Παρουσία ανθεκτικών στη μεθικιλίνη Staphylococcus aureus σε γάλα και γαλακτοκομικά προϊόντα


A. PEXARA (Α. ΠΕΞΑΡΑ)
N. SOLOMAKOS (Ν. ΣΟΛΩΜΑΚΟΣ)
A. GOVARIS (Α. ΓΚΟΒΑΡΗΣ)
Résumé

Ο Staphylococcus aureus είναι ένα θετικό κατά Gram, ευκαιριακά παθογόνο βακτήριο, που μπορεί να προσβάλλει τους ανθρώπους και τα ζώα. Είναι επίσης και σημαντικό τροφιμογενές παθογόνο βακτήριο καθώς ορισμένα στελέχη του S. aureus μπορούν να παράγουν σταφυλοκοκκικές εντεροτοξίνες στα τρόφιμα και να προκαλέσουν σταφυλοκοκκική τοξίνωση. Τα τελευταία χρόνια παρατηρείται ολοένα αυξανόμενη παρουσία στελεχών S. aureus ανθεκτικών στα ευρέως χρησιμοποιούμενα αντιβιοτικά. Στους ανθεκτικούς στη μεθικιλλίνη S. aureus (methicillin resistant S. aureus, MRSA) ανήκουν στελέχη τα οποία, μέσω λήψης συγκεκριμένων γονιδίων, έχουν αναπτύξει αντοχή στη μεθικιλλίνη και σε όλα τα β-λακταμικά αντιβιοτικά. Ο MRSA αρχικά χαρακτηρίζονταν ως ένα ενδονοσοκομειακό παθογόνο βακτήριο (hospital-associated MRSA, HA-MRSA). Από το 1990 όμως άρχισαν να καταγράφονται και περιστατικά σταφυλοκοκκικών λοιμώξεων από MRSA σε ανθρώπους που δεν είχαν καμία επιδημιολογική σύνδεση με νοσοκομεία (community-acquired or community-associated MRSA, CA-MRSA).

Πιο πρόσφατα, έχει περιγραφεί απομόνωση MRSA στελεχών από τα περισσότερα παραγωγικά ζώα καθώς και από τρόφιμα ζωικής προέλευσης, αυξάνοντας τις ανησυχίες για τη δημόσια υγεία. Στελέχη MRSA έχουν απομονωθεί από αγελαδινό, πρόβειο ή γίδινο γάλα και διάφορα γαλακτοκομικά προϊόντα σε πολλές χώρες. Η παρουσία του MRSA στο γάλα και τα γαλακτοκομικά προϊόντα που καταγράφεται σε διαφορετικές χώρες ή ακόμη και στις διάφορες περιοχές της ίδιας χώρας, διαφέρει σημαντικά. Υψηλά ποσοστά παρουσίας του MRSA καταγράφονται στο γάλα που παράγεται στις περισσότερες αφρικανικές χώρες, φτάνοντας και το 60,3%, ποσοστό που καταγράφηκε στην Αιθιοπία. Στις ασιατικές χώρες η συχνότητα της παρουσίας του MRSA ποικίλλει από υψηλά ποσοστά (π.χ. 28,3% στο Ιράν), έως και χαμηλά ποσοστά (π.χ. στην Κορέα και την Ιαπωνία). Στις περισσότερες ευρωπαϊκές χώρες, στελέχη MRSA σε γάλα και γαλακτοκομικά προϊόντα έχουν βρεθεί γενικά σε χαμηλά ποσοστά. Σύμφωνα με έρευνες που πραγματοποιήθηκαν στις ΗΠΑ και τον Καναδά, έχουν καταγραφεί μηδενικά έως χαμηλά ποσοστά παρουσίας του MRSA. Η διερεύνηση της παρουσίας του MRSA στο γάλα μπορεί να χρησιμεύσει για την αξιολόγηση τόσο των συνθηκών υγιεινής που εφαρμόζονται στις εκτροφές των ζώων γαλακτοπαραγωγής, αλλά και των κινδύνων για την υγεία που μπορεί να αντιμετωπίσουν οι καταναλωτές ύστερα από λοιμώξεις με στελέχη ανθεκτικά στα αντιβιοτικά.

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