohou p\u0159en\u00e1\u0161et i o\u010dkovan\u00e9 d\u011bti, jako je tomu nap\u0159\u00edklad u \u010dern\u00e9ho ka\u0161le. MikrobiomZji\u0161t\u011bn\u00ed, \u017ee v\u00a0tr\u00e1vic\u00edm traktu \u010dlov\u011bka \u017eije asi 10 miliard bakteri\u00e1ln\u00edch bun\u011bk, jejich\u017e po\u010det gen\u016f je stokr\u00e1t v\u011bt\u0161\u00ed, ne\u017e je po\u010det gen\u016f na\u0161eho t\u011bla, vyvolalo zm\u011bnu v n\u00e1zoru, \u017ee je t\u0159eba usmrtit ka\u017ed\u00e9ho mikroba, kter\u00fd se objev\u00ed v lidsk\u00e9m t\u011ble. Intenzivn\u00ed v\u00fdzkum sv\u011bta mikrob\u016f (mikrobiomu) dnes prob\u00edh\u00e1 na des\u00edtk\u00e1ch pracovi\u0161\u0165 ve sv\u011bt\u011b.Prvn\u00ed \u201en\u00e1kazu\u201c t\u011bmito bakteriemi d\u00edt\u011b spolkne od matky p\u0159i porodu. D\u011bti, kter\u00e9 p\u0159ijdou na sv\u011bt c\u00edsa\u0159sk\u00fdm \u0159ezem, proto m\u016f\u017eou m\u00edt probl\u00e9my s os\u00eddlen\u00edm st\u0159eva a spr\u00e1vn\u00fdm fungov\u00e1n\u00edm mikrobiomu. Nezastupitelnou \u00falohu v rozvoji mikrobiomu sehr\u00e1v\u00e1 tak\u00e9 kojen\u00ed mate\u0159sk\u00fdm ml\u00e9kem. Miliardy bakteri\u00ed n\u00e1m pom\u00e1haj\u00ed tr\u00e1vit, posilovat imunitu a vyr\u00e1b\u011bt r\u016fzn\u00e9 vitaminy i molekuly, kter\u00e9 ovliv\u0148uj\u00ed dokonce i \u010dinnost mozku.St\u0159evn\u00ed mikrobiom ka\u017ed\u00e9ho z\u00a0n\u00e1s je stejn\u011b jedine\u010dn\u00fd jako otisky prst\u016f. Prom\u00edtaj\u00ed se do n\u011bj v\u0161echny negativn\u00ed vlivy, kter\u00fdm jsme b\u011bhem \u017eivota vystavili na\u0161i tr\u00e1vic\u00ed soustavu, jako je nap\u0159\u00edklad u\u017e\u00edv\u00e1n\u00ed antibiotik, l\u00e9\u010div a \u00e9\u010dek z\u00a0potravin. Ve strav\u011b by proto m\u011blo b\u00fdt dostatek vl\u00e1kniny, m\u011bla by zahrnovat fermentovan\u00e9 ml\u00e9\u010dn\u00e9 v\u00fdrobky a kva\u0161enou zeleninu s obsahem probiotick\u00fdch mikroorganism\u016f. M\u00edsto kupov\u00e1n\u00ed hojn\u011b nab\u00edzen\u00fdch drah\u00fdch dopl\u0148k\u016f stravy s\u00a0obsahem probiotik by se v\u00a0ka\u017ed\u00e9 dom\u00e1cnosti m\u011bla zav\u00e9st fermentace zeleniny, kter\u00e1 obsahuje velk\u00e9 mno\u017estv\u00ed u\u017eite\u010dn\u00fdch mikroorganism\u016f, a nav\u00edc \u0161et\u0159\u00ed na\u0161i pen\u011b\u017eenku.V\u00a0posledn\u00ed dob\u011b se ve sv\u011bt\u011b i u n\u00e1s tak\u00e9 velmi rychle roz\u0161\u00ed\u0159ila tzv. fek\u00e1ln\u00ed transplantace. Transplantace stolice je z\u00e1krok, p\u0159i kter\u00e9m doch\u00e1z\u00ed