{"id":13123,"date":"2026-03-18T19:41:21","date_gmt":"2026-03-18T19:41:21","guid":{"rendered":"https:\/\/csiag.eu\/?p=13123"},"modified":"2026-04-10T10:47:51","modified_gmt":"2026-04-10T10:47:51","slug":"hronisks-bronhits-symbioflor","status":"publish","type":"post","link":"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/","title":{"rendered":"Hronisks bronh\u012bts - Symbioflor\u00ae"},"content":{"rendered":"<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_87_1 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Satura r\u0101d\u012bt\u0101js<\/p>\n<span class=\"ez-toc-title-toggle\"><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Jekyll_Hyde\" >D\u017eekils un Haids<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Was_steckt_dahinter\" >Kas aiz t\u0101 sl\u0113pjas?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Genomische_Besonderheiten_von_DSM_16440\" >Genomische Besonderheiten von DSM 16440<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Was_die_Sequenzierung_zeigt\" >Was die Sequenzierung zeigt<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Eine_bemerkenswerte_Unstimmigkeit\" >Eine bemerkenswerte Unstimmigkeit<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Pro_contra_E_faecalis\" >Par un pret E. faecalis<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Pro_%E2%80%A6\" >Pro ...<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#%E2%80%A6_contra\" >... kontra<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Der_Mechanismus_im_Detail\" >S\u012bk\u0101ka inform\u0101cija par meh\u0101nismu<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Die_Selektion_durch_Antibiotika\" >Atlase, izmantojot antibiotikas<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#VRE_Vancomycin-Resistant_Enterococci\" >VRE (pret vankomic\u012bnu rezistenti enterokoki)<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#%E2%80%A6_und_warum_wird_Symbioflor%C2%AE_dann_verkauft\" >... un k\u0101p\u0113c tad tiek p\u0101rdots Symbioflor\u00ae?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Risikofaktoren\" >Riska faktori<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Welche_Warnzeichen_gibt_es\" >K\u0101das ir br\u012bdin\u0101juma paz\u012bmes?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Harnwegsinfektionen_UTI\" >Ur\u012bnce\u013cu infekcijas (UUI).<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Intraabdominelle_Infektionen_PeritonitisAbszesse\" >Intraabdomin\u0101las infekcijas (periton\u012bts\/abscesi)<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Endokarditis\" >Endokard\u012bts<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Sepsis_%E2%80%93_Notfall-Szenarien\" >Sepse \u2013 Neatliekam\u0101s situ\u0101cijas!<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/#Gibt_es_keine_Alternativen\" >Vai nav alternat\u012bvu?<\/a><\/li><\/ul><\/nav><\/div>\n<span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Las\u012b\u0161anas laiks<\/span> <span class=\"rt-time\"> 8<\/span> <span class=\"rt-label rt-postfix\">protokols<\/span><\/span>\n<p class=\"wp-block-paragraph\">Symbioflor, ko cita starp\u0101 lieto hroniska bronh\u012bta \u0101rst\u0113\u0161anai, ir pieejams tr\u012bs variantos. Princip\u0101 tas ir pieejams tirg\u016b jau vair\u0101k nek\u0101 70 gadus un satur - \u201eim\u016bn\u0101\u201c variant\u0101. <em>Enterococcus faecalis DSM 16440<\/em>- un <em>E.coli DSM 17252<\/em>-bakt\u0113rijas un cinku.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Ikvienu, kas cie\u0161 no z\u0101les ziedputek\u0161\u0146u aler\u0123ijas un hroniska bronh\u012bta, moka past\u0101v\u012bgs, ne\u0101rst\u0113jams klepus kr\u016bt\u012bs, tikl\u012bdz vi\u0146\u0161 ziemas m\u0113ne\u0161os \u201ep\u0101rce\u013cas\u201c. Tikai \u0101r\u0101, aukstum\u0101, ir miers un klusums.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Apmekl\u0113jot \u0101rstu, pat pie it k\u0101 atz\u012btiem plau\u0161u speci\u0101listiem (pulmonologiem), netiek pied\u0101v\u0101ta ne terapija, ne pat m\u0113r\u0137tiec\u012bga diagnoze, jo diagnostiski visi parametri ir norm\u0101li - viss ir piln\u012bg\u0101 k\u0101rt\u012bb\u0101 -, iz\u0146emot joproj\u0101m nemain\u012bgo un patiesi moko\u0161o kairino\u0161o klepu, iesp\u0113jams, l\u012bdz vem\u0161anai.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tas, ka Symbioflor ir efekt\u012bvs pret \u0161o kairino\u0161o klepu, nav t\u0101p\u0113c, ka <em>E. faecalis<\/em> Galvenais iemesls tam ir t\u0101s pozit\u012bv\u0101, stiprino\u0161\u0101 ietekme uz im\u016bnsist\u0113mu zarn\u0101s (GALT - Gut-Associated Lymphoid Tissue), l\u012bdz\u012bgi k\u0101 antibiotik\u0101m.