{"id":46937,"date":"2024-03-12T06:07:06","date_gmt":"2024-03-12T05:07:06","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=46937"},"modified":"2024-03-12T06:36:03","modified_gmt":"2024-03-12T05:36:03","slug":"acienti-s-tuberkulozou-se-mohou-lecit-doma-nekteri","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=46937","title":{"rendered":"Po\u010det lid\u00ed s tuberkul\u00f3zou vzrostl, nejv\u00edc p\u0159ib\u00fdv\u00e1 mezi uprchl\u00edky z Ukrajiny. Pacienti se mohou l\u00e9\u010dit i doma"},"content":{"rendered":"\n<p><\/p>\n\n\n\n<p><strong>Po\u010det lid\u00ed s&nbsp;tuberkul\u00f3zou v&nbsp;\u010cR meziro\u010dn\u011b vzrostl o 64 osob, stoupl i po\u010det nemocn\u00fdch d\u011bt\u00ed. S&nbsp;TBC se loni dle dostupn\u00fdch dat l\u00e9\u010dilo 447 pacient\u016f. \u010ce\u0161t\u00ed plicn\u00ed l\u00e9ka\u0159i n\u00e1por zvl\u00e1daj\u00ed a p\u0159ipravuj\u00ed se na dal\u0161\u00ed n\u00e1r\u016fst. Doporu\u010duj\u00ed zav\u00e9st pravideln\u00e9 testy u lid\u00ed z&nbsp;rizikov\u00fdch zem\u00ed, budou tak\u00e9 roz\u0161i\u0159ovat kapacity tam, kde se nemocn\u00ed l\u00e9\u010d\u00ed. \u00dalevu by m\u011bla p\u0159in\u00e9st i nov\u00e1 vyhl\u00e1\u0161ka, podle kter\u00e9 se mohou spolupracuj\u00edc\u00ed pacienti l\u00e9\u010dit doma. <\/strong><\/p>\n\n\n\n<p><strong>Pneumologov\u00e9 o tom informuj\u00ed u p\u0159\u00edle\u017eitosti Sv\u011btov\u00e9ho <\/strong><strong>dne boje proti tuberkul\u00f3ze, kter\u00fd p\u0159ipad\u00e1 na <\/strong><strong>24. b\u0159ezna. Ve stejn\u00fd den, jen o 142 let d\u0159\u00edve,<\/strong><strong> ozn\u00e1mil n\u011bmeck\u00fd l\u00e9ka\u0159 Robert Koch objev z\u00e1ke\u0159n\u00e9ho bacilu <\/strong><em><strong>Mycobacterium tuberculosis<\/strong><\/em><strong>, jen\u017e nemoc zp\u016fsobuje.<\/strong><\/p>\n\n\n\n<p>\u201e<em>Vzhledem k&nbsp;v\u00e1lce na Ukrajin\u011b nen\u00ed n\u00e1r\u016fst nemocn\u00fdch \u017e\u00e1dn\u00fdm p\u0159ekvapen\u00edm, je zn\u00e1mo \u017ee na v\u00fdchod od \u010cesk\u00e9 republiky nen\u00ed p\u00e9\u010de o tuberkul\u00f3zn\u00ed pacienty na takov\u00e9 \u00farovni jako u n\u00e1s. <\/em><em>Pod\u00edl TBC u <\/em><em>osob narozen\u00fdch mimo \u010cR loni \u010dinil 49,2 % (220 p\u0159\u00edpad\u016f), z toho 140 je z&nbsp;Ukrajiny, co\u017e je t\u00e9m\u011b\u0159 \u010dty\u0159ikr\u00e1t v\u00edce ne\u017e p\u0159ed v\u00e1lkou. Ze Slovenska evidujeme 21 p\u0159\u00edpad\u016f, z Rumunska a Vietnamu n\u00e1m p\u0159ibylo po 11 p\u0159\u00edpadech atp.,\u201c<\/em> \u0159\u00edk\u00e1 MUDr. Ji\u0159\u00ed Wallenfels, vedouc\u00ed N\u00e1rodn\u00ed jednotky dohledu nad tuberkul\u00f3zou, Fakultn\u00ed nemocnice Bulovka. <\/p>\n\n\n\n<p>Nejnov\u011bj\u0161\u00ed data tak\u00e9 uk\u00e1zala v\u00fdrazn\u00fd n\u00e1r\u016fst TBC u d\u011bt\u00ed do 15 let \u2013 z 11 p\u0159\u00edpad\u016f jejich po\u010det loni sko\u010dil na 30. <em>\u201eObvykle evidujeme 5\u201310 nemocn\u00fdch d\u011bt\u00ed za rok,\u201c<\/em> podot\u00fdk\u00e1 MUDr. Wallenfels. Za lo\u0148sk\u00fdm n\u00e1r\u016fstem mal\u00fdch pacient\u016f je nap\u0159\u00edklad lok\u00e1ln\u00ed