k\u00a0odb\u011bru stolice od p\u0159edem vytipovan\u00e9ho a vy\u0161et\u0159en\u00e9ho d\u00e1rce. Odebran\u00e1 stolice je pot\u00e9 sm\u00edch\u00e1na s\u00a0fyziologick\u00fdm roztokem a n\u00e1sledn\u011b je vpravena do tlust\u00e9ho st\u0159eva pacienta. Fek\u00e1ln\u00ed transplantace je velmi dob\u0159e funguj\u00edc\u00ed l\u00e9\u010dbou u pacient\u016f, kte\u0159\u00ed trp\u00ed opakuj\u00edc\u00edmi se z\u00e1n\u011bty st\u0159ev, kter\u00e9 zp\u016fsobuje st\u0159evn\u00ed bakt\u00e9rie zn\u00e1m\u00e1 pod n\u00e1zvem Clostridium difficile. Klinick\u00e9 studie ukazuj\u00ed, \u017ee do budoucna by se tato metoda mohla dob\u0159e uplatnit i p\u0159i l\u00e9\u010db\u011b syndromu dr\u00e1\u017ediv\u00e9ho tra\u010dn\u00edku, ulcer\u00f3zn\u00ed kolitidy, autoimunitn\u00edch onemocn\u011bn\u00ed, chronick\u00e9ho \u00fanavov\u00e9ho syndromu, celiakie, obezity, potravinov\u00fdch alergi\u00ed, revmatoidn\u00ed artritidy, cukrovky a mo\u017en\u00e1 i Parkinsonovy nemoci. M\u00e1te u\u017e sv\u00e9ho zdrav\u00e9ho d\u00e1rce? Co n\u00e1m ukazuje pades\u00e1tilet\u00e1 historie o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m?Na po\u010d\u00e1tku 60. let minul\u00e9ho stolet\u00ed popisovali epidemiologov\u00e9 spalni\u010dky jako st\u0159edn\u011b v\u00e1\u017enou d\u011btskou infekci o\u00a0kr\u00e1tk\u00e9m trv\u00e1n\u00ed a\u00a0n\u00edzk\u00e9 \u00famrtnosti. L\u00e9ka\u0159i v\u011bd\u011bli, \u017ee \u017eeny, kter\u00e9 prod\u011blaly spalni\u010dky jako d\u011bti, pasivn\u011b p\u0159en\u00e1\u0161ely protil\u00e1tky proti vir\u016fm spalni\u010dek v\u00a0pr\u016fb\u011bhu t\u011bhotenstv\u00ed na vyv\u00edjej\u00edc\u00ed se plod. Novorozenci byli chr\u00e1n\u011bni v\u00a0pr\u016fb\u011bhu prvn\u00edho roku \u017eivota (a\u00a0mo\u017en\u00e1 i\u00a0d\u00e9le). Spalni\u010dky byly obvykle nemoc\u00ed \u0161koln\u00edch d\u011bt\u00ed. Jejich prod\u011bl\u00e1n\u00ed poskytlo ka\u017ed\u00e9mu dlouhodobou imunitu a imunita rodi\u010d\u016f byla op\u011btovn\u011b posilov\u00e1na kontaktem s\u00a0viry od jejich nemocn\u00fdch d\u011bt\u00ed.V\u00a0sou\u010dasn\u00e9 dob\u011b je v\u011bt\u0161ina matek proti spalni\u010dk\u00e1m ji\u017e o\u010dkov\u00e1na, a tak v\u00a0porovn\u00e1n\u00ed s t\u00edm, jak\u00e9 by to bylo, kdyby spalni\u010dky prod\u011blaly, maj\u00ed protil\u00e1tek nedostatek. Jejich d\u011bti pak v\u016f\u010di spalni\u010dk\u00e1m imunitu nemaj\u00ed. Vypl\u00fdv\u00e1 z\u00a0toho, \u017ee o\u010dkov\u00e1n\u00ed vakc\u00ednou MMR (spalni\u010dky, p\u0159\u00edu\u0161nice a zard\u011bnky) zaveden\u00e9 