副溶血性弧菌和金黄色葡萄球菌混合感染引起的食物中毒分子流行病学研究  

Molecular epidemiology study of food poisoning caused by Vibrio parahaemolyticus and Staphylococcus aureus

作　　者：刘艳慧[1,2] 刘于飞[2] 袁俊[2] 陈建东[2] 张欣强[2] 陆家海[1] 王鸣[1,2] 

机构地区：[1]中山大学公共卫生学院,广东510800 [2]广州市疾病预防控制中心

出　　处：《医学动物防制》2016年第8期872-875,共4页Journal of Medical Pest Control

基　　金：2015年度广州市医药卫生科技项目(20151A011047)

摘　　要：目的查明一起食物中毒暴发原因,追溯感染来源和感染途径。方法制定病例定义进行病例搜索,开展现场流行病学和卫生学调查。对病例肛拭子、呕吐物、可疑中毒场所剩余食品/半成品、厨工/服务员样本及环境样本开展常规致病菌检测。对检出的副溶血性弧菌菌株进行血清分型和PFGE检测,金黄色葡萄球菌菌株进行肠毒素检测,并对肠毒素进行分型。结果 3例病例的肛拭子均检出副溶血性弧菌,血清型分别为O1∶K1、O3∶K6、O10∶K12;3份环境样本副溶血性弧菌阳性,分别为餐厅A半成品冰柜内壁(O3∶K6)、小炒位荷台(O1∶K1)和餐厅B砧板(O5∶K17)。病例和环境样本来源的2株O3∶K6菌株PFGE带型一致,2株O1∶K1菌株带型基本一致。1例病例的呕吐物检出金黄色葡萄球菌,经培养产E型肠毒素。3份厨工样本金黄色葡萄球菌阳性,分别为餐厅A厨工咽拭子2份(产B型肠毒素)和餐厅B厨工肛拭子1份(产E型肠毒素)。结论副溶血性弧菌和金黄色葡萄球菌混合感染导致了这起食物中毒的发生,建议监管部门加强对餐饮服务单位的监测和监管指导。Objective To find out the causes of the food poisoning in Guangzhou,trace back its source of infection and route of infection.Methods Case definition was established to make a case-finding.Data were obtained by field epidemiology and a hygiene survey.Residual food,the vomited matter,and anal swab of the patients,the specimens of cooks and waiters and environmental sample were collected for laboratory diagnosis.All specimens were tested for common pathogenic enteric bacteria using PCR and bacteria culture.Vibrio parahaemolyticus isolates were then serotyped according to K-and O-antigens,characterized by tdh,and pulsed field gel electrophoresis analysis.Staphylococcus aureus isolates were then detected for enterotoxin.Results Three Vibrio parahaemolyticus isolates were found in anal swabs of three patients,of which,serotypes were O1∶ K1,O3∶ K6 and O10∶ K12 respectively.Three Vibrio parahaemolyticus isolates were collected in environmental samples,of which,serotypes were O1∶ K1,O3∶ K6 and O10：K12 respectively.PFGE patterns of 2 isolates（O3∶ K6） from patient and environmental sample were identical.PFGE patterns of 2 isolates（O1∶ K1） from patient and environmental sample were identical.One Staphylococcus aureus isolate was found in patient vomitus,and identified as enterotoxin E.Three Staphylococcus aureus isolates were found from cook specimens,of which,two isolates were enterotoxin B,and one was enterotoxin E.Conclusion This was a food poisoning caused by Vibrio parahaemolyticus and Staphylococcus aureus.Monitoring and regulation of any violation of proper food handling processes in the food catering industry should be the mainstay of preventive measures to be strengthened.

关 键 词：副溶血性弧菌 金黄色葡萄球菌 食物中毒 

分 类 号：R516.2[医药卫生—内科学]