由带菌者引起的3所学校食物中毒的溯源分析及药敏检测  

Source Tracing and Drug Resistance Analysis of a Food-Poisoning Case in Three Schools Caused by Pathogenic Bacteria Carriers

作　　者：王文斟[1] 许磊[2] 张鹏[3] 成文 熊鹰[1] 李志峰[1] WANG Wenzhen1, XU Lei2, ZHANG Peng3, CHENG Wen4, XIONG Ying1, LI Zhifeng1(1 Chongqing Municipality Center for Disease Control and Prevention, Chongqing 400042, China; 2 Nanan District Center for Disease Control and Prevention, Chongqing 400067, China; 3 Jiulongpo District Center for Disease Control and Prevention, Chongqing 401329, China; 4 Jiangjin District Center for Disease Control and Prevention, Chongqing 402260, China)

机构地区：[1]重庆市疾病预防控制中心,重庆400042 [2]重庆市南岸区疾病预防控制中心,重庆400007 [3]重庆市九龙坡区疾病预防控制中心,重庆401329 [4]重庆市江津区疾病预防控制中心,重庆402260

出　　处：《预防医学情报杂志》2018年第8期1050-1053,共4页Journal of Preventive Medicine Information

摘　　要：目的对由肠炎沙门菌引起的3所不同区县的学校食物中毒分离菌株进行分子流行病学(PFGE)分析,查明爆发源头;同时了解菌株对15种抗生素的耐药状况。方法对该起食物中毒事件中分离的18株肠炎沙门菌,用xbaⅠ酶切进行PFGE分子分型,图谱用BN软件进行聚类分析,观察患者分离株之间和食品分离株、食品加工人员带菌者分离株的相似性;利用微量肉汤稀释法对肠炎沙门菌进行耐药性检测。结果从3所学校食物中毒患者分离的15株和食品中分离的2株、食品加工人员带菌者分离到的1株肠炎沙门菌指纹图谱用BN软件分析相似度为100%;18株菌均对氨苄西林、氨苄西林/舒巴坦、萘啶酸、红霉素、头孢唑啉耐药。结论 18株肠炎沙门菌为同一克隆菌株,结合流行病学调查结果判断为带菌者污染食品引起的食物中毒,引起该起食物中毒的肠炎沙门菌对萘啶酸耐药和对环丙沙星中度敏感提示临床用喹诺酮类治疗可能无效。Objective To trace the source of infection and study the drug resistances of Salmonella enteritidis isolates related to a food-poisoning case in three schools by molecular epidemiology analysis. Methods XbaⅠwas used to digest the genomes of 18 Salmonella enteritidis isolates obtained from the food-poisoning case. Then pulsed field gel electrophoresis（ PFGE） was carried out to identify the molecular fingerprint patterns of the digest products. The patterns were analyzed by UP GMA method using software Bionumerics 6. 0 to identify the similarity of isolates from the patients,foods and food-processing staff carriers. The drug resistance of Salmonella enteritidis isolates was determined by mircrobroth dilution assay. Results The results showed that the molecular patterns and clustering analysis sharing 100 % similarity between 15 isolates from patients,2 isolates foods and 1 isolate from food-processing staff carriers. All 18 isolates were resistant to ampicillin, ampicillin/sulbactam, nalidixic acid,erythromycin and cefazolin. Conclusion Salmonella enteritidis isolates from patients, foods and food-processing staff carriers are identical. Taking into account epidemiological investigation results,this food-poisoning case is a public health event due to contamination by Salmonella enteritidis from the food-processing stuff carriers; resistance to nalidixic acid and moderate susceptibility to ciprofloxacin indicate clinical use of quinolones may be not responded to.

关 键 词：肠炎沙门菌 脉冲场凝胶电泳(PFGE)溯源 耐药分析 

分 类 号：R117[医药卫生—公共卫生与预防医学]