v\u00a060. letech zp\u016fsobilo, \u017ee dne\u0161n\u00ed novorozenci a\u00a0kojenci jsou n\u00e1chyln\u00ed k\u00a0n\u00e1kaze spalni\u010dek od nejrann\u011bj\u0161\u00edho v\u011bku. Objevuj\u00ed se i epidemie p\u0159\u00edu\u0161nic u adolescent\u016f.Plo\u0161n\u00e9 o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m prov\u00e1d\u011bn\u00e9 v\u00a0dob\u011b, kdy byla je\u0161t\u011b velk\u00e1 \u010d\u00e1st osob st\u0159edn\u00edho a vy\u0161\u0161\u00edho v\u011bku chr\u00e1n\u011bn\u00e1 celo\u017eivotn\u00ed imunitou po p\u0159irozen\u011b prod\u011blan\u00e9m onemocn\u011bn\u00ed, vedlo ve spole\u010dnosti k ukon\u010den\u00ed cirkulace p\u016fvodn\u00edho divok\u00e9ho viru spalni\u010dek. O\u010dkov\u00e1n\u00ed tak\u00e9 p\u016fvodn\u00ed virus p\u0159inutilo k\u00a0mnoha mutac\u00edm. Cirkuluj\u00edc\u00ed viry genotyp\u016f D4, D6, D7, a\u00a0B3, proti kter\u00fdm imunizace o\u010dkov\u00e1n\u00edm nechr\u00e1n\u00ed, zp\u016fsobuj\u00ed dnes onemocn\u011bn\u00ed u\u00a0dosp\u011bl\u00fdch.Vypuknut\u00ed spalni\u010dek v\u00a0EU a v USA v\u00a0sou\u010dasn\u00e9 dob\u011b vyvol\u00e1v\u00e1 siln\u00e9 reakce m\u00e9di\u00ed a\u00a0vakcinolog\u016f. V\u00a0b\u0159eznu 2019 bylo v\u00a0EU s\u00a0populac\u00ed 512 milion\u016f ob\u010dan\u016f zaznamen\u00e1no asi 2 000 p\u0159\u00edpad\u016f spalni\u010dek. V\u00a0USA s\u00a0populac\u00ed 328 milion\u016f ob\u010dan\u016f to v\u00a0kv\u011btnu 2019 bylo 839 p\u0159\u00edpad\u016f. Po letech, kdy v\u00fdskyt spalni\u010dek v\u00a0\u010cR nep\u0159esahoval 10\u201320 p\u0159\u00edpad\u016f ro\u010dn\u011b, bylo od za\u010d\u00e1tku roku 2018 a\u017e do 13. 12. 2019 jenom v\u00a0Praze evidov\u00e1no\u00a0290 p\u0159\u00edpad\u016f! Hygienici doporu\u010duj\u00ed o\u010dkov\u00e1n\u00ed, l\u00e9ka\u0159i se nech\u00e1vaj\u00ed p\u0159eo\u010dkovat, av\u0161ak spalni\u010dky se zastavit neda\u0159\u00ed.Vysok\u00fd po\u010det onemocn\u011bn\u00ed spalni\u010dkami je hl\u00e1\u0161en\u00fd ze 170 zem\u00ed sv\u011bta, zejm\u00e9na rozvojov\u00fdch, kde je i vysok\u00e1 \u00famrtnost podvy\u017eiven\u00fdch d\u011bt\u00ed. Varovn\u00fd prst p\u0159edstavitel\u016f WHO a\u00a0vakcinolog\u016f v\u00a0USA a v EU v\u0161ak ukazuje na \u201eantivaxxery\u201c, odp\u016frce o\u010dkov\u00e1n\u00ed, kte\u0159\u00ed nedali sv\u00e9 d\u011bti o\u010dkovat vakc\u00ednou MMR. Podobn\u00e9 n\u00e1zory se \u0161\u00ed\u0159\u00ed i\u00a0v\u00a0\u010cR. MUDr. Milan Kubek, prezident\u00a0\u010cesk\u00e9 l\u00e9ka\u0159sk\u00e9 komory nap\u0159\u00edklad prohl\u00e1sil: \u201eSpalni\u010dky se u n\u00e1s \u0161\u00ed\u0159\u00ed proto, \u017ee n\u011bkte\u0159\u00ed blbe\u010dkov\u00e9 \u2013 rodi\u010de d\u011bt\u00ed je nedali o\u010dkovat.