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tom\u0113r <em>E. faecalis<\/em> Atkar\u012bb\u0101 no zarnu im\u016bnsist\u0113mas st\u0101vok\u013ca tai piem\u012bt gan labas, gan \u201esliktas\u201c \u012bpa\u0161\u012bbas. Tas ir \u0101tras mai\u0146as m\u0101kslinieks, kas imit\u0113 im\u016bnsist\u0113mu.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Jekyll_Hyde\"><\/span>D\u017eekils un Haids<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Dr. D\u017eekils<\/strong>, uzticams \u0101rsts <em>E. faecalis<\/em> zarn\u0101s.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Kop\u0161 pirm\u0101s dienas, burtiski no dzim\u0161anas, t\u0101 ir veikusi priek\u0161z\u012bm\u012bgu darbu: ra\u017eojusi vitam\u012bnus, regul\u0113jusi pH v\u0113rt\u012bbu, aizdzenot kait\u012bg\u0101s bakt\u0113rijas. Ac\u012bmredzams goda v\u012brs.<br>Tom\u0113r t\u0101 sl\u0113pj savus v\u012brusa faktorus t\u0101pat k\u0101 cien\u012bjama skolot\u0101ja kafejn\u012bca sl\u0113pj savu kafijas tas\u012bti. T\u0101 nes pareizos antig\u0113nus un m\u0101n\u012bgi liek im\u016bnsist\u0113mai to ignor\u0113t.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bet tad notiek kaut kas t\u0101ds, kas \u0161aj\u0101 st\u0101st\u0101 paties\u012bb\u0101 \u0161\u0137ita neiedom\u0101jams: antibiotika, trauma, im\u016bndefic\u012bts, un p\u0113k\u0161\u0146i m\u016bsu labais zarnu draugs p\u0101rv\u0113r\u0161as par \u013caunu Haida kungu.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Un Haida kungam ir pl\u0101ni. \u013bauni pl\u0101ni. Vi\u0146\u0161 pamet zarnu dro\u0161\u012bbu un bez iel\u016bguma dodas taisn\u0101 ce\u013c\u0101 uz asinsrites sist\u0113mu.<br>Tur t\u0101 veido \u201ebiofilmas\u201c cietoksni, kas antibiotik\u0101m rada asi\u0146ainus degunus un zobus. T\u0101 sl\u0113pjas makrof\u0101gos k\u0101 goblins me\u017e\u0101 un maldina im\u016bnsist\u0113mu ar olbaltumviel\u0101m, kas izskat\u0101s k\u0101 bi\u013cetes uz VIP ball\u012bti.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Endokard\u012bts? Meistardarbs. Ur\u012bnce\u013cu infekcijas? Parastas. Peritone\u0101l\u0101s infekcijas? Hobijs. Slimn\u012bc\u0101s Haida kungs tagad ir zvaig\u017e\u0146u atrakcija: vi\u0146\u0161 izraisa 11% no vis\u0101m stacion\u0101raj\u0101m infekcij\u0101m.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Robe\u017ea starp D\u017eeikilu un Haidu ir nemateri\u0101la. Haida kungs vienm\u0113r ir doktora D\u017eekila \u0137ermen\u012b. Pla\u0161a spektra antibiotika, im\u016bnsist\u0113ma nav piln\u012bb\u0101 iz\u0101rst\u0113ta, un doktors D\u017eekils izdzer nepareizu eliks\u012bru un p\u0101rv\u0113r\u0161as. \u0160\u012bs bakt\u0113rijas plastiskums ir nep\u0101rsp\u0113jams: t\u0101 p\u0101r\u0146em jebkuru antibiotiku rezistences g\u0113nu ar kabatzag\u013ca \u0101trumu.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Nav \u0101rstniec\u012bbas l\u012bdzek\u013ca, nav seruma, kas var\u0113tu main\u012bt transform\u0101ciju. Atliek tikai cer\u0113t, ka doktors D\u017eekils saglab\u0101s vesel\u012bgu zarnu un nemut\u0113s par Haida kungu...<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Was_steckt_dahinter\"><\/span>Kas aiz t\u0101 sl\u0113pjas?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">K\u0101 <em>Agnieszka Daca<\/em> un <em>Tomasz Jarzembowski<\/em>&nbsp;sav\u0101 2024. gada 19. febru\u0101ra rakst\u0101 \u017eurn\u0101l\u0101 <em>Starptautiskais molekul\u0101ro zin\u0101t\u0146u \u017eurn\u0101ls<\/em> \u201e<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC10888668\/\" target=\"_blank\" rel=\"noreferrer noopener\">No drauga uz ienaidnieku -&nbsp;<em>Enterococcus faecalis<\/em>&nbsp;Daudzveid\u012bga ietekme uz cilv\u0113ka im\u016bnsist\u0113mu<\/a>\u201c, ir <em>E. faecalis<\/em> abpus\u0113ji griez\u012bgs zobens.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">EFSA (<em>Eiropas P\u0101rtikas nekait\u012bguma iest\u0101de<\/em>), kas ir l\u012bdz\u012bgs FDA GRAS (visp\u0101r\u0113ji atz\u012bts par nekait\u012bgu) sarakstam, ir uzskait\u012btas p\u0101rtikas piedevas, materi\u0101li, kas ir saskar\u0113 ar p\u0101rtiku, mikroorganismi un citas vielas, kuru nekait\u012bgums ir zin\u0101tniski nov\u0113rt\u0113ts un apstiprin\u0101ts.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Symbioflor<sup>\u00ae<\/sup> wurde nicht genehmigt, obwohl es den \u201esichereren&#8220; Stamm DSM 16440 enth\u00e4lt. Der Hauptgrund liegt nicht allein in der Jekyll-&amp;-Hyde-Problematik der Spezies, sondern auch darin, dass <strong>keine publizierte Genomsequenz explizit f\u00fcr DSM 16440<\/strong> vorliegt (s. Abschnitt \u201eGenomische Besonderheiten&#8220;). F\u00fcr eine EFSA-QPS-Listung (Qualified Presumption of Safety) reicht die stellvertretende Sequenzierung verwandter Klone formal nicht aus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Probl\u0113ma ir t\u0101, ka nav zin\u0101ma ne deva, ar kuru tiek sasniegts v\u0113lamais efekts, ne ar\u012b tas, kur\u0101 br\u012bd\u012b. <em>E. faecalis<\/em> \u201eir \u201cp\u0101r\u0101k daudz\" un p\u0101rvieto\u0161ana ir nenov\u0113r\u0161ama, <em>Enterococcus faecalis<\/em> izk\u013c\u016bst cauri zarnu sieni\u0146ai un non\u0101k t\u0101d\u0101s viet\u0101s k\u0101 asinsrit\u0113 vai peritone\u0101laj\u0101 dobum\u0101, kur tas izraisa patog\u0113nu iedarb\u012bbu.