一起蜡样芽胞杆菌食物中毒暴发调查  

Investigation on an outbreak of food poisoning caused by Bacillus cereus

作　　者：吕鸿鑫 何文军 林健 刘凤仁[3] 李刚[3] LV Hongxin;HE Wenjun;LIN Jian;LIU Fengren;LI Gang(Shenzhen Longhua District Center for Disease Control and Prevention,Guangdong 518109,China;不详)

机构地区：[1]深圳市龙华区疾病预防控制中心,广东518109 [2]深圳市龙岗区横岗预防保健所 [3]深圳市龙岗区疾病预防控制中心

出　　处：《医学动物防制》2020年第5期507-509,共3页Journal of Medical Pest Control

基　　金：深圳市第四期现场流行病学培训项目(深疾控201811号)。

摘　　要：目的对某市某中学蜡样芽孢杆菌食物中毒暴发事件进行调查,查找危险因素和传播途径,及时采取预防控制措施。方法开展流行病学调查,包括病例定义及搜索,描述性分析,病例对照研究,食品卫生学调查。采集留样食物、部分病例和全体厨工肛拭子、环境表面拭子样本进行4种常见致病菌检测。结果根据病例定义搜索到68例疑似病例,分布在25个班级,差异无统计学意义(P>0.05)。流行曲线呈持续同源暴露模式,临床表现以腹泻(92.6%)、腹痛(58.8%)、呕吐(23.5%)为主。饮食史调查显示56例病例均进食食堂早餐后发病。病例对照分层分析结果显示,售卖汤河粉、汤米粉、炒米粉的设备为可疑设备(OR=4.3,95%CI:2.3~8.1)。实验室在早餐河粉及6名疑似病例肛拭子中检出蜡样芽胞杆菌。结论该起食物中毒系蜡样芽胞杆菌污染食物导致。建议加强对学校食堂的监督与管理,定期进行厨工卫生培训,严格落实各项管理措施和操作规程。Objective To investigate the food poisoning outbreak of Bacillus cereus in a middle school in a city and to find out the risk factors and transmission routes to take preventive and control measures in time.Methods Epidemiological investigations,including case definitions,case searches,descriptive analysis,case-control studies,and food hygiene surveys were conducted.Samples of food,some cases,all kitchen workers’anal swabs and environmental surface swabs were collected for detection of four kinds of common pathogens.Results According to the case definition,68 suspected cases were found,distributed in 25 classes,with no statistically significant difference(P>0.05).The prevalence curve showed consistent homologous exposure,with diarrhea(92.6%),abdominal pain(58.8%),and vomiting(23.5%)as the main clinical manifestations.Dietary history survey showed that 56 cases were infected after eating breakfast in the canteen.The case-control stratified analysis showed that the facilities for selling tanghe noodles,rice noodles,and fried rice noodles were suspicious(OR=4.3,95%CI:2.3~8.1).Bacillus cereus was detected in breakfast rice noodles and laboratory swabs from 6 suspected cases.Conclusion The outbreak of food poisoning was caused by Bacillus cereus food contamination.It is suggested to strengthen the supervision and management of school canteens,carry out regular hygiene training for kitchen workers,and strictly implement various management measures and operating rules.

关 键 词：蜡样芽胞杆菌 食物中毒 中学 暴发疫情 实验室检测 

分 类 号：R516.2[医药卫生—内科学]