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Ng c thc phm do E.

coli

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Ng c thc phm do E.Coli


I.Gii thiu
Hin nay, ng c thc phm tr thnh mi quan tm ca ton x hi. C nhiu nguyn nhn gy ra cc v ng c thc phm nhng phn ln cc trng hp c ngun gc t vi sinh vt. Ng c thc phm thng xy ra do nguyn liu dng ch bin hay thc phm b nhim vi khun v c t ca vi khun. Mt trong nhng loi ng c thc phm gy ra bi vi sinh vt thng gp l ng c thc phm do vi khun E.coli. Escherichia coli (thng c vit tt l E. coli) hay cn c gi l vi khun i trng l mt trong nhng loi vi khun chnh k sinh trong ng rut ca ng vt mu nng (bao gm chim v ng vt c v). Vi khun ny cn thit trong qu trnh tiu ha thc n v l thnh phn ca khun lc rut. S c mt ca E. coli trong nc ngm l mt ch th thng gp cho nhim phn. E. coli thuc h vi khunEnterobacteriaceae v thng c s dng lm sinh vt m hnh cho cc nghin cu v vi khun.

E.coli gy ng c thc phm cho ngi

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Thng k cc v ng c do E.coli _11/2005: hn 1000 ngi Php nhp vin cho nhim khun E.coli _9/2008: 28 tr 1 trng mm non tnh H Tnh nhp vin do n thc n c E.coli _12/2010: 100 cng nhn Long An phi iu tr do ung nc c nhim E.coli _4/2011: E.coli 0104:H4 trn gi bng pht ti c lan rng ra cc nc Chu u khin trn 54 ngi t vong v hn 3800 trng hp mc phi _8/2011: 220 ngi phi nhp vin sau khi n tm hm nhim khun E.Coli ti Trung Quc _11/2011: Anh, 2 tr s sinh v 3 tr khc b nhim E.coli t ngi m ti t vong do E.coli khng thuc _7/2012:Ng c thc phm ln bng pht Hokkaido, su ph n cht Sapporo v Ebetsu trong c 1 b gi 4 tui v 103 ngi khc nhp vin sau khi c cc triu chng ng c thc phm do n bp ci mui nhim vi khun E. Coli.

Bp ci nhp t Trung Quc b nhim E.coli gy ng c Nht

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II. Cu to:
1. Thnh t bo
_Thnh t bo l lp ngoi cng bao bc vi khun, gi cho chng c hnh dng nht nh, chim 15 - 30% trng lng kh ca t bo. Thnh t bo c nhng chc nng sinh l rt quan trng nh duy tr hnh thi t bo v p sut thm thu bn trong t bo, bo v t bo trc nhng tc nhn vt l, ho hc ca mi trng, thc hin vic tch in b mt t bo. _Thnh t bo chnh l ni bm ca Phage v cha ni c t ca mt s vi khun c c t. C mt s vi khun khng c thnh t bo (Micoplasma), mt s trng hp vi khun b ph v thnh t bo m vn sng (Protoplast ...) _Thnh phn ho hc ca thnh t bo vi khun rt phc tp, bao gm nhiu hp cht khc nhau nh Peptidoglycan, Polisaccarit, Protein, Lipoprotein, Axit tecoic, Lipoit v.v.... Da vo tnh cht ho hc ca thnh t bo v tnh cht bt mu ca n, ngi ta chia ra lm 2 loi Gram + v Gram -. Vi cng mt phng php nhum nh nhau, trong c hai loi thuc nhum Cristal Violet mu tm v Fushsin mu hng, vi khun gram + bt mu tm, vi khun gram - bt mu hng. Nguyn nhn l do cu to thnh t bo ca hai loi khc nhau. Ngoi hai loi trn, cn c loi gram bin i (gram variable) c kh nng bin i t gram + sang gram - v ngc li. Sau y l s cu to ca thnh t bo vi khun E.coli.

