某糕点房肠炎沙门菌食物中毒的流行病学调查与溯源分析  

Epidemiological investigation and tracing analysis of a case of Salmonella enteritis food poisoning caused by a bakery

作　　者：于颖慧[1] 刘丽华[1] 夏威[1] 施惠军 陆逊[1] 王晓蕾[1] 邱海岩[1] YU Ying-hui;LIU Li-hua;XIA Wei;SHI Hui-jun;LU Xun;WANG Xiao-lei;QIU Hai-yan(Zhangjiagang Center for Disease Control and Prevention,Jiangsu215600,China)

机构地区：[1]张家港市疾病预防控制中心,江苏215600

出　　处：《医学动物防制》2021年第2期175-178,182,共5页Journal of Medical Pest Control

基　　金：江苏省卫生厅预防医学科研课题(Y2015020)。

摘　　要：目的查明一起食物中毒事件的可疑食品、致病因子及危险因素等,提出防控措施及建议。方法通过描述性流行病学和分析性流行病学等方法进行数据分析,采用脉冲场凝胶电泳(Pulsed Field Gel Electrophoresis,PFGE)方法进行同源性分析。结果某高校共发现病例47例,罹患率0.78%,临床症状以腹泻(100.00%)、发热(93.62%)、腹痛(72.34%)为主,部分伴有恶心(53.19%)、呕吐(25.53%)等;15例病例的白细胞总数、中性粒细胞比值和单核细胞比值升高的比例分别达到66.67%、53.33%和26.67%;发病潜伏期中位数13.5 h(3.0~39.0 h);病例对照分析结果显示,糕点房是本次事件的高风险因素,三明治、面包、鸡肉卷均为可疑中毒食品;8例病例的肛拭子或粪便、1份面包均检出沙门菌,血清分型鉴定均为肠炎沙门菌,经PFGE电泳聚类图谱相似性100%。结论本次事件是糕点房提供的被污染食物引起的肠炎沙门菌性食物中毒,中毒原因是存在多个污染或交叉污染环节,建议加强对同类场所的监管及相关从业人员的食品安全知识宣教,以防类似事件的再次发生。Objective To investigate the suspected food,pathogen and risk factors of a food poisoning accident,and put forward the relevant prevention and control measures and suggestions.Methods Descriptive and analytical epidemiology was used to analyze the data,and the homology was analyzed by Pulsed Field Gel Electrophoresis(PFGE).Results Forty-seven possible cases were identified with a positive rate of 0.78%.The major clinical symptoms contains diarrhea(100.00%),fever(93.62%),abdominal pain(72.34%),nausea(53.19%),and vomiting(25.53%).The ratio of neutrophils,the total number of white blood cells,and the ratio of monocytes increased by 66.67%,53.33%and 26.67%respectively in 15 cases.The median incubation period was 13.5 h(3.0-39.0 h).The results of case-control analysis showed that the bakery shop was a high-risk factor for this event.Sandwiches,breads,and chicken rolls were all suspicious food.Salmonella were detected in anal swabs or feces of 8 cases and 1 bread sample,and their serotypes were all identified as Salmonella enteritis with the PFGE pattern highly consistent.Conclusion This is a Salmonella enteritiis poisoning event caused by the contaminated food provided by a bakery shop.There were multiple pollutions or cross-contaminations in the processing of the bakery shop.It’s suggested that supervision and food safety knowledge education should be reinforced in such place as the pastry shopto prevent similar events.

关 键 词：肠炎沙门菌 食物中毒 流行病学调查 病例-对照分析 溯源分析 

分 类 号：R378.22[医药卫生—病原生物学] R516.2[医药卫生—基础医学]