{"id":55691,"date":"2025-03-14T14:25:48","date_gmt":"2025-03-14T13:25:48","guid":{"rendered":"https:\/\/www.invarena.cz\/?p=55691"},"modified":"2025-03-14T16:10:02","modified_gmt":"2025-03-14T15:10:02","slug":"problemovi-pacienti-s-tbc-zdroj-nakazy-dluhu-nekdy-i-agrese","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=55691","title":{"rendered":"Pacienti s\u00a0TBC ohro\u017euj\u00ed ostatn\u00ed n\u00e1kazou, n\u011bkdy i agres\u00ed. A nech\u00e1vaj\u00ed za sebou dluhy"},"content":{"rendered":"\n<p><strong>Praha, 14. 3. 2025 \u2013 Nespolupracuj\u00edc\u00ed nemocn\u00ed s&nbsp;TBC, dluhy, kter\u00e9 po nepoji\u0161t\u011bn\u00fdch pacientech nemocnic\u00edm z\u016fst\u00e1vaj\u00ed, doplatky za z\u00e1kladn\u00ed l\u00e9ky na tuberkul\u00f3zu, absence vstupn\u00edho rentgenov\u00e9ho vy\u0161et\u0159en\u00ed cizinc\u016f z&nbsp;rizikov\u00fdch zem\u00ed \u2013 toto a \u0159ada dal\u0161\u00edch probl\u00e9m\u016f tr\u00e1p\u00ed \u010desk\u00e9 pneumology, kte\u0159\u00ed infek\u010dn\u00ed pacienty l\u00e9\u010d\u00ed. T\u00e9mata <\/strong><strong>l\u00e9ka\u0159i otev\u00edraj\u00ed p\u0159i p\u0159\u00edle\u017eitosti Sv\u011btov\u00e9ho dne boje proti tuberkul\u00f3ze, jen\u017e p\u0159ipad\u00e1 na <\/strong><strong>24. b\u0159ezna. Ve stejn\u00fd den o 143 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>U\u017e dlouho upozor\u0148ujeme na z\u00e1sadn\u00ed probl\u00e9my v l\u00e9\u010db\u011b tuberkul\u00f3zy. Tato nemoc postihuje p\u0159edev\u0161\u00edm soci\u00e1ln\u011b slab\u00e9 a okrajov\u00e9 skupiny. L\u00e9\u010dba je povinn\u00e1, ale nen\u00ed pln\u011b hrazena \u2013 zejm\u00e9na u lid\u00ed bez zdravotn\u00edho poji\u0161t\u011bn\u00ed, co\u017e vede ke zna\u010dn\u00fdm pohled\u00e1vk\u00e1m zdravotn\u00edch za\u0159\u00edzen\u00ed. I kdy\u017e je ka\u017ed\u00fd druh\u00fd pacient s TBC cizinec a WHO m\u00e1 seznam rizikov\u00fdch zem\u00ed, chyb\u00ed pravideln\u00e9 vyhled\u00e1v\u00e1n\u00ed nel\u00e9\u010den\u00fdch nemocn\u00fdch mezi uchaze\u010di o pr\u00e1ci. Dal\u0161\u00edm probl\u00e9mem je nedostatek pravidel pro zadr\u017een\u00ed pacient\u016f, kte\u0159\u00ed odm\u00edtaj\u00ed l\u00e9\u010dbu a jsou agresivn\u00ed \u2013 nemocnice tak mus\u00ed jednat samostatn\u011b, aby zabr\u00e1nily \u0161\u00ed\u0159en\u00ed nemoci. Nav\u00edc si pacienti na okraji spole\u010dnosti \u010dasto nemohou dovolit doplatky za antituberkulotika a&nbsp;pr\u00e1vn\u00ed r\u00e1mec pro kontrolu l\u00e9\u010dby mimo nemocnice (nap\u0159. telemetrick\u00e9 nebo ter\u00e9nn\u00ed kontroly) chyb\u00ed. K tomu se p\u0159id\u00e1v\u00e1 zdlouhav\u00e9 schvalov\u00e1n\u00ed l\u00e9k\u016f pro rezistentn\u00ed TBC, co\u017e je opravdov\u00e1 komplikace. Apelujeme na Ministerstvo zdravotnictv\u00ed, aby tyto probl\u00e9my co nejd\u0159\u00edve \u0159e\u0161ilo,\u201c<\/em>\u0159\u00edk\u00e1p\u0159edseda \u010cesk\u00e9 pneumologick\u00e9 a&nbsp;ftizeologick\u00e9 spole\u010dnosti (\u010cPFS) doc. MUDr. Vladim\u00edr Kobl\u00ed\u017eek, Ph.D.