\u201cPo\u010det d\u011bt\u00ed, kter\u00e9 nejsou o\u010dkovan\u00e9 proti spalni\u010dk\u00e1m, byl v\u00a0\u010cR do roku 2017 1-3 %. Proto pouze 1-3 % d\u011bt\u00ed (dnes maxim\u00e1ln\u011b 3-4 %) jsou skute\u010dn\u011b rizikov\u00e1 z d\u016fvodu odm\u00edtnut\u00ed o\u010dkov\u00e1n\u00ed sv\u00fdmi rodi\u010di. \u00dadaje o n\u00edzk\u00e9 proo\u010dkovanosti d\u011bt\u00ed proti spalni\u010dk\u00e1m, kter\u00e9 se dnes u\u00a0n\u00e1s uv\u00e1d\u011bj\u00ed v\u00a0rozmez\u00ed 93-83,5 %, jsou tedy zav\u00e1d\u011bj\u00edc\u00ed. Vyjad\u0159uj\u00ed, kolik d\u011bt\u00ed nedostalo v\u00a0z\u00e1konn\u00e9m term\u00ednu ob\u011b d\u00e1vky MMR vakc\u00edny. V roce 2018 bylo v\u00a0\u010cR posunuto doporu\u010den\u00ed pod\u00e1vat druhou d\u00e1vku vakc\u00edny MMR ze 24 m\u011bs\u00edc\u016f na 5. rok v\u011bku d\u00edt\u011bte. V\u011bt\u0161ina z\u00a0d\u011bt\u00ed, ozna\u010den\u00fdch dnes t\u00edmto trikov\u00fdm zp\u016fsobem za neproo\u010dkovan\u00e9, jsou d\u011bti imunologicky chr\u00e1n\u011bn\u00e9 jednou d\u00e1vkou MMR vakc\u00edny nebo dokonce ob\u011bma d\u00e1vkami, pouze jsou doo\u010dkovan\u00e9 o n\u011bco pozd\u011bji. Takov\u00e9 d\u011bti se na sou\u010dasn\u00fdch epidemi\u00edch spalni\u010dek pod\u00edlet v\u016fbec nemohou a rozhodn\u011b nepat\u0159\u00ed mezi jejich p\u0159\u00ed\u010diny.V\u011bdci zjistili, \u017ee imunita navozen\u00e1 o\u010dkov\u00e1n\u00edm vyvane mnohem rychleji ne\u017e imunita vyvolan\u00e1 onemocn\u011bn\u00edm spalni\u010dkami. V\u00a0n\u011bkter\u00fdch p\u0159\u00edpadech je tak\u00e9 \u00a0\u00a0hladina protil\u00e1tek mnohem ni\u017e\u0161\u00ed. Kanadsk\u00e1 studie uk\u00e1zala, \u017ee 92 % t\u0159\u00edm\u011bs\u00ed\u010dn\u00edch a\u00a0100 % \u0161estim\u011bs\u00ed\u010dn\u00edch kojenc\u016f m\u00e1 ni\u017e\u0161\u00ed hladinu protil\u00e1tek, ne\u017e by bylo t\u0159eba k\u00a0jejich ochran\u011b. Sv\u011bd\u010d\u00ed to o\u00a0tom, \u017ee vakc\u00edna MMR nen\u00ed schopn\u00e1 navodit dostate\u010dn\u00fd titr protil\u00e1tek u\u00a0o\u010dkovan\u00fdch matek, kter\u00fd by mohl ochr\u00e1nit jejich\u00a0kojence po prvn\u00ed rok \u017eivota p\u0159ed n\u00e1kazou spalni\u010dkami. Takto mal\u00e9 d\u011bti se o\u010dkovat vakc\u00ednou MMR nemohou a po propuknut\u00ed nemoci maj\u00ed vy\u0161\u0161\u00ed riziko \u00famrtnosti.Nam\u00edsto obvi\u0148ov\u00e1n\u00ed odp\u016frc\u016f o\u010dkov\u00e1n\u00ed je tedy \u010das zodpov\u011bdn\u011b zhodnotit d\u016fsledky o\u010dkov\u00e1n\u00ed proti spalni\u010dk\u00e1m. Patrn\u011b ji\u017e p\u0159ed jeho zah\u00e1jen\u00edm v\u00a060. letech 20. stolet\u00ed m\u011bla b\u00fdt polo\u017eena ot\u00e1zka, zda je o\u010dkov\u00e1n\u00ed vakc\u00ednou MMR v\u016fbec vhodn\u00e9.