Hnh 1.13. Cu to thnh t bo vi khun


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2. V nhy (Capsul)
_Nhiu loi vi khun bn ngoi thnh t bo cn c mt lp v dy hay lp dch nhy. Kch thc ca lp v nhy khc nhau tu theo loi vi khun. vi khun Azotobacter chroococum khi pht trin trn mi trng giu hydrat cacbon c th hnh thnh lp v nhy dy hn chnh bn thn t bo. _V nhy c tc dng bo v vi khun trnh tc dng thc bo ca bch cu. _Chnh v th m mt s vi khun gy bnh ch khi c lp v nhy mi c kh nng gy bnh. Khi mt lp v nhy, lp tc b bch cu tiu dit khi xm nhp vo c th ch. Vi khun c v nhy to thnh khun lc trn bng khi mc trn mi trng thch gi l dng S, ngc li dng R c khun lc x x.

Hnh 1.14. V nhy ca vi khun trong sut _V nhy cn l mt ni d tr cc cht dinh dng. Khi nui cy vi khun c v nhy trn mi trng ngho dinh dng, lp v nhy b tiu bin dn do b s dng lm cht dinh dng. _ mt s vi khun v nhy c dng bm vo gi th. Cc cht trong v nhy l do thnh t bo tit ra, thnh phn ca n tu thuc vo loi vi khun. a s trng

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hp v nhy c cu to bi polysaccarit, i khi c cu to bi polypeptit. Thnh phn ho hc ca v nhy quyt nh tnh khng nguyn ca vi khun.

3. Mng t bo cht (Cell membran)


_Mng t bo cht cn gi l mng nguyn sinh cht l mt lp mng nm di thnh t bo, c dy khong 4 - 5 nm, chim 10 - 15% trng lng t bo vi khun. _Mng t bo cht c nhiu chc nng quan trng: Duy tr p sut thm thu ca t bo, m bo vic ch ng tch lu cht dinh dng v thi cc sn phm trao i cht ra khi t bo. Mng t bo cht l ni sinh tng hp mt s thnh phn ca t bo, c bit l thnh phn ca thnh t bo v v nhy, l ni cha mt s men quan trng nh Permeaza, ATP-aza v.v... Mng t bo cht cn l ni tin hnh qu trnh h hp v quang hp ( vi khun quang dng). _Thnh phn ho hc ca mng t bo cht n gin hn ca thnh t bo nhiu. Bao gm photpholipit v protein v protein sp xp thnh 3 lp: lp gia l photpholipit bao gm hai lp phn mi phn t gm 1 u cha gc photphat ho nc v mt u enzym phn hu cht khng sinh nh Penixilinaza c sinh ra t Mexozom. _Mng t bo cht cn l ni gn ca nhim sc th. Ngoi hai thnh phn chnh trn, mng t bo cht cn cha mt s cht khc nh hydratcacbon, glycolipit, v.v...

4. Riboxom
_Riboxom l ni tng hp protein ca t bo, cha ch yu l ARN v protein. Ngoi ra c cha mt t lipit, v mt s cht khong. Riboxom c ng knh khong 200A, cu to bi 2 tiu th - 1 ln, 1 nh. Tiu th ln c hng s lng l 50S, tiu th nh 30S (1S = 1-13 cm/giy) _Mi t bo vi khun c trn 1000 riboxom, trong thi k pht trin mnh ca n, s lng riboxom tng ln. Khng phi tt c cc riboxom u trng thi hot ng.
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Ch khong 5 - 10% riboxom tham gia vo qu trnh tng hp protein. Chng lin kt nhau thnh mt chui gi l polyxom nh si ARN thng tin. _Trong qu trnh tng hp protein, cc riboxom trt dc theo si ARN thng tin nh kiu c thng tin. Qua mi bc c, mt axit amin li c gn thm vo chui polypeptit.

