2015年-2017年山西省阳泉市食源性多病原监测与溯源分析  

Surveillance and trace research of foodborne multiple pathogen in Yangquan, Shangxi from 2015 to 2017

作　　者：李海清[1] 李荣 郝瑞娥[2] 姚素霞[2] 许学斌[3] 杨红霞[2] LI I lai-qing;LI Rong;HAO Rui-e;YAO Su-xia;XU Xue-bin;YANG Hong-xia(Yangquan Center for Disease Control and Prevention, Yangquan, Shanxi 045000, China)

机构地区：[1]阳泉市疾病预防控制中心,山西阳泉045000 [2]山西省疾病预防控制中心,山西太原030000 [3]上海市疾病预防控制中心,上海200336

出　　处：《中国卫生检验杂志》2019年第10期1153-1156,1160,共5页Chinese Journal of Health Laboratory Technology

基　　金：国家重点研发计划(2017YFC1600104)

摘　　要：目的提高阳泉市食源性多病原实验室监测和溯源能力。方法采集2015年-2017年阳泉市食源性疾病监测点病例样本,进行沙门菌、志贺菌、副溶血性弧菌、5种致泻性大肠埃希菌病原分离和诺如病毒核酸检测,省级实验室复核菌(毒)株的血清、毒力和耐药表型,结合流行病学和实验室诊断开展疑似聚集性病例的分子溯源。结果3年监测标本752份,总阳性率为16.1%,病原谱型依次为诺如病毒38例(Ⅱ型为优势)、致泻性大肠埃希菌34株(不典型EPEC为优势)、副溶血性弧菌20株(tdh阳性)、沙门菌17株(存在暴发菌型)和志贺菌1株(宋内志贺菌)。分子分型确认导致餐饮场所食源性事件的汤卜逊沙门菌为国内新的分子克隆型、1例有乌龟接触史婴幼儿便血病例来自波摩那沙门菌的致病性克隆。结论阳泉市食源性多病原监测、基于流行病学的分子溯源和精准识别行为生态学传染病能力显著加强。Objective To improve the foodborne multiple pathogenic surveillance and traceability in the laboratory of Yangquan CDC. Methods Surveillance sites for diarrheal illness were established in Yangquan from 2015 to 2017. Sample which can meet the case definitions were collected for the isolation of Salmonella ( Sa), Shigella ( Sh), Vibrio Parahaemolyticus ( VP) and five different types of diarrheogenic Escherichia coli ( DEC) and the detection of Norovirus ( NV). The provincial level laboratories re - identified the serotype, virulence and resistant phenotype of the strains, and traced the molecular sources of suspected clustered cases based on epidemiology and laboratory diagnosis. Results Totally 752 feces specimens were tested during the three years and the total positive rate was 16. 1%. The distribution of the pathogens in order were 38 NV cases ( type Ⅱ was the dominant serotype), 34 DEC strains ( atypical EPEC was the dominant serotype), 20 VP strains ( with tdh positive), 17 Sa strains ( existthe outbreak strains) and 1 Sh strain ( Shigella. sonnei). Molecular typing confirmed that the strain from a foodborne outbreak in the dining place was a new clone of S. Thompson in Inland. The strain from the case of hematochezia in infant who had a history of exposure to turtles was identified as the pathogenic clone of S Pomona. Conclusion Yangquan’s capability of multiple pathogenic surveillance, phenotyping diagnosis has been improved significantly. Using big data to trace the molecular sources base on the epidemiology would contribute to accurately identifying behavioral ecological infectious diseases.

关 键 词：食源性多病原监测 溯源 克隆 行为生态传染病 

分 类 号：R155.5[医药卫生—营养与食品卫生学]