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T\u0101p\u0113c tas, vai tas izskat\u0101s labi vai slikti, ir atkar\u012bgs no konteksta:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Vesel\u0101 zarn\u0101<\/strong> varonis<strong>, p\u0113c p\u0101rm\u0113r\u012bgas antibiotiku lieto\u0161anas<\/strong> oport\u016bnists,<strong> br\u016bc\u0113 vai uz sirds<\/strong> slepkava un <strong>Slimn\u012bcas vid\u0113<\/strong> s\u0113rijveida slepkava.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Iepriek\u0161 min\u0113taj\u0101 rakst\u0101 cita starp\u0101 aprakst\u012bts gad\u012bjums, kad <strong>Disbioze<\/strong> (kad mikrobioms k\u013c\u016bst nel\u012bdzsvarots):<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Galvenais elements, kas <em>E. faecalis<\/em> kontrol\u0113ta vesel\u012bg\u0101 st\u0101vokl\u012b ir <em>Deoksihol\u0101ts<\/em> (DCA). DCA paaugstina jut\u012bbu <em>E. faecalis<\/em> un kontrol\u0113 t\u0101s replikat\u012bvo un transkripcijas aktivit\u0101ti.<br>Tas noz\u012bm\u0113: <strong>Pat ar t\u0101du pa\u0161u daudzumu <em>E. faecalis<\/em>, kad deoksihol\u0101ta regul\u0101cija izz\u016bd<\/strong> (piem\u0113ram, p\u0113c antibiotiku lieto\u0161anas)<strong>, t\u0101 ietekme k\u013c\u016bst negat\u012bva.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Port\u0101ls <strong>Absol\u016btais skaits<\/strong> ir maz\u0101k svar\u012bgs nek\u0101 <strong>sist\u0113mas l\u012bdzsvars<\/strong>.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Genomische_Besonderheiten_von_DSM_16440\"><\/span>Genomische Besonderheiten von DSM 16440<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<blockquote class=\"wp-block-quote is-layout-flow wp-block-quote-is-layout-flow\">\n<p class=\"wp-block-paragraph\"><strong>Wichtige Erg\u00e4nzung auf Basis publizierter Sequenzierungsdaten<\/strong><\/p>\n<\/blockquote>\n\n\n\n<p class=\"wp-block-paragraph\">Symbioflor\u00ae enth\u00e4lt <em>E. faecalis<\/em> DSM 16440, einen von urspr\u00fcnglich zehn Isolaten, die in den 1950er Jahren aus dem Stuhl eines gesunden Menschen gewonnen wurden. Diese zehn Isolate tragen DSM-Nummern 16430 bis 16439.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Pulsfeldgelelektrophorese-Analysen ergaben, dass <strong>DSM 16440 zu einer Gruppe von acht genomisch identischen Klonen<\/strong> geh\u00f6rt (DSM 16430, 16432, 16433, 16435\u201316439). Sequenzierungen wurden an den Klonen DSM 16430, 16431 und 16434 durchgef\u00fchrt und in \u00f6ffentlichen Datenbanken hinterlegt (European Nucleotide Archive: FLUS00000000 f\u00fcr DSM 16430, FLUT00000000 f\u00fcr DSM 16434; EMBL: HF558530 f\u00fcr das vollst\u00e4ndige Genom von DSM 16431).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Eine unter dem Akzessionsnamen DSM 16440 direkt publizierte Genomsequenz existiert nicht.<\/strong> SymbioPharm referenziert auf ihrer Website Sequenzierungspublikationen zu verwandten Klonen als Nachweis. Dies stellt eine regulatorisch akzeptierte, aber nicht vollst\u00e4ndig transparente L\u00f6sung dar. Der Hersteller wurde um die vollst\u00e4ndige Genomsequenz von DSM 16440 gebeten; eine Antwort steht aus.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Was_die_Sequenzierung_zeigt\"><\/span>Was die Sequenzierung zeigt<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Die genomische Analyse der Symbioflor-1-Klone ist in einem wesentlichen Punkt <strong>Nomierino\u0161s<\/strong>:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Der Stamm hat die wichtigsten Virulenzgene <strong>verloren<\/strong>. Konkret fehlen:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Cytolysin<\/strong><br>Zellgift, das rote Blutk\u00f6rperchen und Immunzellen zerst\u00f6rt<\/li>\n\n\n\n<li><strong>Gelatinase \/ Coccolysin<\/strong>-<br>Gewebeabbauendes Enzym<\/li>\n\n\n\n<li><strong>Enterokokkales Oberfl\u00e4chenprotein (esp\/efaA)<\/strong> <br>Adh\u00e4sions- und Immunevasionsfaktor<\/li>\n\n\n\n<li><strong>Hyaluronidase<\/strong><br>Gewebs-invasives Enzym<\/li>\n\n\n\n<li><strong>Peptidantibiotikum AS-48<\/strong><\/li>\n\n\n\n<li><strong>vanB-Operon<\/strong><br>Vancomycin-Resistenz<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Noch vorhanden sind hingegen: Aggregationssubstanz, Kollagenadh\u00e4sionsprotein, Kapselbildungsgene, Resistenz gegen Sauerstoffradikale, Eigenschaften, die f\u00fcr die Schleimhautkolonisierung und damit f\u00fcr die probiotische Wirkung relevant sind.