III. MI TRNG SNG:


_Escherichia coli l mt loi trc khun sng thng xuyn trong rut ngi v mt s ng vt c Eschrich pht hin ra t nm 1885. Chng chim ti 80% vi khun hiu kh sng rut. Nh vy s c mt ca E.Coli mi trng bn ngoi chng t mi trng c kh nng nhim t phn. _Trong phn ti, m ca chng c th n 109/g. Chng cng c tm thy trong nc cng rnh, trong cc cng on x l v trong tt c cc ngun nc v t va mi b nhim phn t ngi, ng vt hoc do sn xut nng nghip. Gn y ngi ta ngh n E.Coli c th tn ti hoc thm ch pht trin trong nhng ngun nc vng nhit i khng phi l i tng b nhim phn. Tuy nhin, ngay c nhng vng su, vng xa cng khng bao gi c php loi tr kh nng nhim phn do ng vt hoang di, k c chim. Bi l ng vt c th lan truyn vi khun gy bnh cho ngi nn khng c qun s hin din ca E.Coli hoc coliforms chu nhit, v s c mt ca chng chng t nc c th b nhim phn hoc x l khng hiu qu. _Chng pht trin nhit 44-45oC trn mi trng tng hp, ln men ng lactose v mannitol c sinh hi v sinh axit, sinh endol t triptophan. Tuy nhin mt s chng c th pht trin 37oC ch khng pht trin 44-45oC v mt s th khng sinh hi. E.Coli khng sinh oxidase hoc thy phn ur.

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IV. Phn loi


_ Tp on trc khun E.coli thuc h Enterobacteriacae hng rut rt phong ph v chng loi. _ i vi c th : Ngi ta phn chng ra lm 2 loi: c li v c hi. Li:+ Loi c li l nhng vi khun k sinh trong ng rut tham ra vo qu trnh ln men, phn hu thc n, tham gia qu trnh tng hp cc loi men, cc vitamin B, C, K..., tng kh nng ng ho v trao i cht. Ngoi ra, chng cn c chc nng lm cht ch th nhm xc nh s c mt ca cc loi vi khun gy bnh khc (coliform). + Bnh thng chng khng gy bnh, khi c th suy yu mt s chng c kh nng gy bnh. trong rut chng sng i khng vi mt s vi khun khc nh Salmonella v Shigella ( thng hn v l) nh c kh nng to ra mt loi cht c ch l Colixin. + Loi vi khun E.Coli c hi l nhng vi khun gy bnh cho c th, chng c yu t bm ( khng nguyn) vo lng mao nim mc rut v kh nng to cht c ph hu cu trc lng mao rut v nim mc rut. Chng pht trin tt trn b mt rut v sn sng gy bnh khi c tc ng bi cc yu t stress c hi. _ Da vo bn cht khng nguyn ca E.coli m ngi ta phn lp c 157 chng c khng nguyn O, 94 chng c khng nguyn K, 50 chng c khng nguyn H. Trong mi chng loi chng li c chia ra thnh nhiu di chng khc nhau, ta thng gi l di type (Subtype). _V d: E.Coli cha khng nguyn K c K88, K99, K05, K08, K055, K064, 078, 0194 . V t K88 li chia ra cc di chng (subtyp) nh: K88ab, K88ca, K88a, v gn y nht t cc chng K ngi ta li tch ra chng F (v d: F107, F2134, F41..). _da vo v tr gy bnh E.coli c chia thnh 2 nhm: Nhm gy bnh trong ng rut v nhm gy bnh ngoi ng rut.

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+Nhm gy bnh ngoi ng rut c bit n ph bin nht l: MACE: E.coli gy bnh vim mng no v UPCE: E.coli gy nhim khun ng tit niu

+ Nhm gy bnh trong ng rut (hay cn gi l nhm gy bnh tiu chy) c chia lm 5 nhm chnh: nhm E.coli gy bnh (EPEC), nhm E.coli sinh c t rut (ETEC), nhm E.coli xm nhp (EIEC), nhm E.coli gy xut huyt ng rut (EHEC) v nhm E.coli kt dnh rut (EAEC).

Biu th hin t l phn b cc nhm E.coli trong t nhin _Mt s loi E.coli gy bnh c bit bao gm:

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EPEC (Enteropathogenic E.coli): y l nhm E.coli gy bnh. Dng E. coli ny gy nn hi chng nn i, tiu chy c nht. Cc triu chng xut hin sau khi n 12 n 36 gi. tr em, cc triu chng th hin nghim trng hn so vi cc bnh tiu chy khc v ko di hn.

