某单位一起副溶血性弧菌引起的食物中毒调查  

An investigation on food poisoning owing to Vibrio parahaemolyticus in an employer

作　　者：赵梦蓝 游杰[3] 夏伟[3] 冯晶 夏天龙[2,5] 徐震东 ZHAO Meng-lan;YU Jie;XIA Wei;FENG Jing;XIA Tian-long;XU Zhen-dong(Shenzhen Futian District Center for Disease Control and Prevention,Guangdong518040,China;不详)

机构地区：[1]深圳市福田区疾病预防控制中心,广东518040 [2]深圳市现场流行病学培训项目五期 [3]深圳市罗湖区疾病预防控制中心 [4]深圳市宝安区疾病预防控制中心 [5]深圳市疾病预防控制中心 [6]深圳市盐田区疾病预防控制中心

出　　处：《医学动物防制》2022年第5期414-418,共5页Journal of Medical Pest Control

基　　金：深圳市福田区公益类科研项目(FTWS2020019)。

摘　　要：目的查明某单位一起中毒事件的致病因子及分析可疑危险因素,及时控制事件,为类似调查提供科学依据。方法通过对单位内搜索、查询系统、查询医疗机构门诊记录和访谈的方式搜索病例,开展病例对照研究分析可疑餐次及食品,采集病例和食堂厨工生物样品、厨房环境样品、留样食品进行致病菌检测。结果共搜索到40例病例,某单位员工罹患率14.5%。临床表现以腹泻(100.0%)、腹痛(92.5%)为主;93.9%(31/33)的患者出现白细胞计数升高(11.57×10^(9)/L~31.08×10^(9)/L)和中性粒细胞百分比升高(78.3%~92.4%);9例病例粪便常规检测均显示隐血试验阳性。窗口区取餐人员罹患率显著高于自助区取餐人员,差异有统计学意义(χ^(2)=13.00,P<0.01)。病例对照研究结果提示食用11月18日午餐为风险因素(OR=15.97,95%CI:2.02~126.46),可疑食品为烧鸭(OR=14.24,95%CI:1.85~109.67)。在33份病例肛拭子中检出同一血清型的副溶血性弧菌(OUT∶K4)。结论此事件为某单位食堂午餐提供的部分烧鸭在配送或加工过程中受到副溶血性弧菌污染而引起的中毒事件,建议有关部门加强对机关事业单位食堂和食品配送公司的监管。Objective To provide scientific evidence for other similar investigations and timely control the event by ascertaining the pathogenic factors and analyzing suspicious factors for an poisoning incident occurring in an employer.Methods The cases were screened by means of checking intra-employer retrieval&query system and records of medical institutions and interviewing.Suspicious poisoning meals and food were analyzed by using a case-control study.Samples were collected from patients,canteen stafs,kitchen environmen,and food retention,to detect the pathogen.Results A total of 40 cases were searched,the attack rate of an employer was 14.5%.The clinical manifestations were dominated by diarrhea(100.0%)and abdominal pain(92.5%).The elevated white blood cell count(11.57×10^(9)/L-31.08×10^(9)/L)and percent of neutrophile granulocyte(78.3%-92.4%)were detected in 93.9%(31/33)of patients taking blood routine examinations.All the 9 patients were tested positive in fecal occult blood tests.The attack rate of staff receiving food in the window region of the canteen was significantly higher than in those receiving food in the self-service buffet area,and with statistically significant difference(χ^(2)=13.00,P<0.01).The results of case-control study indicated that the lunch had on Nov.18 th was a risk factor(OR=15.97,95%CI:2.02-126.46),and roast ducks were considered to be the suspicious dishes(OR=14.24,95%CI:1.85-109.67).Homologous serotype Vibrio parahaemolyticus(OUT∶K4)was detected in rectal swabs from 33 patients.Conclusion The event is caused by Vibrio parahaemolyticus contaminating some of roast ducks from the lunch provided by the canteen of an employer.The competent authority is advised to tighten the supervision on public institution’s canteen and food distribution company.

关 键 词：副溶血性弧菌 食物中毒 食源性疾病 病例对照研究 LOGISTIC回归 流行病学调查 暴发 

分 类 号：R378.3[医药卫生—病原生物学] R516.2[医药卫生—基础医学]