一起肠炎沙门菌食物中毒的病原鉴定与溯源分析  

Pathogen identification and source tracing analysis on a food poisoning caused by Salmonella enteritidis

作　　者：刘兰芳[1] 吕均[2] 杨康[1] 李艳丽 杜云[1] LIU Lan-fang;LYU Jun;YANG Kang;LI Yan-li;DU Yun(Shiyan Center for Disease Control and Prevention,Hubei 442000,China;不详)

机构地区：[1]十堰市疾病预防控制中心,湖北442000 [2]十堰市太和医院

出　　处：《医学动物防制》2022年第11期1039-1042,共4页Journal of Medical Pest Control

基　　金：湖北省卫生计生委联合基金项目(WJ2018H260)。

摘　　要：目的对一起高中学生细菌性食物中毒事件进行病原鉴定和溯源分析,为救治病例和消除感染源提供参考依据。方法采集发病病例和食堂从业人员的肛拭子、手拭子样本,剩余食品、食品原料和食品留样样本,以及食堂环境样本,开展沙门菌、金黄色葡萄球菌等病原菌的分离与鉴定。对检出的沙门菌分离株进行血清分型、多位点序列分型(multilocus sequence typing,MLST)、肠杆菌基因间重复序列分型(enterobacterial repetitive intergenic consensus PCR,ERIC-PCR)、毒力基因检测和药敏试验。结果从发病病例、食堂从业人员、食品和食堂环境样本中检出10株肠炎沙门菌,从食品原料中检出1株鸭沙门菌。10株肠炎沙门菌均为ST11型,ERIC-PCR指纹图谱100%相似,且毒力基因型完全相同,均对氨苄西林、萘啶酸和氨苄西林-舒巴坦耐药。结论实验室检测结果与流行病学调查显示,本次食物中毒事件由食堂从业人员感染肠炎沙门菌引起。提示餐饮机构,尤其是学校食堂应加强食品卫生管理和从业人员健康监测,预防此类事件再次发生。Objective To provide reference for clinical treatment of patients and elimination of infection sources by identifying pathogens and tracing the source of a student bacterial food poisoning incident in a senior high school.Methods Anal swab and hand swab samples from patients and cafeteria catering practitioners,residual food&food raw material samples,reserved food samples and cafeteria environmental samples were collected.The isolation and identification of pathogenic bacteria including Salmonella and Staphylococcus aureus were implemented,and the detected Salmonella bacteria were subject to serotyping,multilocus sequence typing(MLST),enterobacterial repetitive intergenic consensus PCR(ERIC-PCR)typing,virulence gene detection and drug susceptibility test.Results Ten strains of Salmonella enteritidis were detected from patients,cafeteria practitioners and food&cafeteria environments,and 1 strain of Salmonella anatum from food ingredients was detected.All the 10 strains of Salmonella enteritidis were of ST11 type,and their ERIC-PCR fingerprints and virulence genotypes were fully similar,the virulence genotypes were completely identical,and they were all resistant to ampicillin,nalidixic acid and ampicillin-sulbactam.Conclusion Laboratory test results and epidemiological investigations indicate that the food poisoning incident is caused by that the staff in the cafeteria are infected with Salmonella enteritidis.Therefore,catering entities,especially school cafeteria should strengthen food hygiene management and health monitoring on practitioners to prevent such incidents from reoccurrence.

关 键 词：食物中毒 沙门菌 病原鉴定 溯源 毒力基因 耐药性 分析 

分 类 号：R155.31[医药卫生—营养与食品卫生学] R378.22[医药卫生—公共卫生与预防医学]