<\/p>\n\n\n\n<p>\u201e<em>Proto\u017ee screening na TBC se neprov\u00e1d\u00ed, do nemocnic p\u0159ich\u00e1zej\u00ed cizinci s vysp\u011blou formou nemoci a&nbsp;ve \u0161patn\u00e9m zdravotn\u00edm stavu, co\u017e vede k \u00famrt\u00edm i p\u0159es intenzivn\u00ed p\u00e9\u010di. Ob\u010das se setk\u00e1v\u00e1me i&nbsp;s&nbsp;vz\u00e1cn\u00fdmi fat\u00e1ln\u00edmi formami, nap\u0159\u00edklad s tuberkul\u00f3zou st\u0159ev, kter\u00e1 zp\u016fsobuje jejich akutn\u00ed nepr\u016fchodnost,\u201c<\/em> dopl\u0148uje prof. MUDr. Martina Koziar Va\u0161\u00e1kov\u00e1, Ph.D., p\u0159ednostka Pneumologick\u00e9 kliniky Fakultn\u00ed Thomayerovy nemocnice a 1. LF UK.<\/p>\n\n\n\n<p>S&nbsp;agresivn\u00edm pacientem se loni museli vypo\u0159\u00e1dat na uzav\u0159en\u00e9m odd\u011blen\u00ed pro l\u00e9\u010dbu TBC pacient\u016f v&nbsp;nemocnici v&nbsp;\u017damberku. <em>\u201eP\u0159ijali jsme pacienta s&nbsp;tuberkul\u00f3zou. Neum\u011bl se sm\u00ed\u0159it s&nbsp;izolac\u00ed, opakovan\u011b slovn\u011b napadal person\u00e1l, ostatn\u00ed pacienty, kradl, ut\u00edkal, po\u0161kozoval majetek nemocnice. Situace vygradovala ve chv\u00edli, kdy vyhro\u017eoval person\u00e1lu zn\u00e1siln\u011bn\u00edm a zabit\u00edm,&nbsp;rozbil dve\u0159e a \u00fato\u010dil na spolupacienty \u2013 tehdy jsme na doporu\u010den\u00ed policie zakoupili paralyz\u00e9ry a policie musela b\u00fdt na odd\u011blen\u00ed p\u0159\u00edtomna nonstop n\u011bkolik dn\u016f,\u201c <\/em>vzpom\u00edn\u00e1 MUDr. M\u00e1ria Michalovi\u010dov\u00e1, prim\u00e1\u0159ka odd\u011blen\u00ed Pneumologie a ftizeologie odborn\u00e9ho l\u00e9\u010debn\u00e9ho \u00fastavu Albertinum. <em>\u201e<\/em><em>Proto\u017ee pacient nebyl odsouzen\u00fd, ne\u0161lo jej p\u0159edat do vazby. O radu a pomoc jsme \u017e\u00e1dali <\/em><em>Ministerstvo zdravotnictv\u00ed<\/em><em>, \u010ceskou l\u00e9ka\u0159skou komoru, pr\u00e1vn\u00edky. Nikdo n\u00e1m ale nebyl schopen pomoci, proto\u017ee <\/em><em>dle sou\u010dasn\u00e9 legislativy m\u016f\u017ee b\u00fdt infek\u010dn\u00ed pacient um\u00edst\u011bn pouze do izolace ve zdravotnick\u00e9m za\u0159\u00edzen\u00ed,\u201c<\/em>pokra\u010duje MUDr.&nbsp;Michalovi\u010dov\u00e1. Po 3 m\u011bs\u00edc\u00edch hospitalizace tohoto pacienta pot\u0159ebovala \u010d\u00e1st person\u00e1lu krizovou intervenci a pomoc psychologa. By\u0165 jde zat\u00edm o jednotky p\u0159\u00edpad\u016f, agresivn\u00edch lid\u00ed s&nbsp;TBC podle pneumolog\u016f p\u0159ib\u00fdv\u00e1. Jak \u0159\u00edk\u00e1 prof. Koziar Va\u0161\u00e1kov\u00e1, Ph.D., pomohlo by psychiatrick\u00e9 uzav\u0159en\u00e9 za\u0159\u00edzen\u00ed. D\u0159\u00edve takov\u00e9 fungovalo v Dob\u0159anech, nyn\u00ed je v\u0161ak mimo provoz.<\/p>\n\n\n\n<p>Stejn\u011b velk\u00fdm probl\u00e9mem, na kter\u00fd plicn\u00ed l\u00e9ka\u0159i opakovan\u011b upozor\u0148uj\u00ed, jsou nepoji\u0161t\u011bn\u00ed pacienti. Podle prof. MUDr.