\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0 Snaha o p\u0159\u00edli\u0161nou \u010distotu m\u016f\u017ee \u0161koditBakterie a jejich spory i viry jsou v\u0161ude kolem n\u00e1s, na v\u0161ech p\u0159edm\u011btech, ve vzduchu i na na\u0161ich ruk\u00e1ch. Pokud je n\u00e1\u0161 imunitn\u00ed syst\u00e9m zdrav\u00fd, dok\u00e1\u017ee jim odol\u00e1vat. Je-li v\u0161ak imunitn\u00ed syst\u00e9m oslaben\u00fd, vyvol\u00e1v\u00e1 p\u0159emno\u017een\u00ed patogenn\u00ed bakterie nebo viru nemoc. Uv\u011bdomili jste si n\u011bkdy, \u017ee p\u0159i usilovn\u00e9 snaze o o\u010distu sv\u00e9ho t\u011bla a cel\u00e9 dom\u00e1cnosti m\u016f\u017eete navodit zna\u010dn\u011b nebezpe\u010dnou situaci pro zdrav\u00ed cel\u00e9 rodiny a m\u016f\u017eete zp\u016fsobit prav\u00fd opak toho, o\u010d usilujete?D\u00edt\u011b, kter\u00e9 vyr\u016fst\u00e1 v\u00a0dom\u00e1cnosti prosycen\u00e9 antibakteri\u00e1ln\u00edmi m\u00fddly a dezinfek\u010dn\u00edmi prost\u0159edky, dost\u00e1v\u00e1 antibiotika a je \u00fazkostliv\u011b chr\u00e1n\u011bno p\u0159ed p\u0159irozenou \u201e\u0161p\u00ednou\u201c, viry a bakteriemi, toti\u017e nen\u00ed schopn\u00e9 vytvo\u0159it si p\u0159irozenou ochranu p\u0159ed nemocemi a tak\u00e9 se st\u00e1v\u00e1 n\u00e1chyln\u00e9 v\u016f\u010di nemocem v\u00a0pozd\u011bj\u0161\u00edm v\u011bku.V\u00a0posledn\u00ed dob\u011b se diskutuje o tom, \u017ee p\u0159ehnan\u00e1 p\u00e9\u010de o hygienu je p\u0159\u00ed\u010dinou mnoha alergi\u00ed a poruch imunitn\u00edho syst\u00e9mu. Prosp\u011b\u0161n\u00e9 bakterie, kter\u00e9 \u017eij\u00ed na na\u0161\u00ed k\u016f\u017ei i ve vlasech, se tak\u00e9 po\u0161kozuj\u00ed \u010dast\u00fdm myt\u00edm. V\u011bdci zji\u0161\u0165uj\u00ed, \u017ee dezinfek\u010dn\u00ed \u010dinidla ve z\u0159ed\u011bn\u00e9 form\u011b mohou mnohdy bakterie pos\u00edlit a stimulovat vznik rezistentn\u00edch kmen\u016f. K\u00a0tomu doch\u00e1z\u00ed i v\u00a0dom\u00e1cnostech.Nejlep\u0161\u00edmi a ne\u0161kodn\u00fdmi prost\u0159edky pro udr\u017eov\u00e1n\u00ed \u010distoty t\u011bla jsou m\u00fddlo a voda. Pro \u00faklid kuchyn\u011b, prk\u00e9nek a koupelen je vhodn\u00fd 3% peroxid vod\u00edku a ocet. Ka\u017edou z\u00a0t\u011bchto