EPEC gy ra s hnh thnh ca b trn b mt t bo ch

ETEC (Enterotoxigenic E.coli): E.coli sinh c t ng rut, gy nn hi chng st v tiu chy nh hoc nghim trng hn vi cc triu chng tiu chy nc khng c mu, au bng v nn i. Cc triu chng bt u xut hin sau khi n t 12 n 36 gi. Bnh s t khi sau 2 n 3 ngy.

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EIEC (Enteroinvasive E.coli): E.coli xm nhp rut, gy hi chng tng t bnh l. y l dng gy nn cc vim lot trong rut a n cc triu chng st, au bng, tiu chy nhiu nc v c nht.

EAEC (Enteroaggregative E.coli): E.coli ngng tp rut. Biu hin lm sng l tiu chy nc, khng vim, c cht nhy. Mt s nghin cu, EAEC cng c bo co l nguyn nhn gy tiu chy mt bnh nhn b nhim HIV Hoa K. Dng bnh ny gy ph hy t bo biu m, lm tan mu v lm mt thng bng khi vn chuyn cc ion qua mng. Dch bng pht EAEC c m t c nhng nc ang pht trin cng nh nhng nc pht trin, bao gm nhng ngi kho mnh ln nhng ngi suy dinh dng.

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EHEC (Enterohaemorrhagic E.coli): Dng E. coli gy xut huyt rut, ph bin nht l E. coli O157:H7. y l dng thng gp trong thc phm nht, chng gy nn cc hi chng t tiu chy khng c mu, vim rut km tiu chy c mu n cc hi chng nguy him nh chng huyt tan km ur mu (HUS) v chng ban xut huyt nghn mch (TTP). Hi chng vim rut tiu chy xut hin sau khi n t 1 n 2 ngy, bt u bng cc triu chng au bng sau tiu chy trong vng 1 n 2 ngy ri tiu chy c mu v au bng nhiu hn, bnh c th ko di 4 n 10 ngy. Bnh thng xy ra ngi ln v rt nguy him i vi ngi gi. Hi chng huyt tan ur mu c c trng bi chng suy thn v thiu mu do huyt tan, i khi km theo tiu chy c mu.

V. c im chung
_Tt c cc chng loi E.Coli u c hnh thi phong ph, khng bt mu nn c xp vo nhm vi khun Gram (-). Tu vic vo iu kin sinh thi c tng chng E.Coli ring bit tn ti v pht trin.
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_E.Coli l mt trong nhng loi vi sinh vt ph bin nht trn hnh tinh. Chng c mt khp mi ni, mi ch. Trong c th ng vt cng nh con ngi chng sng, tn ti bnh thng trong rut v c o thi ra ngoi cng vi phn. Bi vy, chng l ngun gy bnh di do cho nhiu loi vt nui v con ngui. _c tnh sinh ho hc ni bt ca E.Coli l ln men ng, to ra cc loi axit v gii phng kh. Chnh v c trng ny m ngi ta phn bit E.Coli vi Salmonella thng qua qu trnh phn hu ng Lactose ca E.Coli. _E.Coli d nui cy trong trong mi trng thch thng (agar) v trong nc tht. Trn mi trng agar chng pht trin mnh hnh thnh khun lc trn, hnh Ovan, sng bc mu kem ghi. Trong mi trng sinh Indol cc khun lc c mu nh kim loi. Trong mi trung nc tht chng nhanh chng pht trin lm c mi trng v kt ta phn di mu xm trng. E.Coli khng c kh nng lm chy tan Gelatin, nhng chng li lm ng sa v khng pht trin trong mi trng Koser. Trong dung dch pepton chng to ra Indol Mt vi chng khi pht trin chng c c tnh lm dung huyt, to kh c H2S v chng c kh nng to c ngoi v ni c t hng huyt v thn kinh. _E.Coli b cht nhit t 60oC tr ln, b tiu dit bi cc dung dch thuc st trng nh 1% Focmn, 2 - 2,5% Kresil, nc vi 10 - 20%, 1/40 Paccoma, 1/200 Dinalon, 2% ca Vinadin 10% v B.K.Vet. Chng cc k nhy cm v d b tiu dit di tc ng ca nhiu loi khng sinh khc nhau. Song nu chng ta s dng thuc ba bi, hoc khng ng liu trnh th E.Coli cng d thch nghi vi iu kin mi lm nhn thuc, gim hiu qu phng tr bnh do E.Coli.

