VI KHUN VIBRIO CHOLERAE V BNH DCH T

in nay, trn th gii v ngay c nc ta, v sinh an ton thc phm ang l vn ht sc quan trng. Mt trong nhng tc nhn gy ng c chnh l vi khun t Vibrio cholerae. Nu hiu bit ng v kp thi, chng ta c th ngn nga ngun ly nhim bo v cho mnh v cng ng xung quanh.

Ths. Nguyn Khnh Linh (*)

Gii (regnum): Lp (class): B (order): H (family): Chi (genus): Loi (species):

Bacteria Gamma Proteobacteria Vibrionales Vibrionaceae Vibrio V. cholerae

Ngnh (phylum): Proteobacteria

H1. Cu to vi khun V. cholerae

Vi khun t c mt s c im chnh nh sau: Vi khun hnh que hi cong, gram m (-), khng sinh bo t, c mt roi u v c kh nng di ng rt mnh. Nhit pht trin ti u 37oC trn nhiu loi mi trng nui cy c mui khong v asparagine l ngun carbon v nitrogen. Chng pht trin trn thch a to khun lc li, nhn v trn, c mu vng nht. Hiu kh, pht trin tt trong mi trng kim (pH 8.5 - 9.5), d b tiu

dit trong mi trng acid, c kh nng chu mui cao ( 3%). Tnh cht ha sinh: oxidase (+), indole (+), ln men glucose (+), sucrose (+), mannose (+), lactose (-), arabinose (-) , H2S (-), urease (-). khng yu vi cc tc nhn l ha, tr pH kim; c th sng vi gi trong phn v vi ngy trong nc. V mt phn loi, da vo cu to a dng ca lipopolysaccharid 0 nm trn b mt t bo V.cholerae (100 nhm khng nguyn 0 khc nhau) m

phn chia cc type cho vi khun t. Tuy nhin, nhm 01 l nhm c in v gy bnh tiu chy nghim trng nht. Cn nhm khng phi 0 ( k hiu l non-01) ch gy bnh tiu chy nh, khng c kh nng pht thnh dch. C CH GY TIU CHY CA VI KHUN V.CHOLERAE Khi theo nc ung hay thc n vo trong d dy, vi khun chu tc ng ca dch d dy c pH thp (mi trng acid). Nhng vi khun

Bng 1. So snh kh nng gy bnh cc nhm vi khun t.

Nhm vi khun t V.cholerae serotype 01 V.cholerae serotype non-01 V. parahaemolyticus Mt s loi khc ( V. mimicus, V. vulnificus, V. hollisae, V. damsela. . . ) Kh nng gy bnh Gy bnh tiu chy nghim trng, c th thnh i dch Gy tiu chy nh, ch xm nhim ngoi rut non Nh, xm nhim ngoi rut non Khng ph bin, thng xm nhim vt thng, m mm.

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sng st s tip tc xung rut non. rut non, vi khun c kh nng tn ti rt lu. Phy khun c kh nng khng tc ng ca mui mt, xm nhp qua lp mng nhy trn nim mc rut. Qu trnh xm nhp c h tr bi men tan nhy v cc men phn ct protein thnh cc peptide. Do kh nng t bi, vi khun c th chuyn ng ngc chiu vi nhu ng rut tip cn vi nim mc rut nh c im ho hng ng ca chng. Ti rut non, chng tit ra ni c t choleraetoxin c trng lng phn t khong 84.000 gm 2 tiu n v l A v B (do gen c sn nm trong DNA ca vi khun tng hp). Tiu n v B s gn vo th quan Ganglioside GM1. Vic gn kt ny s h tr tiu n v A xm nhp vo bn trong t bo rut non. Chng khng xm nhp vo biu m rut m bm vo nim mc rut. Khi tiu n v A xm nhp vo bn trong t bo, chng s kch hot adenylate cyclase lin tc gia tng sn sinh hm lng cAMP (Adenosine monophosphate vng) trong t bo lm phng thch hng lot ion, cht in gii t trong t bo ra ngoi dch rut. Chnh v th, t bo s mt rt nhiu in gii ( K+, Cl-, Na+. . . ). Ngoi ra, chng cng to thnh mi trng u trng trong lng rut dn n vic nc trong t bo s ra t, gy tiu chy trm trng. Phy khun cn c th s hu protein b mt gy ngng kt hng cu v nhm protein do gen acf m ho. Nhm gen ny quy nh yu t h tr gn kt ca vi khun (accessory colonization factor). t bin gen acf dn n gim kh nng c nh ca vi khun vo nim mc rut. Chng ch xm nhp vo ng rut, khng truyn nhim qua ng mu. pht bnh, hm lng t bo vi khun t trong rut phi t nng cao khong 108-1010 tb/ ml. Trong khi bnh do khun Samonella hay Shigella ch cn nng thp c 105-106 tb/ml l pht bnh. Do , nu ngi no b ri lon tiu ha, pH acid d dy khng kim hm s lng t bo vi khun th chng s sng st di chuyn n rut non gy bnh.