epidemie v&nbsp;Ben\u00e1tk\u00e1ch nad Jizerou, ale tak\u00e9 p\u0159esn\u011bj\u0161\u00ed diagnostick\u00e9 postupy. <\/p>\n\n\n\n<p><em>\u201eP\u0159i hled\u00e1n\u00ed p\u0159\u00edpadn\u00fdch lo\u017eisek tuberkul\u00f3zy jsme u vybran\u00fdch pacient\u016f za\u010dali pou\u017e\u00edvat CT, a p\u0159esto\u017ee na rentgenu plic nebyla nemoc vid\u011bt, CT vy\u0161et\u0159en\u00ed jej\u00ed p\u0159\u00edtomnost prok\u00e1zalo. Poprv\u00e9 jsme tak\u00e9 m\u011bli d\u00edt\u011b s&nbsp;potvrzenou <\/em><em>odolnou,<\/em><em> tzv. multirezistentn\u00ed<\/em><em> formou <\/em><em>TBC,\u201c<\/em> popisuje MUDr. Karol\u00edna Dole\u017ealov\u00e1, Ph.D., vedouc\u00ed l\u00e9ka\u0159ka Plicn\u00ed ambulance a St\u0159ediska p\u00e9\u010de pro d\u011bti s tuberkul\u00f3zou a mykobakteri\u00f3zami Fakultn\u00ed Thomayerovy nemocnice (FTN). Zde se l\u00e9\u010d\u00ed jak mal\u00e9 d\u011bti, tak dosp\u00edvaj\u00edc\u00ed do 18 let v\u011bku. Kv\u016fli o\u010dek\u00e1van\u00e9mu n\u00e1r\u016fstu mlad\u00fdch pacient\u016f se budou kapacity tohoto pracovi\u0161t\u011b roz\u0161i\u0159ovat o 2\u20133 pokoje, s&nbsp;t\u00edm, \u017ee zcela nov\u011b by s&nbsp;d\u011btmi mohly b\u00fdt na pokoji i jejich matky.<\/p>\n\n\n\n<p>Vzhledem k&nbsp;n\u00e1r\u016fstu multirezistentn\u00edch forem tuberkul\u00f3zy v&nbsp;\u010cesk\u00e9 republice (loni 31) je t\u0159eba, aby vzniklo nov\u00e9 pracovi\u0161t\u011b s&nbsp;kapacitou 10\u201315 l\u016f\u017eek, o tom nyn\u00ed pneumologov\u00e9 jednaj\u00ed s&nbsp;Ministerstvem zdravotnictv\u00ed. <em>\u201eV\u0161e ale z\u00e1le\u017e\u00ed na financ\u00edch, stavba takov\u00e9 jednotky nen\u00ed levn\u00e1. Dosud se v\u0161ichni tito pacienti l\u00e9\u010d\u00ed v&nbsp;Thomayerov\u011b nemocnici, ale kapacity brzy p\u0159estanou sta\u010dit,<\/em>\u201c \u0159\u00edk\u00e1 doc. MUDr. Vladim\u00edr Kobl\u00ed\u017eek, Ph.D., p\u0159edseda \u010cesk\u00e9 pneumologick\u00e9 a&nbsp;ftizeologick\u00e9 spole\u010dnosti (\u010cPFS).<\/p>\n\n\n\n<p>\u010cesk\u00e1 republika si za to, jak dok\u00e1\u017ee zajistit l\u00e9\u010dbu zejm\u00e9na multirezistentn\u00ed tuberkul\u00f3zy podle posledn\u00edch doporu\u010den\u00ed, vyslou\u017eila pochvalu od Sv\u011btov\u00e9 zdravotnick\u00e9 organizace (WHO) &#8211; \u0159\u00edk\u00e1 prof. MUDr. Martina Koziar Va\u0161\u00e1kov\u00e1, Ph.D., p\u0159ednostka Pneumologick\u00e9 kliniky FTN a 1. LF UK. P\u0159ipom\u00edn\u00e1 ale, \u017ee je t\u0159eba neusnout na vav\u0159\u00ednech a pracovat na tom, aby situace z\u016fstala klidn\u00e1 i nad\u00e1le. <\/p>\n\n\n\n<p><em>\u201eN\u00e1r\u016fst odoln\u00fdch forem TBC, <\/em><em>necitliv\u00fdch na b\u011b\u017en\u00e1 antituberkulotika, je dvojn\u00e1sobn\u00fd. O \u00fahradu modern\u00edch l\u00e9k\u016f, kter\u00e9 z<\/em><em>kracuj\u00ed<\/em><em> dobu hospitalizace <\/em><em>z 18\u201324 na 6\u20139 m\u011bs\u00edc\u016f, mus\u00edme \u017e\u00e1dat zdravotn\u00ed poji\u0161\u0165ovny <\/em><em>mimo\u0159\u00e1dn\u011b na paragraf 16. L\u00e9\u010dba jednoho pacienta stoj\u00ed kolem 1,5 milionu korun,\u201c <\/em>uv\u00e1d\u00ed prof. Koziar Va\u0161\u00e1kov\u00e1.