&nbsp;Milana Sovy, Ph.D., p\u0159ednosty Kliniky nemoc\u00ed plicn\u00edch a tuberkul\u00f3zy Fakultn\u00ed nemocnice Brno jsou pacienti s TBC \u010dasto nepoji\u0161t\u011bni. <em>\u201eN\u00e1klady na jejich l\u00e9\u010dbu jdou za n\u00e1mi. Zrovna te\u010f m\u00e1me na odd\u011blen\u00ed cizince bez zdravotn\u00edho poji\u0161t\u011bn\u00ed, kter\u00fd u\u017e nyn\u00ed dlu\u017e\u00ed 664&nbsp;000 korun. Ne\u017e jej pln\u011b vyl\u00e9\u010d\u00edme, vy\u0161plh\u00e1 se \u010d\u00e1stka na milion,\u201c<\/em> uv\u00e1d\u00ed prof. Sova. Loni zde hospitalizovali 36 pacient\u016f s&nbsp;tuberkul\u00f3zou, co\u017e je o dev\u011bt v\u00edce ne\u017e v&nbsp;roce 2023.<\/p>\n\n\n\n<p>Prof. Koziar Va\u0161\u00e1kov\u00e1, Ph.D., p\u0159ipom\u00edn\u00e1, \u017ee \u010cesk\u00e1 republika pat\u0159\u00ed k zem\u00edm s nejni\u017e\u0161\u00edm v\u00fdskytem tuberkul\u00f3zy. <em>\u201ePo\u010det nov\u011b nemocn\u00fdch se pohybuje kolem 4,8 na 100&nbsp;000 obyvatel ro\u010dn\u011b. N\u00edzk\u00e1 \u010d\u00edsla jsou v\u00fdsledkem pe\u010dliv\u00e9 a systematick\u00e9 pr\u00e1ce <\/em><em>\u010desk\u00fdch pneumolog\u016f.<\/em><em> M\u016f\u017eeme se srovn\u00e1vat se sousedn\u00edm <\/em><em>N\u011bmeckem s 4,8 TBC pacient\u016f na 100&nbsp;000 obyvatel ro\u010dn\u011b nebo Rakouskem s 5,0 na 100&nbsp;000 obyvatel,\u201c<\/em> \u0159\u00edk\u00e1 prof. Koziar Va\u0161\u00e1kov\u00e1. Tato \u010d\u00edsla se v\u0161ak mohou m\u011bnit k&nbsp;hor\u0161\u00edmu, a to p\u0159edev\u0161\u00edm kv\u016fli migraci ze zem\u00ed s vy\u0161\u0161\u00edm v\u00fdskytem TBC. <em>\u201eTo jsou v&nbsp;podstat\u011b v\u0161echny zem\u011b na v\u00fdchod od n\u00e1s, nap\u0159\u00edklad Ukrajina s&nbsp;incidenc\u00ed 112\/100 000, Rumunsko 55\/100 000 nebo Bulharsko 16\/100 000. Neust\u00e1le \u017e\u00e1d\u00e1me o to, aby nov\u011b p\u0159\u00edchoz\u00ed absolvovali zdravotn\u00ed prohl\u00eddku v\u010detn\u011b zji\u0161t\u011bn\u00ed z\u00e1kladn\u00edch infek\u010dn\u00edch onemocn\u011bn\u00ed. Pokud cht\u011bj\u00ed&nbsp;v&nbsp;\u010cesku z\u016fstat, m\u011bli by b\u00fdt vy\u0161et\u0159eni na z\u00e1kladn\u00ed p\u0159enosn\u00e1 onemocn\u011bn\u00ed, zejm\u00e9na na tuberkul\u00f3zu, a v p\u0159\u00edpad\u011b d\u011bt\u00ed je t\u0159eba nechat doplnit v\u0161echna&nbsp;povinn\u00e1 o\u010dkov\u00e1n\u00ed,\u201c <\/em>dod\u00e1v\u00e1 prof. Koziar Va\u0161\u00e1kov\u00e1.<\/p>\n\n\n\n<p>Podle nov\u00fdch dat z&nbsp;n\u00e1rodn\u00edho registru TBC se po\u010det lid\u00ed v&nbsp;\u010cesk\u00e9 republice, kte\u0159\u00ed maj\u00ed tuberkul\u00f3zu, dr\u017e\u00ed na obdobn\u00fdch \u010d\u00edslech jako v&nbsp;roce 2023. Nemoc m\u00e1 454 lid\u00ed, z&nbsp;toho 337 mu\u017e\u016f a 117 \u017een. <em>\u201ePod\u00edl osob narozen\u00fdch mimo \u010ceskou republiku \u010din\u00ed 48 % a pr\u016fm\u011brn\u00fd v\u011bk nemocn\u00fdch je 48 let. Evidujeme 18 p\u0159\u00edpad\u016f TBC u d\u011bt\u00ed do 15 let, z&nbsp;toho 12 je narozen\u00fdch v&nbsp;\u010cesk\u00e9 republice, \u010dty\u0159i na Ukrajin\u011b a po jednom <\/em><em>v&nbsp;Rumunsku a ve Vietnamu,\u201c<\/em> \u0159\u00edk\u00e1 MUDr. Ji\u0159\u00ed Wallenfels, vedouc\u00ed N\u00e1rodn\u00ed jednotky dohledu nad tuberkul\u00f3zou FN Bulovka. V&nbsp;porovn\u00e1n\u00ed jednotliv\u00fdch kraj\u016f zaznamenal nejv\u011bt\u0161\u00ed r\u016fst po\u010dtu nemocn\u00fdch s&nbsp;TBC kraj Jihomoravsk\u00fd \u2013 meziro\u010dn\u011b o deset p\u0159\u00edpad\u016f, na 56 lid\u00ed.