北京一起副溶血性弧菌和非O1/O139霍乱弧菌共感染导致急性胃肠炎暴发事件病原检测分析  

Etiology analysis of an acute gastroenteritis outbreak caused by co-infection with Vibrio parahaemolyticus and non-O1/O139 Vibrio cholerae

作　　者：康颖 乔胜鑫 闫爱霞 赵文轩 崔尧 李首飞 王苗[1,2] 王园园[1,2] 王洛桐 李颖[1,2] 逄波 KANG Ying;QIAO Shengxin;YAN Aixia;ZHAO Wenxuan;CUI Yao;LI Shoufei;WANG Miao;WANG Yuanyuan;WANG Luotong;LI Ying;PANG Bo(Beijing Shunyi District Center for Disease Control and Prevention,Beijing 101300,China;Workstation for Microbial Infectious Disease,Shunyi District Center for Disease Control and Prevention,Beijing 101300,China;Hebei North University,Hebei Zhangjiakou 075000,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)

机构地区：[1]北京市顺义区疾病预防控制中心,北京101300 [2]北京市顺义区疾病预防控制中心微生物感染性疾病检测工作站,北京101300 [3]河北北方学院,河北张家口075000 [4]中国疾病预防控制中心传染病预防控制所,北京102206

出　　处：《中国食品卫生杂志》2024年第1期93-100,共8页Chinese Journal of Food Hygiene

基　　金：基于病原细菌基因组的传染病网络化监测技术体系研究(2018ZX10714-002-001)

摘　　要：目的对一起副溶血性弧菌和非O1/O139霍乱弧菌共感染导致急性胃肠炎暴发事件进行实验室病原学分析。方法采用实时荧光PCR方法对4个病例肛拭子、12件可疑污染食品和8件环境涂抹的增菌液进行多种腹泻病原检测,将副溶血性弧菌和霍乱弧菌分离培养,并对分离株进行全基因组测序,获取菌株毒力基因和耐药基因,基于核心基因组单核苷酸多态性构建聚类树。结果4件病例肛拭子增菌液荧光PCR检测副溶血性弧菌结果均为toxRVP+/tdh+/trh-,其中2件肛拭子荧光PCR检测霍乱弧菌结果为阳性。病例肛拭子副溶血性弧菌培养法检出率为100%(4/4),分离株均为toxR_(VP)+/tdh+/trh-,血清型均为O4:KUT;病例肛拭子霍乱弧菌培养法检出率为50%(2/4),均为非O1/O139血清型,其中1分离株为toxR_(VC)+/ctx-/t3ss+。可疑污染食品副溶血性弧菌培养法检出率为66.67%(8/12),环境涂抹副溶血性弧菌检出率为12.50%(1/8),可疑污染食品和环境副溶血性弧菌分离株均为toxR_(VP)+/tdh-/trh-;可疑污染食品霍乱弧菌检出率为25.00%(3/12),分离株均为toxR_(VC)+/ctx-/t3ss-。基于病例、可疑污染食品和环境分离副溶血性弧菌形成10个相互独立且遗传距离较远的分支,全部病例分离株处在同一分支,为高度克隆化分支。分离自2个病例和3件可疑污染食品的霍乱弧菌分离株形成5个相互独立且遗传距离较远的分支。结论本次暴发事件由副溶血性弧菌和非O1/O139霍乱弧菌共感染导致;弧菌共感染暴发事件中应加强多病原荧光PCR的辅助检测和菌株基因组特征分析,优化弧菌优化培养路径。Objective To analyze an acute gastroenteritis outbreak caused by co-infection with Vibrio parahaemolyticus(V.parahaemolyticus)and non-O1/O139 Vibrio cholerae(V.cholerae).Methods Four anal swabs,12 food samples,and 8 environmental samples enriched in liquid culture media were subjected to pathogen screening with real-time PCR.V.parahaemolyticus and V.cholerae strains isolated were subjected to whole genome sequencing,and virulence and antibiotic resistance genes were screened.Cladograms were constructed based on core genome single nucleotide polymorphisms.Results V.parahaemolyticus strains were detected in anal swab samples with real-time PCR that were toxR_(VP)+/tdh+/trh-,and two of them were positive for V.cholerae.The positive rate of V.parahaemolyticus in the anal swab samples was 100%(4/4),the isolates were toxR_(VP)+/tdh+/trh-,and their serotype was O4:KUT.The positive rate of V.cholerae culture in the anal swabs of patients was 50%(2/4).The serogroup of the isolates was non-O1/O139,and one of them was toxR_(VC)+/ctx/t3ss+.The positive rate of V.parahaemolyticus in the food samples was 66.67%(8/12),and that in the environment samples was 12.50%(1/8).The strains isolated from food and environmental samples were toxR_(VP)+/tdh-/trh-.The positive rate of V.cholerae culture in the food samples was 25.00%(3/12)and the isolated strains were toxRVC+/ctx/t3ss-.The V.parahaemolyticus strains isolated from patient,food,and environment samples formed 10 distinct lineages.The four patient isolates were highly clonal.The V.cholerae strains isolated from two patients and three food samples formed five distinct lineages.Conclusion The outbreak was caused by co-infection with V.parahaemolyticus and non-O1/O139 V.cholerae.Real-time PCR and whole-genome sequence analysis of strains should be performed in the detection and analysis of outbreaks caused by vibrio co-infection.Additionally,optimization of vibrio culture pathways is recommended.

关 键 词：急性胃肠炎 暴发 副溶血性弧菌 非O1/O139霍乱弧菌 实时荧光PCR 基因组测序 食源性致病菌 

分 类 号：R155[医药卫生—营养与食品卫生学]