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Eine_bemerkenswerte_Unstimmigkeit\"><\/span>Eine bemerkenswerte Unstimmigkeit<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">Allerdings zeigt sich bei genauem Hinsehen eine Inkonsistenz: <strong>DSM 16430<\/strong>, der als Repr\u00e4sentant der acht identischen Klone (zu denen DSM 16440 geh\u00f6rt) sequenziert wurde, besitzt ein <strong>kleineres Genom<\/strong> als die anderen Isolate. Ihm fehlt ein ~100 kb-Bereich, der unter anderem die <strong>Aggregationssubstanz<\/strong> kodiert, sowie ein ~36 kb-<strong>Prophagen<\/strong>-kodierender Bereich.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Das bedeutet: Wenn DSM 16430 als Sequenzierungsnachweis f\u00fcr DSM 16440 gilt, ist unklar, ob DSM 16440 die Aggregationssubstanz tats\u00e4chlich besitzt oder nicht, obwohl andere Publikationen sie f\u00fcr den Symbioflor-Stamm als vorhanden beschreiben (basierend auf dem vollst\u00e4ndiger sequenzierten DSM 16431). Dieser Widerspruch ist in der Literatur nicht aufgel\u00f6st.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pro_contra_E_faecalis\"><\/span>Par un pret E. faecalis<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Pro_%E2%80%A6\"><\/span>Pro ...<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong><em>E. faecalis<\/em> ra\u017eo vitam\u012bnus, metaboliz\u0113 bar\u012bbas vielas un uztur zarnu pH v\u0113rt\u012bbu.<\/strong>. Tas ir b\u016btiski.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Im\u016bnsist\u0113mai tas ir nepiecie\u0161ams k\u0101 treni\u0146\u0161<\/strong><br>MALT (ar g\u013cot\u0101m saist\u012btie limfo\u012bdie audi) savu pilno funkcion\u0101lo un struktur\u0101lo sp\u0113ju sasniedz tikai saskar\u0113 ar komens\u0101l\u0101m bakt\u0113rij\u0101m. E. faecalis ir galvenais \u201etreneris\u201c.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tas aizsarg\u0101 pret inv\u0101ziju<\/strong><br>E. faecalis un citi komens\u0101lie mikroorganismi, konkur\u0113jot par vietu un bar\u012bbas viel\u0101m un ra\u017eojot bakterioc\u012bnus, nov\u0113r\u0161 patog\u0113no bakt\u0113riju att\u012bst\u012bbu.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tas dzied\u0113 iekaisumu<\/strong><br>Symbioflor piem\u0113rs liecina, ka hroniska bronh\u012bta recid\u012bvu bie\u017eums tika samazin\u0101ts par 43% papildin\u0101\u0161anas laik\u0101 un par 68% 8 m\u0113ne\u0161us p\u0113c tam.<\/li>\n<\/ul>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%80%A6_contra\"><\/span>... kontra<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tas ir sl\u0113pts slepkava<\/strong><br>E. faecalis var izrais\u012bt endokard\u012btu, uro\u0123enit\u0101l\u0101s infekcijas, intraperitone\u0101las infekcijas un septic\u0113miju. Aptuveni 10-20% no sabiedr\u012bb\u0101 ieg\u016btajiem endokard\u012btiem izraisa E. faecalis.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tas ir visur slimn\u012bc\u0101<\/strong><br>E. faecalis izraisa vismaz 11% no vis\u0101m slimn\u012bc\u0101 ieg\u016btaj\u0101m infekcij\u0101m (HAI - Hospital-Acquired Infection), t. i., slimn\u012bc\u0101 ieg\u016bt\u0101m infekcij\u0101m, kuru izrais\u012bt\u0101ji ir slimnieki, un kuru saslimst\u012bba un mirst\u012bba pieaug.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>To ir nesam\u0113r\u012bgi gr\u016bti \u0101rst\u0113t<\/strong><br><em>E. faecalis<\/em> sp\u0113j veidot biofilmas - polisahar\u012bdu, prote\u012bnu un lip\u012bdu strukt\u016bru, kas ir praktiski necaurlaid\u012bga antibiotik\u0101m un im\u016bn\u0161\u016bn\u0101m.<\/li>\n<\/ul>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Tas sl\u0113pjas no im\u016bnsist\u0113mas lab\u0101k nek\u0101 jebkur\u0161 spiegs.<\/strong><br>Rakst\u0101 nor\u0101d\u012bts: lai izdz\u012bvotu, t\u0101 ra\u017eo ROS, sl\u0113pjas makrof\u0101gos, izmanto Tax (enterokoku agreg\u0101cijas vielu), lai aktiviz\u0113tu T-\u0161\u016bnas un t\u0101d\u0113j\u0101di atkal t\u0101s maldin\u0101tu.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Bet ne <em>E. faecalis<\/em> pati par sevi ir probl\u0113ma, bet bie\u017ei (piem\u0113ram, pirms oper\u0101cij\u0101m) - pla\u0161a spektra antibiotikas, kas v\u0101jina im\u016bnsist\u0113mu.<br>Patog\u0113n\u0101s \u012bpa\u0161\u012bbas tiek ieg\u016btas, horizont\u0101li p\u0101rnesot patog\u0113niskumu un ar rezistenci pret antibiotik\u0101m saist\u012btos \u0123en\u0113tiskos elementus. Tas ir sal\u012bdzin\u0101ms ar gad\u012bjumu, kad band\u012bti nevis pa\u0161i izgatavo iero\u010dus, bet aiz\u0146emas visu arsen\u0101lu no citiem.