Salmonellosi: sintomi , contagio, trattamento e prevenzione
Definizione
Con il termine salmonellosi o infezioni da salmonelle si designano tutte le affezioni provocate da batteri del genere salmonella. Le infezioni provocate da salmonella si distinguono in forme tifoidee (S. typhi e S. paratyphi, responsabili della febbre tifoide e delle febbri enteriche in genere) e forme non tifoidee, causate dalle cosiddette salmonelle minori (come S. typhimurium e la S. enteritidis), responsabili di forme cliniche a prevalente manifestazione gastroenterica.
Eziologia
Le salmonelle sono bacilli asporigeni gram-negativi, appartenenti alla famiglia delle enterobacteriaceae; presentano una buona sopravvivenza nell’ambiente esterno, resistono al congelamento in acqua. Sono caratterizzate da una struttura antigenica complessa.
Le salmonelle sono dotate di numerosi antigeni:
Antigeni H (flagellari)
Antigeni O (somatici)
Antigeni K (periferici)
Secondo lo schema di Kaufmann White, gli antigeni O permettono di distinguere le salmonelle in numerosi gruppi mentre gli antigeni H servono al differenziare le singole specie all’interno di un gruppo. Come tutti i batteri gram– , le salmonelle possiedono un ‘endotossina di natura lipopolisaccaridi , identificata nell’ antigene O.
Manifestazioni cliniche
I sintomi compaiono dopo 12-48 ore l’ingestione dell’alimento contaminato e sono caratterizzati da:
Febbre preceduta da brivido che persiste per 48-72 ore
Nausea
Vomito
Dolori addominali crampiformi
Diarrea costituita da feci poltacee o liquide di colorito verdastro con presenza di muco e raramente sangue.
Prognosi
La malattia è autolimitante, ma nei soggetti defedati, nei neonati e nei lattanti il decorso può assumere un andamento particolarmente grave per la diarrea profusa, che si accompagna a segni di disidratazione, acidosi, alterazioni elettrolitiche.
Terapia
I fluorochinoloni, ciprofloxacina per os per 7-10 giorni, rappresentano attualmente i farmaci di scelta per il trattamento delle salmonellosi maggiori. Nelle salmonellosi minori la terapia consiste nella correzione degli eventuali squilibri elettrolitici.
Prevenzione
Le salmonellosi sono soggette a notifica obbligatoria. Le misure preventive consistono in provvedimenti che mirano a ridurre la circolazione delle salmonelle negli animali domestici, nonché la contaminazione degli alimenti a livello industriale e familiare. L’osservazione delle più scrupolose norme igieniche nelle comunità e nell’ambiente ospedaliero ha un ruolo fondamentale nel ridurre notevolmente la diffusione del contagio interumano.
Alimenti a rischio
In particolare, sono da considerarsi alimenti a rischio:
Uova crude (o poco cotte)
Latte crudo e derivati del latte crudo
Carne e derivati (specialmente se poco cotti)
Salse e condimenti per insalate
Preparati per dolci, creme
Gelato artigianale e commerciale
Frutta e verdura (angurie, pomodori, germogli di semi, meloni, insalata, sidro e succo d’arancia non pastorizzati), contaminate durante il taglio.
2 pensieri riguardo “Salmonellosi: sintomi , contagio, trattamento e prevenzione”
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