<\/p>\n\n\n\n<p>U b\u011b\u017en\u00fdch forem tuberkul\u00f3zy, citliv\u00fdch na l\u00e9ky, by m\u011bla l\u00e9ka\u0159\u016fm i pacient\u016fm ulevit nov\u00e1 vyhl\u00e1\u0161ka o<strong> <\/strong>podm\u00ednk\u00e1ch p\u0159edch\u00e1zen\u00ed vzniku a \u0161\u00ed\u0159en\u00ed infek\u010dn\u00edch onemocn\u011bn\u00ed, platn\u00e1 od ledna. <em>\u201eTa n\u00e1m umo\u017e\u0148uje pustit nemocn\u00e9 s&nbsp;b\u011b\u017enou tuberkul\u00f3zou po n\u011bkolika dnech z nemocnice dom\u016f. Mus\u00ed ale spolupracovat, dodr\u017eovat dom\u00e1c\u00ed izolaci a u\u017e\u00edvat pravideln\u011b l\u00e9ky. Do plicn\u00ed ambulance pak ji\u017e doch\u00e1z\u00ed jen na kontroly. Zda je v\u0161e tak, jak m\u00e1 b\u00fdt, m\u016f\u017eeme posoudit s&nbsp;pomoc\u00ed telemedic\u00edny, kter\u00e1 n\u00e1m umo\u017en\u00ed b\u00fdt s&nbsp;pacientem v&nbsp;pravideln\u00e9m kontaktu,\u201c<\/em> vysv\u011btluje doc. MUDr.&nbsp;Milan Sova, Ph.D., p\u0159ednosta Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy Fakultn\u00ed nemocnice Brno. Pr\u00e1v\u011b zde meziro\u010dn\u011b vzrostl po\u010det pacient\u016f o 61 % na lo\u0148sk\u00fdch 21. Doc. Sova odhaduje, \u017ee spolupracuj\u00edc\u00edch pacient\u016f by mohla b\u00fdt a\u017e polovina a p\u0159ipom\u00edn\u00e1, \u017ee takto nastaven\u00fd syst\u00e9m ulev\u00ed nemocnic\u00edm, l\u00e9\u010debn\u00e1m a je pro pacienty v\u00fdrazn\u011b p\u0159\u00edjemn\u011bj\u0161\u00ed.<\/p>\n\n\n\n<p>\u010ce\u0161t\u00ed plicn\u00ed l\u00e9ka\u0159i tak doporu\u010duj\u00ed ambulantn\u00edm pneumolog\u016fm a praktick\u00fdm l\u00e9ka\u0159\u016fm prov\u00e9st u v\u0161ech pacient\u016f z\u00a0rizikov\u00fdch zem\u00ed p\u0159i prvn\u00edm kontaktu rentgenov\u00fd sn\u00edmek hrudn\u00edku. Plicn\u00ed l\u00e9ka\u0159i mohou nav\u00edc zajistit speci\u00e1ln\u00ed krevn\u00ed test na mo\u017enou p\u0159\u00edtomnost latentn\u00ed tuberkul\u00f3zy v\u00a0t\u011ble. <em>\u201eU v\u0161ech osob s\u00a0pozitivn\u00edm krevn\u00edm testem je pak vhodn\u00e9 prov\u00e9st CT vy\u0161et\u0159en\u00ed plic. To je schopno odhalit i men\u0161\u00ed formy tuberkul\u00f3zy, kter\u00e9 nejsou p\u0159i klasick\u00e9m rentgenov\u00e9m vy\u0161et\u0159en\u00ed hrudn\u00edku vid\u011bt.<\/em>\u00a0<em>Pneumologov\u00e9 tedy mohou u ka\u017ed\u00e9ho dosp\u011bl\u00e9ho \u010dlov\u011bka z\u00a0rizikov\u00e9 oblasti pomoc\u00ed komplexn\u00edho nebolestiv\u00e9ho vy\u0161et\u0159en\u00ed vylou\u010dit tuberkul\u00f3zn\u00ed onemocn\u011bn\u00ed \u010di zat\u00edm bezp\u0159\u00edznakovou n\u00e1kazu. Pro l\u00e9\u010dbu maj\u00ed k\u00a0dispozici modern\u00ed prepar\u00e1ty. \u00da\u010delem je podchytit nemocn\u00e9 v\u010das, v\u00a0dob\u011b, kdy je\u0161t\u011b nemaj\u00ed \u017e\u00e1dn\u00e9 \u010di zcela minim\u00e1ln\u00ed pot\u00ed\u017ee, a zabr\u00e1nit tak dal\u0161\u00edmu \u0161\u00ed\u0159en\u00ed nemoci,\u201c <\/em>dod\u00e1v\u00e1 doc. Kobl\u00ed\u017eek.