<\/p>\n\n\n\n<h4 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Der_Mechanismus_im_Detail\"><\/span>S\u012bk\u0101ka inform\u0101cija par meh\u0101nismu<span class=\"ez-toc-section-end\"><\/span><\/h4>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>1. plazm\u012bdas - transport\u0113\u0161anas l\u012bdzeklis.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tiek uzskat\u012bts, ka ar plazm\u012bd\u0101m saist\u012btie enterokoku g\u0113ni ir veicin\u0101ju\u0161i pret vankomic\u012bnu rezistentu enterokoku (VRE) att\u012bst\u012bbu, kas ir \u012bpa\u0161i svar\u012bgi medic\u012bnas vid\u0113, piem\u0113ram, kl\u012bnik\u0101s, \u0101rstu kabinetos u. c.).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Plazm\u012bdi ir<\/strong> mazi, ap\u013cveida DNS gabali\u0146i, kurus var p\u0101rn\u0113s\u0101t starp bakt\u0113rij\u0101m vai kas l\u012bdzin\u0101s USB atmi\u0146as ier\u012bc\u0113m, uz kur\u0101m tiek saglab\u0101ta \u201erezistence pret antibiotik\u0101m\u201c. <em>E. faecalis<\/em> pa\u0146em USB atmi\u0146as ier\u012bci un nokop\u0113 uz t\u0101s g\u0113nus.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>2. horizont\u0101la g\u0113nu p\u0101rnese - akt\u012bva pl\u0113son\u012bba<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E. faecalis var b\u016bt ne tikai pas\u012bvs, bet ar\u012b akt\u012bvs:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>p\u0101r\u0146em plazm\u012bdas no cit\u0101m bakt\u0113rij\u0101m (<strong>Transform\u0101cija<\/strong>)<\/li>\n\n\n\n<li>Absorb\u0113 miru\u0161o bakt\u0113riju DNS fragmentus<\/li>\n\n\n\n<li>Tie\u0161a saskare ar cit\u0101m bakt\u0113rij\u0101m un apmai\u0146a ar g\u0113niem (<strong>Konjug\u0101cija<\/strong>)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">... ir k\u0101 g\u0113nu z\u0101dz\u012bba zarn\u0101s.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Die_Selektion_durch_Antibiotika\"><\/span>Atlase, izmantojot antibiotikas<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Tas ir <strong>dabisk\u0101 atlase<\/strong> \u0101tri p\u0113c k\u0101rtas:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Scen\u0101rijs bez antibiotik\u0101m:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>J\u016bsu zarn\u0101s ir 100 da\u017e\u0101du E. faecalis celmu.<\/li>\n\n\n\n<li>99 ir jut\u012bgi, 1 ir nejau\u0161i iztur\u012bgs<\/li>\n\n\n\n<li>Rezistentajam celmam nav nek\u0101du priek\u0161roc\u012bbu (uz vietas nav antibiotiku).<\/li>\n\n\n\n<li>Visi 100 izdz\u012bvo vienl\u012bdz labi<\/li>\n\n\n\n<li>Rezistents celms joproj\u0101m ir 1%<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Scen\u0101rijs ar antibiotik\u0101m:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Past\u0101v 100 da\u017e\u0101di E. faecalis celmi.<\/li>\n\n\n\n<li>99 ir jut\u012bgi, 1 iztur\u012bgs<\/li>\n\n\n\n<li>Tiek ievad\u012btas antibiotikas, un 99 mirst nekav\u0113joties.<\/li>\n\n\n\n<li>Rezistents celms p\u0101r\u0146em visu partiju...<\/li>\n\n\n\n<li>P\u0113c antibiotiku lieto\u0161anas 95% no popul\u0101cijas ir rezistenti.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">... un ka p\u0113c da\u017e\u0101m dien\u0101m stat gadiem<strong>: atlases spr\u0101dziens<\/strong>!<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"VRE_Vancomycin-Resistant_Enterococci\"><\/span>VRE (pret vankomic\u012bnu rezistenti enterokoki)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">k\u0101 piem\u0113ru no iepriek\u0161 min\u0113t\u0101 raksta:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Vankomic\u012bnam rezistentus enterokokus (VRE) da\u013c\u0113ji izraisa ar plazm\u012bd\u0101m saist\u012bti g\u0113ni.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>K\u0101p\u0113c \u0161is ir de facto \u0161ausmu scen\u0101rijs?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Jo <em>Vankomic\u012bns<\/em> . <strong>Antibiotikas p\u0113d\u0113jais l\u012bdzeklis<\/strong> p\u0101rst\u0101v. Ja patog\u0113ns ir rezistents pret vis\u0101m cit\u0101m antibiotik\u0101m, vien\u012bg\u0101s atliku\u0161\u0101s kl\u012bnisk\u0101s iesp\u0113jas ir. <em>Vankomic\u012bns<\/em>. Bet, ja patog\u0113ns pats ir pret to rezistents, tad t\u0101 ir probl\u0113ma, ko nevar atrisin\u0101t ar tradicion\u0101lo medic\u012bnu...<br>Vien\u012bg\u0101 efekt\u012bv\u0101 iesp\u0113ja ir \u0113terisko e\u013c\u013cu izmanto\u0161ana, kur\u0101m ir bakteric\u012bda un viruic\u012bda iedarb\u012bba un pret kur\u0101m patog\u0113ns nevar k\u013c\u016bt rezistents, jo t\u0101s p\u0101rst\u0101v simtiem da\u017e\u0101du \u201eantibiotiku\u201c, kur\u0101m patog\u0113ns ir pak\u013cauts. T\u0101p\u0113c pat <em>E. faecalis<\/em> atcelt buras.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>F\u00fcr DSM 16440 gilt:<\/strong> Das vanB-Operon, der h\u00e4ufigste Resistenzweg gegen Vancomycin bei Enterokokken, fehlt dem Stamm genomisch vollst\u00e4ndig. Das ist ein wesentlicher Sicherheitsvorteil gegen\u00fcber klinischen Isolaten.