VI. c im khng nguyn v c t :


_Gm 3 loi khng nguyn: O, K, H v ni c t gy tiu chy, ngoi c t gy tan huyt v ph thng.

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_c t ca E.coli: Loi E.coli c gip m (khng nguyn K) gy ng mnh hn loi khng gip m. Khng nguyn K c 13 loi KA, KB, KL. Ni c t ng rut: Gm 2 loi chu nhit v khng chu nhit. C hai loi ny u gy tiu chy: +Loi chu nhit ST (Thermostable): gm cc loi STa, STb. +Loi khng chu nhit LT (Thermolabiles): gm cc loi LT1, LT2. _Nhng dng E.coli sn sinh c t (ETEC) gm nhiu type huyt thanh khc nhau nhng thng gp nht l cc type O66:H16, O8:H9, O78:H12, _E. Coli O157: H7 tit ra c t Shiga-like toxin (SLT) thng c gi l c t Verotoxin (VT1 v VT2), nguy him n thit mng cho tr nh vn khng chu ni s mt mu v cc dch t khc trong c th. _c t verotoxin ca E.coli 0157:H7 lm dung huyt (hemolysis), hy hoi nim mc rut gy tiu chy c mu, lm h thn, v ng thi lm gim lng nc tiu.Khoa hc gi y l hi chng HUS (Hemolytic Uremic Syndrome), rt nguy him c th cht, bng khng th cng cn phi c lc thn (renal dialysis) sut i. _Trng hp nng thng lm tr em b bi thn vnh vin. _Trng hp nh bao gm tiu chy (thng c mu trong phn) hay au bng ngm dng dai, thnh thong i ma, nhng khng b nng lnh (fever). Triu chng thng ko di khong 8 ngy. Nhiu ngi ch i tiu ra nc m thi. Hu ht bnh nhn l tr nh hoc ngi gi.

VII. Tnh cht gy bnh :


1. Nguyn nhn:

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_Ng c thc phm thng hay xy ra khi c s chnh mng trong vn v sinh lc sn xut, lc bin ch, lc bo qun hoc lc chng ta s dng thc n. Thc phm c th b nhim ti l st sinh, ti nh my bin ch, ti ch hoc c chnh ngay ti nh bp ca chng ta na. Sau y l s phn b cc nguyn nhn theo th t quan trng - Phng php tr lnh khng ng cch, khng lnh cn thit. - Nhit khng ng lc cn gi nng thc n. - V sinh c nhn thiu st nh khng chu ra tay k gy nhim trng t ngi bin ch mn n hoc do chnh chng ta lc n ung.

Gnh hng rong c by bn mt v sinh trn va h, ngay trn cng rnh - Dng c nh bp v dng c tn tr d bn khng sch s.

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Thc phm c th b nhim do s ch trong mi trng nhim - Thc n mi nu, hoc d ba, khng c tn tr v bo qun ng cch, ng lc. - Thc n b hm i hm li qu nhiu ln nhit khng thch hp. - Do nhim trng cho nh s dng li dao, tht, thau, ni, cho, chn da b nhim trng sn t trc ri. - S dng thc phm ti sng b nhim trng sn t trc. - Ngun cung cp thc phm khng tt, ng nghi ng. -S dng thc phm b nhim vi khun hoc qua phn ca ngi,gia sc nhim bnh.

Ming tht ti ngon ny liu c an ton???


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_Khi gia sc c git m v ch bin, khun E. coli vi trong rut c th c trn tht. Tht b v tht kt hp t nhiu ng vt khc nhau lm tng nguy c nhim. Tht b xay nhim thng c cc vi khun ly lan trn ton hn hp, khng ch trn b mt (chng hn nh trn mt ming tht b), nu n chn c nhiu kh nng tiu dit vi khun. _Sa cha c tit trng. Vi khun E. coli vo bu v ca con b hoc trn thit b vt sa c th vo c sa ti. _Sn phm ti. Nc thi t chn nui trang tri c th lm nhim cc sn phm ti c trng. Cc loi rau nh rau bina v rau dip c bit d b loi nhim ny.