<\/p>\n\n\n\n<p><strong>Epidemiologick\u00e1 situace TBC v\u00a0\u010cR v\u00a0roce 2024 v \u010d\u00edslech<\/strong><\/p>\n\n\n\n<p>MUDr. Ji\u0159\u00ed Wallenfels<br \/>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 11. 3. 2025 z&nbsp;n\u00e1rodn\u00edho registru TBC, registr TBC se \u201euzav\u00edr\u00e1\u201c 30. 4. 2025. 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 do registru TBC hl\u00e1\u0161eno 454 p\u0159\u00edpad\u016f TBC<\/li>\n\n\n\n<li>Mu\u017ei: 337 p\u0159\u00edpad\u016f, \u017eeny 117 p\u0159\u00edpad\u016f<\/li>\n\n\n\n<li>TBC u d\u0159\u00edve l\u00e9\u010den\u00fdch je 21<\/li>\n\n\n\n<li>TBC plic je 409<\/li>\n\n\n\n<li>Kultiva\u010dn\u011b pozitivn\u00edch TBC je 346<\/li>\n\n\n\n<li>Po\u010det mikroskopicky pozitivn\u00edch TBC ze sputa (siln\u00e9 zdroje infekce) je 197<\/li>\n\n\n\n<li>Pod\u00edl TBC u osob narozen\u00fdch mimo \u010cR \u010din\u00ed 48 % (218 p\u0159\u00edpad\u016f), z toho narozeni na Ukrajin\u011b 133 p\u0159\u00edpad\u016f, na Slovensku 16 p\u0159\u00edpad\u016f, ve Vietnamu 13 a v\u00a0Bulharsku a Rumunsku po 8 p\u0159\u00edpadech atd.<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno je 16 p\u0159\u00edpad\u016f multirezistentn\u00ed TBC<\/li>\n\n\n\n<li>Pr\u016fm\u011brn\u00fd v\u011bk nemocn\u00fdch je 48 rok\u016f<\/li>\n\n\n\n<li>Po\u010det TBC u d\u011bt\u00ed do 15 let v\u011bku je 18, z\u00a0nich 12 narozeno v\u00a0\u010cR, 4 na Ukrajin\u011b a po 1 v\u00a0Rumunsku a ve Vietnamu<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno 11 p\u0159\u00edpad\u016f TBC u HIV pozitivn\u00edch (z 325 vy\u0161et\u0159en\u00fdch na HIV), v\u0161ichni narozeni na Ukrajin\u011b<\/li>\n\n\n\n<li>Hl\u00e1\u0161eno 21 \u00famrt\u00ed na TBC<\/li>\n<\/ul>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>Praha, 14. 3. 2025 \u2013 Nespolupracuj\u00edc\u00ed nemocn\u00ed s&nbsp;TBC, dluhy, kter\u00e9 po nepoji\u0161t\u011bn\u00fdch pacientech nemocnic\u00edm z\u016fst\u00e1vaj\u00ed, doplatky za z\u00e1kladn\u00ed l\u00e9ky na tuberkul\u00f3zu, absence vstupn\u00edho rentgenov\u00e9ho vy\u0161et\u0159en\u00ed <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=55691\" title=\"Pacienti s\u00a0TBC ohro\u017euj\u00ed ostatn\u00ed n\u00e1kazou, n\u011bkdy i agres\u00ed. A nech\u00e1vaj\u00ed za sebou dluhy\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":15786,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-55691","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\/55691","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=55691"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/55691\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/15786"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=55691"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=55691"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=55691"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}