一起GⅠ型诺如病毒混合感染多克隆蜡样芽胞杆菌致急性胃肠炎暴发事件实验室分析  

Laboratory study for one gastroenteritis outbreak caused by norovirus GⅠand Bacillus cereus

作　　者：甄国新[1] 范佳欣 袁凯丽 林帆 李颖[1,3] 王苗[1,3] 康颖 闫爱霞 张爽[1,3] 荆红波[1,3] 马红梅[1,3] 王园园[1,3] 张茂俊 Zhen Guoxin;Fan Jiaxin;Yuan Kaili;Lin Fan;Li Ying;Wang Miao;Kang Ying;Yan Aixia;Zhang Shuang;Jing Hongbo;Ma Hongmei;Wang Yuanyuan;Zhang Maojun(Shunyi District Center for Disease Control and Prevention,Beijing 101300,China;HeBei North University,Zhangjiakou 075000,Hebei,China;Workstation for Microbial Infectious Diseases Shunyi District Center for Disease Control and Prevention,Beijing 101300,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]北京市顺义区疾病预防控制中心,北京101300 [2]河北北方学院,河北张家口075000 [3]北京市顺义区疾病预防控制中心微生物感染性疾病检测工作站,北京101300 [4]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《疾病监测》2021年第8期845-850,共6页Disease Surveillance

摘　　要：目的通过一起急性胃肠炎暴发事件的实验室检测,分析暴发相关病原特征。方法对患者粪便、呕吐物标本以及可疑污染食品样本进行相关病原及毒力基因的实时荧光PCR筛查以及阳性菌的培养检测,对分离菌株进一步进行毒力基因分布分析和脉冲肠凝胶电泳分型分析。结果25例患者的粪便标本诺如病毒荧光PCR阳性,检出率为71.43%(25/35),均为GⅠ型;5例患者的6份标本中蜡样芽胞杆菌荧光PCR和病原培养均为阳性,1名厨师粪便标本蜡样芽胞杆菌荧光PCR和培养结果均为阳性。7件可疑食品样本中4件检出蜡样芽胞杆菌,其中5份食品样本ces基因阳性。19株蜡样芽胞杆菌分离株脉冲场凝胶电泳(PFGE)分为14种带型,5例患者分离株中有2株PFGE带型相同且与厨师来源菌株分型一致,相同食品来源分离株的PFGE带型不完全一致。19株分离株均不携带ces基因。结论诺如病毒和蜡样芽胞杆菌可能是导致本次急性胃肠炎暴发事件重要病原,以多病原快速筛查为指导的实验室检测对于病原的识别具有重要意义。Objective To understand the etiological characteristics of an acute gastroenteritis outbreak.Methods The common enteric pathogen screening was performed for the samples from the patients(stool and vomitus)and the suspected contaminated food samples by using real time PCR.Bacteria culture was carried out according to the real time PCR results.The ces gene was tested for both the collected samples and the bacteria isolates.The Bacillus cereus isolates were sub-typed with PFGE.Results By using real time PCR,Norovirus GⅠwas detected in 25 of the 35 patients(71.43%,25/35)and 6 B.cereus strains were detected in 5 of the 35 patients(14.29%,5/35),including 5 strains from stool samples and 1 strain from vomitus samole.One stool sample from a cooker was positive for B.cereus by both PCR and culture method.In 7 suspected food samples,4 were positive for B.cereus and 5 were positive for ces gene by real time PCR.The plate count culture for suspected food indicated that 1 sample had over 160000 cfu/g bacteria.Nineteen B.cereus isolates had 14 PFGE patterns and in 5 isolates from the patients,2 shared the same pattern with the isolate from the cooker.The isolates from the same food samples had different patterns.The 19 strains of B.cereus isolates were negative for ces gene.Conclusion Norovirus GⅠand Bacillus cereus might be the major pathogens for this outbreak.The multi-pathogen screening with real time PCR is useful for rapid laboratory response for food-borne outbreaks.

关 键 词：诺如病毒 蜡样芽胞杆菌 急性胃肠炎 暴发 

分 类 号：R211[医药卫生—中医学] R511