一起米酵菌酸中毒事件的病因学诊断  

Etiology diagnosis of a food poisoning incident caused by bongkrekic acid

作　　者：赵凌国[1] 雷蕾[1] 孙健[1] 刘勇 蔡志斌[3] 尹江伟[1] ZHAO Lingguo;LEI Lei;SUN Jian;LIU Yong;CAI Zhibin;YIN Jiangwei(Baoan Center for Disease Control and Prevention of Shenzhen,Guangdong Shenzhen 518101,China;Shenzhen Hospital of Southern Medical University,Guangdong Shenzhen 518000,China;Longgang Center for Disease Control and Prevention of Shenzhen,Guangdong Shenzhen 518116,China)

机构地区：[1]深圳市宝安区疾病预防控制中心,广东深圳518101 [2]南方医科大学深圳医院,广东深圳518000 [3]深圳市龙岗区疾病预防控制中心,广东深圳518116

出　　处：《中国食品卫生杂志》2022年第3期606-610,共5页Chinese Journal of Food Hygiene

基　　金：广东省医学科学技术研究基金项目(A2021416)。

摘　　要：目的调查深圳市一起食用黑木耳引起的中毒事件,鉴定病原菌种类,追溯产毒菌株来源,研究米酵菌酸在体内的分布和代谢情况,为此类中毒事件的处置提供借鉴。方法病原菌的分离和鉴定参照GB/T 4789.29—2003,同时采用基质辅助激光解吸电离-飞行时间质谱(MALDI-TOF MS)对病原菌种类进行鉴定。采用超高效液相色谱-复合线性离子阱串联质谱技术(UPLC-QTRAP-MS/MS)对黑木耳以及患者血液、肝脏和尿液、菌悬液等样品中的米酵菌酸进行检测。结果在残留食材黑木耳、患者血液和尿液中均检出不同浓度的米酵菌酸。患者中毒5 d后进行了肝移植,坏死的肝脏中检出高浓度米酵菌酸。患者中毒9 d后,跟踪监测显示患者血液、尿液中仍然含有一定浓度的米酵菌酸。从患者采摘的干木耳及泡发的湿木耳中均分离出唐菖蒲伯克霍尔德菌,经实验室培养后,两株菌株均产出米酵菌酸。结论本次事件是因患者采摘的干木耳带有病原菌,在长时间泡发过程中细菌产毒,患者食用含高浓度米酵菌酸的木耳后,毒素广泛分布于患者各个器官,导致多器官衰竭死亡。Objective To investigate a black fungus poisoning incident in Shenzhen and identify the specie of pathogen.Meanwhile,the toxogenic strains,the distribution and metabolism of bongkrekic acid(BA)in vivo were also studied to provide references for treatments of similar incidents.Methods Isolation and identification of pathogenic bacteria were carried out according to GB/T 4789.29-2003.MALDI-TOF MS was also used.UPLC-QTRAP-MS/MS was used for determination of BA in Black Fungus,blood,liver,urine,bacterial suspension and other samples.Results Different concentrations of BA were found in soaked Black Fungus,blood and urine samples.BA was also found in necrotic liver acquired from liver transplant 5 days after BA intake.Continuous surveillance showed that certain concentration of BA still exist in patient’s blood and urine even 9 days after BA intake.Burkholderia gladioli were isolated from both dried and soaked Black Fungus,and both two strains produced abundant BA after bacilli-culture.Conclusion Burkholderia gladioli in the Black Fungus produced large amount of BA during the soaking process.Then BA was ingested by the patient and widely distribute in vivo.Consequently,the patient died of multiple organ failure.

关 键 词：唐菖蒲伯克霍尔德菌 黑木耳 米酵菌酸 食物中毒 

分 类 号：R155[医药卫生—营养与食品卫生学]