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"%E2%80%A6_und_warum_wird_Symbioflor%C2%AE_dann_verkauft\"><\/span>... un k\u0101p\u0113c Symbioflor<sup>\u00ae<\/sup> p\u0113c tam p\u0101rdots?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>T\u0101 ir pietiekami pamatota, lai b\u016btu \u201eizm\u0113\u0123in\u0101ta un p\u0101rbaud\u012bta\u201c, bet nav pietiekami caursp\u012bd\u012bga, lai to uzskat\u012btu par modernu.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Vai ar\u012b t\u0101p\u0113c, ka tas ir \u201edro\u0161s\u201c celms un - tas darbojas. Cik ilgi, v\u0113l nav zin\u0101ms. Piem\u0113ram, EF-2001 celms (probiotikas celms) satur sal\u012bdzino\u0161i maz rezistences pret antibiotik\u0101m g\u0113nu, bet tie, kas taj\u0101 ir, ir saist\u012bti ar dabisko enterokoku rezistenci pret noteikt\u0101m antibiotik\u0101m.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Die Sequenzierungsdaten f\u00fcr den Symbioflor 1 Stamm DSM 16440 sind nicht verf\u00fcgbar gemacht, weshalb eine \u00dcberpr\u00fcfung der exakten Zusammensetzung nicht gegeben ist, obwohl der Hersteller auf seiner Webseite verk\u00fcndet &#8222;<strong>Enterococcus faecalis DSM 16440 k\u0101 z\u0101les ir \u013coti labi p\u0113t\u012bts jau vair\u0101kus gadu desmitus, un t\u0101 g\u0113ni ir piln\u012bb\u0101 sekven\u0113ti.<\/strong>&#8220; Verwandte Klone sind hingegen sequenziert und hinterlegt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Es l\u016bdzu ra\u017eot\u0101jam pilnu genoma sec\u012bbu no <strong>Enterococcus faecalis DSM 16440<\/strong> piepras\u012bts. Es attiec\u012bgi atjaunin\u0101\u0161u.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tas noz\u012bm\u0113: <strong>Pat \u201edro\u0161ie\u201c probioti\u0137u celmi var p\u0101rnest savus dabiskos rezistences g\u0113nus uz savva\u013cas E. faecalis zarn\u0101s.<\/strong> <strong>nodot t\u0101l\u0101k<\/strong>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tie\u0161i t\u0101p\u0113c rakst\u0101 min\u0113ts, ka E. faecalis tiek uzskat\u012bts par vienu no visizplat\u012bt\u0101kajiem multirezistentajiem slimn\u012bcu patog\u0113niem pasaul\u0113.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Tas noz\u012bm\u0113, ka jau ir ciltis, kas ir biju\u0161as<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Ampicil\u012bns<\/li>\n\n\n\n<li>Eritromic\u012bns<\/li>\n\n\n\n<li>Fluorhinoloni<\/li>\n\n\n\n<li>Gentamic\u012bns<\/li>\n\n\n\n<li>Vankomic\u012bns<\/li>\n\n\n\n<li>iesp\u0113jams, vair\u0101kas no t\u0101m kop\u0101<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">ir iztur\u012bgi.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>E. faecalis<\/em> ir <strong>dabas<\/strong> Iztur\u012bba pret:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Trimetoprims<\/li>\n\n\n\n<li>Linkosam\u012bdi (piem\u0113ram, klindamic\u012bns)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Tas ir <strong>iek\u0161\u0113jais<\/strong>, nav ieg\u016bta.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">(Pla\u0161\u0101ku inform\u0101ciju par p\u0113tniec\u012bbas st\u0101vokli 2010. gad\u0101 sk. <a href=\"https:\/\/www.clinicalmicrobiologyandinfection.org\/article\/S1198-743X(14)61686-4\/fulltext\" target=\"_blank\" rel=\"noreferrer noopener\">\u0161eit<\/a> pieejams pilns teksts).<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Risikofaktoren\"><\/span>Riska faktori<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Antibiotiku (p\u0101rm\u0113r\u012bgs) pat\u0113ri\u0146\u0161<\/strong> izraisa disbiozi<\/li>\n\n\n\n<li><strong>Zarnu barjeras trauc\u0113jumi<\/strong>, piem\u0113ram, zarnu oper\u0101cijas, zarnu iekaisuma slim\u012bbu (IBD, Krona slim\u012bba) un intens\u012bv\u0101s apr\u016bpes pas\u0101kumu (piem\u0113ram, ku\u0146\u0123a zondes, katetra) d\u0113\u013c.<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Ja zarnas ir \u201eievainotas\u201c un <em>E. faecalis<\/em> atrodas zarn\u0101s, palielin\u0101s translok\u0101cijas risks.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Welche_Warnzeichen_gibt_es\"><\/span>K\u0101das ir br\u012bdin\u0101juma paz\u012bmes?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Kad uz skatuves par\u0101d\u0101s Haida kungs, tas parasti notiek galvenok\u0101rt ar<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Harnwegsinfektionen_UTI\"><\/span><strong>Ur\u012bnce\u013cu infekcijas (UTI)<\/strong>.