Ra rau bng nc cng ???

2. Triu chng trng c :


_Thi k bnh 2-20 gi _ Tiu chy t nh n nng, phn nc c km theo mu. _ Bng au qun, st cao. _ Bun nn v km theo nn mt s trng hp.

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Nn i v st cao l mt trong nhng triu chng ca ng c E.coli 3.

C ch gy ng c
_Khi c th b nhim vi khun vi s lng nhiu km theo c t ca chng. E.coli

gy tiu chy thng gp cc nhm sau: tui. Nhm ETEC (Enterotoxigenic E.coli): gy bnh cho tr em, ngi ln do tit ra 2 c t rut ST v LT: + LT hot ha men adenyl cyclase trong t bo rut lm gia tng yu t C.AMP (cyclicadenozin 5 monophosphat). Yu t ny s kch thch ion Cl- v bicarbonat tch ra khi t bo ng thi c ch Na+ bn trong t bo. Hu qu l gy tiu chy mt nc. + c t ST: hot ha men Guanyl Cyclase lm tng yu t C.GMC (cyclic guanosin 5 monophosphat) bn trong t bo dn n kch thch bi tit mui v nc gy ra tiu chy. Nhm EPEC (Enteropathogenic E.coli): gm cc type thng gp O26:B6,

O44, O55:B5, O112:B11, O124, O125:B5, O142 l nguyn nhn gy tiu chy tr em di 2

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Nhng dng E.coli c c 2 loi ni c t LT v ST s gy ra tiu chy trm trng v ko di. Nhm EIEC (Enteroinvasine E.coli): nhng E.coli ny bm ln nim mc

v lm trc nim mc gy lot nim mc do gy tiu chy c m ln mu (ging Shigella). Cc chng ny c th ln men hay khng ln men ng lactose v c phn ng lysin decarboxylaza m tnh. Thng gp cc type O125, O157, O144 Nhm VETEC (Verocytoxin produccing E.coli): Va gy tiu chy va l nguyn nhn gy vim i trng xut huyt (hermorrhagic colilic) v lm tn thng mao mch gy hin tng sng ph (ederma) rt nguy him n tnh mng (do bin chng). Nhm VETEC bao gm cc type: O26, O11, O113, O145, O157 ; y l ngoi c t vetec gy tiu chy. Cc bin chng trn do vi khun tit ra mt trong 2 loi ngoi c t VT1 (verocytoxin) v VT2 gy tc ng thn kinh. _Gn y ngi ta pht hin chng E.coli mi k hiu l E.coli O157:H7. Chng ny gy ra nhng v ng c ln trn th gii trong nhng nm gn y (theo Center for Disease Control and prevention ca M) : _Nm 1982, ln u tin ngi ta ghi nhn c ngun bnh do E.coli O157:H7. Nm 1985, ngi ta nhn thy triu chng hoi huyt c lin quan n chng O157:H7. Nm 1990, bng n trn dch t ngun nc nhim chng E.coli O157:H7. Nm 1996, xy ra trn dch kh phc tp Nht Bn do ung nc to cha dit khun. _Nm 2011, dch E.Coli bng pht mnh m Chu u, c bit l c lm hn 50 ngi t vong v 3000 ngi khc mc bnh. Theo nghin cu ca cc chuyn gia th y l chng E.Coli gy nn l mt chng hon ton mi, mang hm lng c t cao v c t tn l O104:H4.

