预防性健康检查中沙门菌分离方法的优化与评估  

Optimization and Evaluation of the Methods for Isolating Salmonella in Preventive Occupational Physical Examination

作　　者：赵文良[1] 杨兰萍[2] 胡雪明[1] 许学斌[3] 

机构地区：[1]上海市静安区疾病预防控制中心微生物实验室,上海200041 [2]上海市卢湾区疾病预防控制中心微生物实验室,上海200025 [3]上海市疾病预防控制中心微生物实验室,上海200336

出　　处：《环境与职业医学》2010年第12期739-741,744,共4页Journal of Environmental and Occupational Medicine

基　　金：中美新发和再发传染病合作项目[编号:美国疾病预防控制中心(CDC)5U2GGH000018-02]

摘　　要：[目的]沙门菌检测方法在预防性健康检查中的优化与效果评估。[方法]用实验室保存菌株测试CHROMagarTM沙门菌显色琼脂平板(CAS)、木糖赖氨酸胆酸盐琼脂平板(XLD)和武汉SS琼脂平板(WS)的敏感性、特异性;使用单盲法比较经亚硒酸盐增菌液(SF)增菌后用CAS与WS、亚硒酸煌绿增菌液(SBG)与SF增菌后,用XLD与WS分别在1 717件和1 000件食品从业者体检肛拭中分离沙门菌的效果;评价优化检测方法在上海市静安区预防性健康检查中的应用。[结果]CAS和XLD菌株测试和现场检测的敏感性和特异性均明显优于WS,SBG-XLD/CAS组合的优化方法的检测效果明显优于传统的SF-WS的结果。2008年静安区职业体检的年度阳性率分别是2006年的8倍和2007年的10倍,月度阳性率也是历史同期水平的2～10倍,7、8月份的阳性率高达1%。[结论]CAS能兼备伤寒、副伤寒在内的所有沙门菌的分离能力;SBG-XLD/CAS组合的沙门菌优化检测流程具有易于掌握和高敏感性的优点,适于预防性职业体检中沙门菌常规分离。[Objective] To optimize and evaluate the effectiveness of detection methods for Salmonella in preventive occupational physical examination.[Methods] Using the stock of Salmonella strains we tested the susceptibility and specificity among CHROMagarTM Salmonella（CAS）,Xylose Lysine Deoxycholate agar（XLD）and Wuhan Salmonella-Shigella agar（WS）.Using single blind method,we detected 1 717 anal swabs from food-handlers during their occupational physical examination to compare the effectiveness of isolating Salmonella in CAS and WS after selenite F broth（SF）enrichment,and also detected 1 000 anal swabs of them to compare the effectiveness of isolating Salmonella in CAS and WS after selenite brilliant green enrichment broth（SBG）and SF,respectively.Finally,we evaluated the application of isolating Salmonella by optimized process of SBG-XLD/CAS from anal swabs in the course of preventive occupational physical examination in Jing＇an District.[Results] The susceptibility and specificity of CAS and XLD from the stock Salmonella strains and on site detection were significantly higher than that of WS.The results from optimum method of SBG-XLD combining process were significantly superior to that of the SF-WS.In Jing＇an District,the positive rate of Salmonella in occupational physical examination in 2008 increased by eight times than in 2006 and ten times than in 2007.Monthly positive rate of Salmonella increased by 2-10 times than before.The peak value of positive rate was over 1% in July and Augest.[Conclusion] CAS may be applied to isolate all Salmonellae including Salmonella typhi and Salmonella paratyphi.The SBG-XLD/CAS combining process has high susceptibility and easy to grasp.This optimum method is suitable for routine isolating Salmonella in preventive occupational physical examination.

关 键 词：沙门菌 食品从业者 敏感性 特异性 优化方法 

分 类 号：R115[医药卫生—公共卫生与预防医学]