<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">UTI caur <em>E. faecalis<\/em> visbie\u017e\u0101k ir ak\u016bta, un diagnoze ir viegli uzst\u0101d\u0101ma, jo \u0101tri par\u0101d\u0101s specifiski simptomi:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>P\u012b\u0161anas saj\u016bta urin\u0113jot<\/li>\n\n\n\n<li>Bie\u017e\u0101ka urin\u0113\u0161ana (pollaki\u016brija)<\/li>\n\n\n\n<li>Du\u013c\u0137ains un \/ vai asi\u0146ains ur\u012bns<\/li>\n\n\n\n<li>S\u0101pes v\u0113dera lejasda\u013c\u0101 un\/vai iegur\u0146a zon\u0101<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Uzman\u012bbu<\/strong>Ar <strong>im\u016bnkompromit\u0113tiem pacientiem<\/strong> (piem\u0113ram, p\u0113c transplant\u0101cijas), simptomi ir daudz v\u0101j\u0101ki vai to visp\u0101r nav. <em>v\u0101jin\u0101ta im\u016bn\u0101 reakcija<\/em> saist\u012bta ar nespecifiskiem (vai pat neeso\u0161iem) simptomiem.<br>\u0160eit <strong>j\u0101piev\u0113r\u0161 \u012bpa\u0161a uzman\u012bba!<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Intraabdominelle_Infektionen_PeritonitisAbszesse\"><\/span>Intraabdomin\u0101las infekcijas (periton\u012bts\/abscesi)<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">kad patog\u0113ns iek\u013c\u016bst v\u0113dera dobum\u0101. Aptuveni 25% infekciju intens\u012bv\u0101s terapijas noda\u013c\u0101s (intens\u012bv\u0101s terapijas noda\u013cas) izraisa <em>E. faecalis<\/em> izrais\u012bja.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Praktiski simptomi:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Stipras s\u0101pes v\u0113der\u0101<\/strong><\/li>\n\n\n\n<li><strong>Fieber &#8211; oft hoch &gt;38,5\u00b0C<\/strong><\/li>\n\n\n\n<li><strong>Slikta d\u016b\u0161a \/ vem\u0161ana<\/strong><\/li>\n\n\n\n<li><strong>Periton\u012bta paz\u012bmes<\/strong> (klasisks: sarg\u0101\u0161ana - musku\u013ci sasprindzin\u0101s uzreiz, kad tiek izdar\u012bts spiediens uz v\u0113deru, atsitiena jut\u012bgums - stipras s\u0101pes, kad spiediens p\u0113k\u0161\u0146i tiek atbr\u012bvots).<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Probl\u0113ma:<\/strong> \u0160ie simptomi parasti nav rakstur\u012bgi <em>E. faecalis<\/em>, bet ir tikko<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>v\u0113dera dobuma oper\u0101cija<\/li>\n\n\n\n<li>Aknu transplant\u0101cija<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">veikt un p\u0113c tam izstr\u0101d\u0101t<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Drudzis<\/li>\n\n\n\n<li>S\u0101pes v\u0113der\u0101<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">to sauc par <strong>Sarkan\u0101 FAG z\u012bme E. faecalis<\/strong> interpret\u0113t<strong>!<\/strong><\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Endokarditis\"><\/span>Endokard\u012bts<span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">kad ir skartas sirds musku\u013ca. Tiek pie\u0146emts, ka <em>E. faecalis<\/em> pa\u0161laik ir atbild\u012bgs par 10-20% endokard\u012bta gad\u012bjumu, kas ieg\u016bti \u0101rpus slimn\u012bcas vides.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Praktiskie simptomi (klasisk\u0101):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Past\u0101v\u012bgs drudzis<\/strong> (dienas\/ned\u0113\u013cas)<\/li>\n\n\n\n<li><strong>Reibonis, v\u0101jums, nogurums<\/strong><\/li>\n\n\n\n<li>Jauns vai pasliktin\u0101s <strong>patolo\u0123isks<\/strong> <strong>Sirds \u010duksti<\/strong><\/li>\n\n\n\n<li><strong>Petechiae<\/strong> (mazi sarkani punkti\u0146i uz \u0101das - asinsizpl\u016bdumi)<\/li>\n\n\n\n<li><strong>Oslera mezgls<\/strong> (s\u0101p\u012bgi mezgli\u0146i uz pirkstu galiem)<\/li>\n\n\n\n<li><strong>D\u017eeimvejas p\u0101rk\u0101pumi<\/strong> (neskarti sarkani plankumi uz plaukst\u0101m\/ p\u0113du p\u0113d\u0101m)<\/li>\n\n\n\n<li><strong>\u0160\u0137embu asi\u0146o\u0161ana<\/strong> (nelielas asinsizpl\u016bdumi zem nagiem)<\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\">Endokard\u012bts, ko izraisa <em>E. faecalis<\/em> var <strong>klusais<\/strong> t. i., nepar\u0101d\u0101s neviens no iepriek\u0161 min\u0113tajiem simptomiem.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Sepsis_%E2%80%93_Notfall-Szenarien\"><\/span>Sepse - <strong>\u0100rk\u0101rtas scen\u0101riji!<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h3>\n\n\n\n<p class=\"wp-block-paragraph\">sist\u0113miskas patog\u0113na inv\u0101zijas gad\u012bjum\u0101, t. i., ja ir skarts viss organisms.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Praktiski simptomi (<\/strong>SIRS krit\u0113riji - <em>Sist\u0113misk\u0101s iekaisuma atbildes reakcijas sindroms<\/em><strong>):<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Fieber &gt;38\u00b0C oder Hypothermie &lt;36\u00b0C<\/strong><\/li>\n\n\n\n<li><strong>Herzfrequenz &gt;90\/min<\/strong><\/li>\n\n\n\n<li><strong>Atemfrequenz &gt;20\/min oder pCO2 &lt;32 mmHg<\/strong><\/li>\n\n\n\n<li><strong>Leikoc\u012bti<\/strong> (baltie asins\u0137ermen\u012b\u0161i)<strong> &gt;12.000 <\/strong>vai<strong> &lt;4.000<\/strong><\/li>\n<\/ul>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Septisk\u0101 \u0161oka gad\u012bjum\u0101<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Asinsspiediena pazemin\u0101\u0161an\u0101s (nevar nov\u0113rst ar \u0161\u0137idrumiem).