4. Bin chng

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_Ngy 6/2011, T chc Y t th gii (WHO) thng bo khun vic E.Coli nhm gy xut huyt ng rut (EHEC) ang gy dch bnh tiu chy cp ti c v lan rng ra mt s nc chu u. _Bnh tiu chy do EHEC gy ra c th din bin t th nh, phn khng c mu hoc t mu n th nng phn ton mu nhng khng cha bch cu. Nguy him hn khi nhim chng STEC c th gy ra hi chng tan mu suy thn cp (Haemolytic Uraemic Syndrom: HUS) v cc ban do thiu tiu cu, y l cn nguyn chnh gy t vong. _Hi chng tan mu suy thn cp c ghi nhn c ngi ln v tr em vi biu hin thiu mu tan huyt, gim tiu cu v suy thn cp tnh tng ur huyt, c th km theo cc ri lon thn kinh hoc st. _Chng E.Coli O157:H7 l cn nguyn ch yu gy ra hi chng tan mu suy thn cp trn ton th gii. Khong 15% tr em v mt t l thp hn ngi ln nhim E.Coli O157:H7 tin trin ti hi chng ny, trong 50% s bnh nhn phi chy thn v 5% t vong. _Nhim khun huyt cng do bin chng ca E.coli gy ra. l khi vi khun ny xm nhp vo ng tiu ha ri tip tc xm nhp vo cc mch mu lm tn thng cc tng nh tim, thn, no khin ngi bnh c th t vong.

5.Cch tr liu
_Da trn cc biu hin bnh thng thng, ta khng th nhn bit bnh do E. coli gy ra c m phi cn n xt nghim vi sinh. _Nhiu trng hp bnh nhn b tiu chy c th iu tr ngay nh da vo bnh s, xt nghim phn v nh gi mc nng nh ca tnh trng mt nc. im chnh trong
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iu tr cc bnh tiu chy l bi ph nc v in gii. V vy, iu tr bnh t v cc bnh tiu chy gy mt nc khc nn s dng dung dch oresol theo ng ung. Vic dng dung dch oresol ung lm gim t l t vong do bnh t t trn 50% (nu khng c iu tr) xung cn di 1%. Bnh nhn mt nc nng hay nhng bnh nhn nn nhiu khng ung c th phi truyn tnh mch dung dch Lactat Ringer.

S dng dung dch oresol theo ng ung gim t l t vong do bnh t _ Tuy hu ht cc dng tiu chy khch du lch do vi khun E. coli gy ng c ng rut gy ra thng c iu tr c hiu qu bng cch bi ph nc, thuc bismuth subsalicylat hay thuc gim nhu ng rut, nhng thuc khng sinh c th rt ngn thi gian b bnh t 3 - 4 ngy xung cn 24 - 36 gi. _ i vi cc bnh gy ra do E.coli O157:H7, khng c phng php iu tr . Hin nay, c th cha tr cc nhim trng, lm gim triu chng hoc ngn chn cc bin chng. i vi hu ht mi ngi, s la chn tt nht l ngh ngi v ung nhiu nc gip vi tnh trang mt nc v mt mi. Tuyt i trnh dng thuc chng tiu chy, iu ny lm chm h thng tiu ha, ngn chn c th loi b cc c t.

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Ngh ngi v ung nhiu nc gip vi tnh trang mt nc v mt mi

VIII. Cch phng trnh


Hin nay, cha c vc xin, thuc c th bo v khi bnh E.coli, mc d cc nh nghin cu ang nghin cu vc xin tim nng lm gim c hi tip xc vi E.coli, trnh cc thc phm nguy him v trnh ly nhim cho. 1 s cc bin php phng trnh nh sau:

1. C nhn
_Ct t ng ly nhim ph bin ca E.coli bng cch ra tay bng x phng dit khun sau khi i v sinh, trc khi n chun b lm thc n hay va mi tip xc vi ng vt.

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Ra tay bng x phng dit khun trc khi n trnh ly nhim E.coli _Hn ch n ung nhng qun mt v sinh, gn cng rnh, nhiu rui nhng, hng rong

Hn ch n ung nhng ni mt v sinh nh th ny _ Trnh ung nc khi bi li di sng hay ao h, s dng nc ung qua un si 100oC.

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2.

V sinh thc phm

_i vi rau qu v tri cy: nn chn loi cn ti, t dp nt. Ra tht k trc khi dng. Khi ra nn ngm vi dch mui long hoc javel st khun v hn ch n rau sng.

Ra k rau qu trc khi n, hn ch n rau sng _i vi tht c: khng nn xay hay no sn ti ni bn trnh ly vi khun t nhng dng c _Ra dao, bn, tht trc v sau khi tip xc vi sn phm ti sng hoc tht sng bng x phng.

