北京市一起由宋内志贺菌引起的细菌性痢疾暴发病原学分析  

Etiological analysis on a bacillary dysentery outbreak caused by Shigella sonnei in Beijing

作　　者：吕冰[1] 田祎[1] 杨艳娜[2] 甄博珺[2] 贾蕾[1] 林长缨[1] 张新[1] 黄瑛[1] 曲梅[1] Lyu Bing;Tian Yi;Yang Yanna;Zhen Bojun;Jia Lei;Lin Changying;Zhang Xin;Huang Ying;Qu Mei(Institute for Infectious Disease and Endemic Disease Control,Beijing Center for Disease Prevention and Control,Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning,Beijing 100013,China;Tongzhou District Centre for Disease Control and Prevention,Beijing 101100,China)

机构地区：[1]北京市疾病预防控制中心,传染病地方病控制所,食物中毒诊断溯源技术北京市重点实验室,北京100013 [2]北京市通州区疾病预防控制中心,北京101100

出　　处：《疾病监测》2022年第1期139-143,共5页Disease Surveillance

基　　金：国家科技重大专项(No.2018ZX10714002–003–002)。

摘　　要：目的对北京市一起由宋内志贺菌引起的暴发疫情进行流行病学调查以及病原学分析,为此类疫情处理提供参考。方法2019年9月5—20日,采集病例及厨师粪便/肛拭子样本,以及水样、外环境等标本进行病原分离鉴定,并将分离到的病原菌进行药物敏感性试验、脉冲场凝胶电泳(PFGE)分子分型、全基因组测序,利用全基因组数据分析病原菌的耐药、毒力相关基因,并进行多位点序列分型(MLST),构建全基因组单核苷酸多态性(wgSNP)分型树状图。结果共分离到16株宋内志贺菌和1株肠产毒性大肠埃希菌(ETEC),志贺菌均对氨苄西林、四环素、复方新诺明、头孢唑啉、头孢噻肟、庆大霉素、萘啶酸、阿奇霉素、多西环素耐药,且均为产超广谱β-内酰胺酶(ESBLs)菌株。均为ST152型,是国内常见型别。其中1株宋内志贺菌全基因组中存在insA插入序列,而在其他志贺菌全基因组中未发现,与其同时分离到的ETEC全基因组中发现有该插入序列。结论本次疫情是由多耐药宋内志贺菌引起。在病原溯源研究中,全基因组数据分析是PFGE分型的必要补充。Objective To investigate the etiologic and epidemiologic characteristics of an outbreak of bacillary dysentery caused by Shigella sonnei in a boarding school in Beijing,China.Methods Stool samples of the cases and cookers,water samples and environment smear samples were collected from 5^(th) to 20^(th) September,2019 for pathogen isolation and identification.Drug susceptibility test,pulsed-field gel electrophoresis(PFGE),whole genome sequencing(WGS),multi-locus sequence type(MLST),drug resistance related gene and virulence gene detection were performed,and the phylogenetic tree was constructed by whole genome single nucleotide polymorphism(wgSNP).Results In this outbreak,16 Shigella sonnei strains and 1 enterotoxigenic Escherichia coli(ETEC)strain were isolated.The antibiotic susceptibility testing revealed that 16 S.sonnei isolates were resistant to ampicillin,tetracycline,trimethoprim and sulphame-thoxazole,cephazoline,cefotaxime,gentamicin,nalidixic acid,azithromycin,doxycycline.Further tests confirmed these isolates to be extended-spectrum betalactamase(ESBLs)producing strains.MLST unfolded that all isolated S.sonnei strains in this outbreak belonged to ST152,a common epidemic sequence type in China.An insertion sequence was found in a S.sonnei strain and the ETEC strain,but not in other S.sonnei strains.Conclusion It was confirmed that the pathogen of this outbreak was S.sonnei.In addition to PFGE,WGS is necessary for epidemiological investigation.

关 键 词：宋内志贺菌 暴发 全基因组 全基因组单核苷酸多态性 脉冲场凝胶电泳 

分 类 号：R211[医药卫生—中医学] R378.2