<\/p>\n\n\n\n<p><strong>Epidemiologick\u00e1 situace TBC v&nbsp;\u010cR v&nbsp;roce 2023 v \u010d\u00edslech<\/strong><\/p>\n\n\n\n<p>MUDr. Ji\u0159\u00ed Wallenfels<\/p>\n\n\n\n<p>N\u00e1rodn\u00ed jednotka dohledu nad tuberkul\u00f3zou, FN Bulovka, Praha<\/p>\n\n\n\n<p><strong>Jde o p\u0159edb\u011b\u017en\u00e1 data<\/strong> k 6. 3. 2024 z&nbsp;n\u00e1rodn\u00edho registru TBC, registr TBC se \u201euzav\u00edr\u00e1\u201c 30. 4. 2024. P\u0159ehled podle kraje bydli\u0161t\u011b nemocn\u00e9ho (v\u010d. porovn\u00e1n\u00ed s&nbsp;minul\u00fdmi roky) je uveden zvl\u00e1\u0161\u0165.<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Celkem zat\u00edm do registru TBC hl\u00e1\u0161eno 447 p\u0159\u00edpad\u016f TBC<\/li>\n\n\n\n<li>Mu\u017ei: 319 p\u0159\u00edpad\u016f, \u017eeny 128 p\u0159\u00edpad\u016f<\/li>\n\n\n\n<li>TBC u d\u0159\u00edve l\u00e9\u010den\u00fdch je 19<\/li>\n\n\n\n<li>TBC plic je 391<\/li>\n\n\n\n<li>Kultiva\u010dn\u011b pozitivn\u00edch TBC je 318<\/li>\n\n\n\n<li>Po\u010det mikroskopicky pozitivn\u00edch TBC ze sputa (siln\u00e9 zdroje infekce) je 182<\/li>\n\n\n\n<li>Pod\u00edl TBC u osob narozen\u00fdch mimo \u010cR \u010din\u00ed 49,2 % (220 p\u0159\u00edpad\u016f), z toho narozeni na Ukrajin\u011b 140 p\u0159\u00edpad\u016f, na Slovensku 21 p\u0159\u00edpad\u016f, v&nbsp;Rumunsku a ve Vietnamu po 11 p\u0159\u00edpadech atd.<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno je 31 p\u0159\u00edpad\u016f multirezistentn\u00ed TBC*<\/li>\n\n\n\n<li>Pr\u016fm\u011brn\u00fd v\u011bk nemocn\u00fdch je 45,5 roku<\/li>\n\n\n\n<li>Po\u010det TBC u d\u011bt\u00ed do 15 let v\u011bku je 30, z&nbsp;nich 22 narozeno v&nbsp;\u010cR, 5 na Slovensku a 3 na Ukrajin\u011b<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno 16 p\u0159\u00edpad\u016f TBC u HIV pozitivn\u00edch (z 300 vy\u0161et\u0159en\u00fdch na HIV), 14 z nich u osob narozen\u00fdch na Ukrajin\u011b, 2 v \u010cR<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno 15 \u00famrt\u00ed na TBC<\/li>\n<\/ul>\n\n\n\n<p>*Dle \u00fadaj\u016f Fakultn\u00ed Thomayerovy nemocnice<\/p>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Po\u010det lid\u00ed s&nbsp;tuberkul\u00f3zou v&nbsp;\u010cR meziro\u010dn\u011b vzrostl o 64 osob, stoupl i po\u010det nemocn\u00fdch d\u011bt\u00ed. S&nbsp;TBC se loni dle dostupn\u00fdch dat l\u00e9\u010dilo 447 pacient\u016f. \u010ce\u0161t\u00ed plicn\u00ed <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=46937\" title=\"Po\u010det lid\u00ed s tuberkul\u00f3zou vzrostl, nejv\u00edc p\u0159ib\u00fdv\u00e1 mezi uprchl\u00edky z Ukrajiny. Pacienti se mohou l\u00e9\u010dit i doma\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":40275,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-46937","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/46937","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=46937"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/46937\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/40275"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=46937"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=46937"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=46937"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}