<\/strong><\/li>\n\n\n\n<li><strong>Org\u0101nu mazsp\u0113ja (nieru, aknu, plau\u0161u).<\/strong><\/li>\n\n\n\n<li><strong>Apzi\u0146as mai\u0146a<\/strong><\/li>\n\n\n\n<li><strong>Tahikardija, sv\u012b\u0161ana<\/strong><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><span class=\"ez-toc-section\" id=\"Gibt_es_keine_Alternativen\"><\/span>Vai nav alternat\u012bvu?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p class=\"wp-block-paragraph\">Jain - lai gan ap vi\u0146u ir p\u0113tnieku komanda. <em>Mar\u00eda C. Urdaci, Laboratoire de Microbiologie et Biochimie Appliqu\u00e9e (LBMA), Bordo Universit\u0101te, Francija.<\/em>, kas attiecas uz <em>E. durans EP1<\/em> nodarbojas ar:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E. durans EP1 celms atbilst EFSA noteiktaj\u0101m pras\u012bb\u0101m. E. durans EP1 uzr\u0101d\u012bja pretiekaisuma \u012bpa\u0161\u012bbas, p\u0113c 7 dien\u0101m palielin\u0101ja IgA \u0161\u016bnu daudzumu mezenteriskajos limfmezglos un modul\u0113ja mikrobiomu, palielinot Faecalibacterium prausnitzii. Turkl\u0101t pel\u0113m, kas sa\u0146\u0113ma EP1 21 dienu, netika nov\u0113rota nek\u0101da nev\u0113lama ietekme, k\u0101 \u0161aj\u0101 sal\u012bdzino\u0161aj\u0101 p\u0113t\u012bjum\u0101. <em><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/17466591\/\" target=\"_blank\" rel=\"noreferrer noopener\">Sal\u012bdzino\u0161\u0101 genomisk\u0101 anal\u012bze par potenci\u0101lo enterokoku virulences faktoru kl\u0101tb\u016btni probiotikas Enterococcus faecalis celm\u0101 Symbioflor 1<\/a><\/em> aiz\u0146emts.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">E. duran OSY-EGY nav plazm\u012bdu, kas var satur\u0113t \u201esliktu\u201c kodu, piem\u0113ram, Trojas zirgu (sk. USB zibatmi\u0146u iepriek\u0161), un t\u0101s genoms satur vienu apstiprin\u0101tu un tr\u012bs potenci\u0101lus CRISPR mas\u012bvus, kas pie\u0161\u0137ir uz sekvenci balst\u012btu imunit\u0101ti pret f\u0101gu modifik\u0101ciju un horizont\u0101lu g\u0113nu p\u0101rnesi.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Neraugoties uz vis\u0101m pier\u0101d\u012btaj\u0101m priek\u0161roc\u012bb\u0101m, jo \u012bpa\u0161i saist\u012bb\u0101 ar dro\u0161\u012bbu, nav pieejams neviens komerci\u0101ls produkts.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>","protected":false},"excerpt":{"rendered":"<p><span class=\"span-reading-time rt-reading-time\" style=\"display: block;\"><span class=\"rt-label rt-prefix\">Las\u012b\u0161anas laiks<\/span> <span class=\"rt-time\"> 8<\/span> <span class=\"rt-label rt-postfix\">protokols<\/span><\/span>Symbioflor, u.a. gegen chronische Bronchitis eingesetzt, wird in drei Varianten angeboten. Es ist vom Grundsatz her seit \u00fcber 70 Jahren auf dem Markt und beinhaltet &#8211; in der &#8222;immun&#8220;-Variante &#8211; Enterococcus faecalis DSM 16440&#8211; und E.coli DSM 17252-Bakterien und Zink. Wer an einer Gr\u00e4serpollen-Allergie und chronischer Bronchitis leidet, wird in den Wintermonaten von einem permanenten,&hellip;&nbsp;<a href=\"https:\/\/csiag.eu\/lv\/blog\/2026\/03\/18\/chronische-bronchitis-symbioflor\/\" rel=\"bookmark\">Las\u012bt vair\u0101k \"<span class=\"screen-reader-text\">Hronisks bronh\u012bts - Symbioflor\u00ae<\/span><\/a><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","neve_meta_sidebar":"","neve_meta_container":"","neve_meta_enable_content_width":"","neve_meta_content_width":0,"neve_meta_title_alignment":"","neve_meta_author_avatar":"","neve_post_elements_order":"","neve_meta_disable_header":"","neve_meta_disable_footer":"","neve_meta_disable_title":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-13123","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"modified_by":"Achim Goerner","_links":{"self":[{"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/posts\/13123","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/comments?post=13123"}],"version-history":[{"count":3,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/posts\/13123\/revisions"}],"predecessor-version":[{"id":13408,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/posts\/13123\/revisions\/13408"}],"wp:attachment":[{"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/media?parent=13123"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/categories?post=13123"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csiag.eu\/lv\/wp-json\/wp\/v2\/tags?post=13123"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}