H2. C ch tc ng ca c t choleraetoxin ln t bo rut non

BNH DCH T - TRIU CHNG V BIN PHP PHNG NGA Bnh t l bnh nhim trng nng, ly nhim qua ngun thc n, ngun nc khng hp v sinh, gm cc biu hin sau y: nNn, i phn ton nc ln nhng ht nhy, i ngoi >3 ln/ngy. nPhn mu nh nc vo go, khng pht hin mu ln bch cu. nKhng gy nhim trng ton thn. nTng nh bch cu a nhn trung tnh. nKhng st, cm gic mt mi, kht nc. nMt nc v in gii trm trng dn n tng huyt p, thiu nng tim, thn. Nu khng iu tr, t l t vong c th t t 25-50%. xt nghim vi khun t trong bnh phm (cht nn v phn), ta c th nhum hoc soi ti di knh hin vi, s dng k thut khng th hunh quang trc tip hoc nui cy phn lp. Thc t khng s dng chn on huyt thanh v cho kt qu chm. Khi nm c c im cu to v sinh ha ca vi khun t, ta c th phng nga mt cch hiu qu nh: +B sung nc v cht in gii ngay khi c biu hin bnh. +C th dng khng sinh tetracycline tiu dit vi khun t. +Vng nguy c cao c th cho s dng vaccine t. +Do V. cholerae c kh nng chu mui cao, do thi quen ra rau bng mui gia nh hon ton khng tc dng. Ngc li nu dng

mui vi nng qu cao ra th s lm mt nc trong rau qu, mt cht dinh dng. V vy thc phm cn nn n si, nu chn l an ton nht. +Ngoi ra, c th dng nc ozone (my OZ-magic) to ozone trc tip vo ngun nc kh trng rau qu, tht c. +Phi ra tay sch trc khi n v ch bin thc n. Ngun thc phm s dng phi r ngun gc, m bo v sinh v cn trong hn s dng. +X l v sinh khu vc c nhim phn bnh nhn bng cloramin B 10%. Ty trng vt dng c nhn bng nc Javen, nc si, cloramin 2%, khng nn dng vi bt kh trng. +Ra tay sau khi i v sinh hay vo cc ni cng cng. +Mc d bnh tiu chy l bnh nguy him nhng c th d dng phng v iu tr nu ngun nc sinh hot m bo v sinh v thi quen n ung c ch . Mi ngi phi hiu bit v t bo v chnh bn thn mnh, cng l cch tt nht bo v cng ng. (*): Ging vin Khoa Khoa hc ng dng Trng H Tn c Thng
TI LIU THAM KHO 1.Ernest Jawetz, Joseph L. Melnick, Edward . Adelberg, Medical Microbiology, 8th edition, 1989. 2.Bs. L Huy Chnh, Nguyn V Trung, Vi sinh vt y hc, NXB y hc. 3.http://www.emi.unsw.edu.au 4.http://www.nature.com/nrmicro/ journal/v3/n8/fig_tab/nrmicro1207_F4.html

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