tekutin bychom m\u011bli m\u00edt ve zvl\u00e1\u0161tn\u00ed n\u00e1dob\u011b s\u00a0rozpra\u0161ova\u010dem, nejprve povrch post\u0159\u00edkat peroxidem vod\u00edku a pot\u00e9 octem. \u00a0Peroxid vod\u00edku je v\u00a0porovn\u00e1n\u00ed s r\u016fzn\u00fdmi dezinfek\u010dn\u00edmi a b\u011bl\u00edc\u00edmi p\u0159\u00edpravky s\u00a0chlorem bezpe\u010dn\u011bj\u0161\u00ed. Tak\u00e9 soda je skv\u011bl\u00fd \u010dist\u00edc\u00ed prost\u0159edek. Sm\u00edch\u00e1me-li ji s\u00a0jable\u010dn\u00fdm octem, vznikne bublav\u00e1 sm\u011bs, kter\u00e1 dob\u0159e vy\u010dist\u00ed odpady v\u00a0kuchy\u0148sk\u00e9 v\u00fdlevce i v\u00a0koupeln\u011b. Po 15 minut\u00e1ch p\u016fsoben\u00ed prolijeme v\u00fdlevku horkou vodou.Ocet m\u016f\u017eeme pou\u017e\u00edt k\u00a0vy\u010di\u0161t\u011bn\u00ed prakticky \u010dehokoliv v\u00a0dom\u00e1cnosti. Jestli\u017ee ho sm\u00edch\u00e1me s\u00a0trochou tekut\u00e9ho m\u00fddla, levandulov\u00fdm olejem a vodou, m\u016f\u017eeme s\u00a0takovou sm\u011bs\u00ed um\u00fdvat dve\u0159e, okna, kuchyn\u011b i koupelny. Jsou to prost\u0159edky, kter\u00e9 jsou zdrav\u00ed ne\u0161kodn\u00e9, a nav\u00edc jsou levn\u00e9.Nezapom\u00ednejme na to, \u017ee tak\u00e9 slune\u010dn\u00ed z\u00e1\u0159en\u00ed je t\u00edm nejlep\u0161\u00edm dezinfek\u010dn\u00edm prost\u0159edkem. M\u011bli bychom co nejv\u00edc vyu\u017e\u00edvat mo\u017enost su\u0161en\u00ed pr\u00e1dla na slunci, jeho\u017e v\u016fn\u011b ur\u010dit\u011b p\u0159ed\u010d\u00ed v\u0161echny um\u011bl\u00e9 aviv\u00e1\u017ee.<\/p>\n","protected":false},"author":3,"featured_media":9696,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[134,1],"tags":[],"class_list":["post-9694","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ctenarska-sekce","category-medunka"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/posts\/9694","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/comments?post=9694"}],"version-history":[{"count":1,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/posts\/9694\/revisions"}],"predecessor-version":[{"id":9695,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/posts\/9694\/revisions\/9695"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/media\/9696"}],"wp:attachment":[{"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/media?parent=9694"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/categories?post=9694"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.mojemedunka.cz\/index.php\/wp-json\/wp\/v2\/tags?post=9694"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}