V sinh cc dng c nh bp bng x phng _ thc phm sng ring bit, khng bao gi t c nu chn trn nhng dng c c dng cho nguyn liu sng.

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3. i vi cc sn phm
_ Trnh hambuger m tht cn ; cc loi tht phi c un nng t nht phi 71o C. _Nn ung sa, nc tri cy v ru qua thanh trng, tit trng. Bt k nc tri cy ng chai hoc ng hp phi c gi nhit phng tit trng. _S dng cc loi tht, rau qu c r ngun gc hoc mua nhng ni c uy tn. _Nu k cc loi thc phm trc khi n. _Khi mua hng, nn chn cc loi sn phm cn nguyn nhn mc, bao b khng b rch. _Dng thng p lnh tht v gia cm nu cha s dng. _Lm tan tht sau khi ly ra t t lnh. _Khng n nu cng a ng cc ming tht sng. _Ra sch hoa qu v rau di vi nc, nht l nhng th khng th nu.

4. Cch bo qun thc phm


_Nn che y cn thn v hn ch tch tr n qu lu. Vi nhng thc n khi dng li, cn phi un tht k trc khi dng m bo an ton. _p lnh hoc ng lnh tht ngay khi mua t ch v v s dng trong vng 1 hoc 2 ngy sau khi mua. _Khng tht hoc cc sn phm ti sng trong nhit phng qu 2h.
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_Khng n nu chung a vi cc thc phm tht cha chn nhm trnh b phi nhim.

TIU CHUN NH GI S LNG E.COLI CHO PHP C TRONG MT S MU THC PHM

Sn phm Pho mt c sn xut t sa ti nguyn liu Pho mt Whey ( c sn xut t whey qua x l nhit) Cream v b Tht v cc sn phm ch bin t tht s dng trc tip khng cn x l nhit Tht v sn phm t tht phi qua x l nhit trc khi s dng Nhuyn th hai mnh v, ng vt chn bng, ng vt da gai, hi tiu cn sng Gip xc v ng vt thn mm c v hoc b v gia nhit Rau n sng Qu n ngay

Gii hn cho php (CFU/ml hoc CFU/g) m 102 102 101 5x101 M 103 103 102 5x102

Phn loi ch tiu A A A B

5x102

5x103

230(3)

700(3)

101

102 102

103 103

B B

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Trong :

- n: s mu cn ly t l hng kim nghim. - c: s mu ti a cho php c kt qu kim nghim nm gia m v M. Trong n mu kim nghim c php c ti a c mu cho kt qu kim nghim nm ga m v M. - m: gii hn di, nu trong n mu kim nghim tt c cc kt qu khng vt qu gi tr m l t. - M: gii hn trn, nu trong n mu kim nghim ch 01 mu cho kt qu vt qu gi tr M l khng t.

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T LIU THAM KHO


1. http://thuviensinhhoc.com/chuyen-de-sinh-hoc/vsv/3547-dac-diem-cau-tao-te-bao-

vi-khuan.html?start=1
2. http://vi.scribd.com/doc/74967218/Ecoli 3. https://docs.google.com/viewer?a=v&q=cache:PJEqrUpCjzoJ:www.bvbnd.vn/do

wnloads/GermanyEcoli.ppt+ph%C3%A2n+lo%E1%BA%A1i+E.Coli&hl=vi&gl=vn&pi d=bl&srcid=ADGEESjeE77OcoFLEqF5yQjuNGIH0OBC7EDC1jW7VRqNh4blzLXym Vlb_AOMEGK40ECYV6xYxZE6KYv8apqkFexTlsiV4YqoXEgs53Gec5p325HUXqBY1VRfcEgbi52uLheGu4CYS3Z&sig=AHIEtbRE_bDlcflie7v2bhFMFf__z JtJNw


4. http://www.medinet.hochiminhcity.gov.vn/data/news/2011/6/8182/eschei.htm 5. http://congdong.cz/home/20806/benh-nhiem-khuan-e-coli-va-nhung-dieu-can-

biet.htm#ixzz276yFTZ1N
6. http://www.scribd.com/doc/86196384/e-coli

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