1例新生儿单核细胞增生李斯特菌感染致病菌的溯源分析  

Laboratory traceability analysis on a newborn case of Listeria monocytogenes infection

作　　者：张晓妮 高远 李涛 王济忠 ZHANG Xiao-ni;GAO Yuan;LI Tao;WANG Ji-zhong(Bacterial Testing Department,Linyi City Center for Disease Control and Prevention,Linyi,Shandong 276000,China)

机构地区：[1]临沂市疾病预防控制中心细菌检验科,山东276000

出　　处：《预防医学论坛》2023年第6期461-464,共4页Preventive Medicine Tribune

摘　　要：目的 通过对1例新生儿单核细胞增生李斯特菌(LM)感染致病菌进行溯源分析,追踪病例感染来源并对致病菌病原特征等进行溯源分析,为此类事件溯源调查提供参考。方法 1例发生胃肠道感染的孕妇所分娩的新生儿因出现嗜睡等症状,采集患儿脑脊液、血液做常规检测,均检出LM。对LM感染病例开展流行病学现场调查,采集病例、病例家庭等相关样本进行病原菌分离和鉴定,利用脉冲场凝胶电泳(PFGE)、全基因组测序技术对分离菌株进行菌株间系统发育关系分析。结果 共在样本中分离鉴定出6株LM,2株分离自病例血液和脑脊液,4株分离自流行病学调查样品,分别是猪肉、水煮花生、虾皮和腌渍生姜。6株菌株血清型均为1/2a,除猪肉检出的菌株为ST155型,其余5株均为ST91型,与PFGE分子分型结果一致。采用核心基因组单核苷酸多态性分析,推测腌渍生姜为本次事件家庭污染源头,继而交叉污染了水煮花生和虾皮,最终导致本病发生。结论 该例新生儿LM感染来源于腌渍生姜,菌株血清型均为1/2a,以ST91型为主,推测由家庭不良卫生习惯造成即食食品间的交叉污染、通过母婴垂直传播致使新生儿感染。Objective A case of Listeria monocytogenes(LM)infection in a newborn was analyzed retrospectively to trace the source of infection as well as to analyze the pathogenic characteristics of the causative agent,so as to provide a reference for the investigation of such events.Methods A newborn of a pregnant woman with gastrointestinal infection developed symptoms such as drowsiness,therefore the cerebrospinal fluid and blood of the child were collected for routine testing,and LM was detected.Epidemiological investigations were conducted on LM infection cases,relevant samples were collected from cases and their families for pathogenic bacteria isolation and identification,and phylogenetic relationships between strains were analyzed using pulsed field gel electrophoresis(PFGE)and whole genome sequencing techniques on isolated strains.Results A total of 6 strains of Listeria monocytogenes were isolated,and 2 strains were isolated from the blood and cerebrospinal fluid of the patient,and 4 strains were isolated from the epidemiological investigation samples,including pork,boiled peanuts,dried small shrimps and pickled ginger.The serotype of the 6 strains was 1/2a.Except that the strain detected from pork was ST155,the other 5 strains were ST91,which was consistent with the results of PFGE.Using cgSNP analysis,it was further speculated that pickled ginger was the source of this event,and then cross contaminated the boiled peanuts and dried shrimp skin and then led to this event.Conclusion This newborn case with LM infection originated from pickled ginger,and the serotypes of the strains were all 1/2a,with ST91 being the predominant type,which was presumed to be caused by cross-contamination between ready-to-eat foods due to poor family hygiene practices and vertical transmission from mother to child.

关 键 词：单增李斯特菌 分子溯源 脉冲场凝胶电泳 全基因组测序 食源性疾病 

分 类 号：R446.5[医药卫生—诊断学]