食源性相关腹泻病原菌感染监测分析  

作　　者：李宏杰[1] 陈志杭 王海明 叶斌 葛荣跃 

机构地区：[1]杭州市西湖区第二人民医院,310024 [2]杭州市西湖区古荡街道社区卫生服务中心,310013 [3]浙江省食品药品检验研究院,310004

出　　处：《浙江临床医学》2018年第9期1525-1527,共3页Zhejiang Clinical Medical Journal

基　　金：2016年杭州市卫生科技计划一般（B类）项目（2016805）

摘　　要：目的食源性相关腹泻病原茵感染的菌属种分布，为控制相关细菌的感染及传播提供技术支持。方法对2015年至2017年2家社区卫生服务中心就诊的食源性相关腹泻患者粪便（或肛拭子）标本进行分离培养，根据生化反应和血清学试验进行病原确定或自动化细菌或微生物鉴定，并自动化抗茵药物敏感性试验；通过现况调查进行流行病学危险因素分析。结果自动化细菌鉴定结果能够覆盖常规血清学快速鉴定结果，同属相应茵群，分别为沙门菌属（42．00％）、志贺菌属（6．00％）、致病性大肠埃希茵（500％）、非ol群霍乱弧菌（200％）；副溶血弧茵（36．00％）、空肠弯曲茵（2．00％）、金黄色葡萄球菌（2．00％）等可进行自动化细菌鉴定。通过现况调查．发现患者有腹痛、腹泻等胃肠道症状，可伴有发热，所有患者48h内有可疑食物暴露史，无水源性案例，均为散发。结论沙门茵属、副溶血弧茵、志贺茵属、致病性大肠埃希菌、空肠弯曲茵、金黄色葡萄球菌和非O1群霍乱弧菌等为10种常见食源性腹泻病原菌。将鉴定菌种与药敏报告相关联，可根据药敏结果合理选用敏感抗菌药物；应对社区居民开展针对性的健康宣教；“五水共治”以来，水环境质量稳步改善。Objective To understand the distribution of pathogenic bacteria in food borne diarrhoea under the background of five water co-governance, and so as to provide technical support for controlling the infection and transmission of related bacteria. Methods From 2015 to 2017, stool （or anal swab ） specimens of foodborne diarrhea patients were cultured and isolated in 2 community health service centers in Xihu district by the method of combining direct separation with bacteria increasing separation. Rapid serotyping by serum agglutination test, and automated biochemical identification and antimicrobial susceptibility tests were done. Risk factors were analyzed by investigation of epidemiological. Results The results of automated biochemical identification were able to cover the results of the rapid identification of normal serology. Salmonella （42%） , Shigella （6%） , pathogenic Escherichia coli（5%） , non O1 group of Vibrio cholerae （2%） , Vibrio parahaemolyticus （36%） , Campylobacter jejuni （2%） , Staphylococcus aureus （2%） , etc. can be automated biochemical identification. Through the current survey, it was found that the patients had abdominal pain, diarrhea and other gastrointestinal symptoms, with fever. All the patients had a history of suspected food exposure in 48h, and no water source cases were distributed. Conclusions The identification of strain should be based on the results of routine rapid serological agglutination. Automatic biochemical identification is for reference only. Salmonella, Vibrio parahaemolyticus, Shigella, pathogenic Escherichia coli, Campylobacter jejuni, Staphylococcus aureus and non O1 group Vibrio cholerae are 10 common food borne diarrhea pathogens. It is related to the identification of bacteria and drug sensitivity report. Rational use of sensitive antibiotics according to the results of drug sensitivity are recommended. Targeted health education for community residents should be carried out. Since five water co-governance is done, the quality of wate

关 键 词：食源性 腹泻 鉴定 抗菌药物敏感性试验 

分 类 号：R155.31[医药卫生—营养与食品卫生学]