一起致泻性大肠埃希菌引起的食源性疾病暴发事件病原检测与溯源分析  

Pathogen detection and traceability analysis of a food-borne outbreak caused by diarrheagenic Escherichia coli

作　　者：王君 韩蓓 陈晓草 宋海清 贺金明 刘新利 苏翠 WANG Jun;HAN Bei;CHEN Xiaocao;SONG Haiqing;HE Jinming;LIU Xinli;SU Cui(School of Public Health,Health Science Center,Xi’an Jiaotong University,Xi’an,Shaanxi 710061,China;Center for Disease Control and Prevention of Tongchuan,Xi’an,Shaanxi 727031,China)

机构地区：[1]西安交通大学医学部公共卫生学院,陕西西安710061 [2]铜川市疾病预防控制中心,陕西铜川727031

出　　处：《应用预防医学》2024年第2期79-84,共6页Applied Preventive Medicine

基　　金：陕西省卫生科研基金项目(2018E007)。

摘　　要：目的对陕西省铜川市某工厂一起疑似食源性疾病暴发事件进行病原检测与溯源分析,以期为今后相关病原体检测工作的开展提供参考依据。方法采集该厂出现消化道症状患者的粪便样本、可疑食物剩余物样本以及后厨环境样本,利用病原体培养分离、多重PCR检测、脉冲场凝胶电泳(PFGE)、药敏试验等方法对致病菌类型、毒力基因、来源、耐药表型等进行检测和分析。结果从该厂职工食堂采集可疑食物剩余物样本6份,后厨环境样本10份,医院采集患者粪便样本14份,合计30份样本中分离出肠聚集性大肠埃希菌(enteroaggregative Escherichia coli,EAEC)11株。其中14份患者粪便样本中检出9株;6份后厨环境样本中检出1株,来源为荤案板;6份可疑食物剩余物样本中检出1株,来源为凉拌肉丝。11株EAEC菌株中,有10株菌株携带毒力基因ast A、agg R,1株菌株携带毒力基因ast A;PFGE指纹图谱显示两种带型,患者粪便样本与可疑食物剩余物样本凉拌肉丝分离的10株菌株呈现同一带型,相似度为100.0%,后厨环境样本荤案板中分离的1株菌株与其他菌株带型相似度为68.6%。药敏试验结果显示病,患者粪便和可疑食物剩余物样本凉拌肉丝中分离的10株EAEC菌株对氨苄西林、哌拉西林/他唑巴坦、环丙沙星、复方新诺明、头孢唑林表现为耐药,且超广谱β-内酰胺酶(ESBL)表型为阳性。结论本次食源性疾病暴发事件是由EAEC污染食品所导致。本次感染的致病菌株携带毒力基因ast A、agg R,ESBL表型为阳性,且对多种抗生素耐药。建议卫生监督部门今后加强食品安全管理,采取针对性的控制措施,预防和控制食源性疾病的发生,同时加强食源性致病菌的耐药监测,提升多重耐药菌暴发流行的预警能力。Objective To conduct pathogen detection and traceability analysis on a suspected foodborne disease outbreak in a factory in the Tongchuan,Shaanxi,provide references for the development of relevant pathogen detection work in the future.Methods Fecal samples from employees with digestive symptoms,suspicious food samples,and samples of the kitchen environment in the factory were collected.Pathogen types,virulence genes,sources,and drug resistance phenotypes of pathogenic bacteria were detected and analyzed by pathogen culture and isolation,multiple PCR detections,pulsed field gel electrophoresis(PFGE),antimicrobial susceptibility test,and other methods.Results 6 samples of suspicious food residues were collected from the staff canteen in factory,10 samples of the kitchen environment,and 14 samples of patient feces were collected from the hospital.11 strains of(enteroaggregative Escherichia coli,EAEC)were isolated from a total of 30 samples.Among them,9 strains were detected in 14 patient fecal samples.1 strain was detected in 6 kitchen environment samples,and the source was meat chopping boards.1 strain was detected in 6 suspicious food leftover samples,and the source was cold shredded pork.Among the 11 EAEC strains,10 strains carried the virulence genes astA and aggR,and 1 strain carried the virulence gene astA.The PFGE model showed two band types.The 10 strains isolated from the patient’s feces samples and the cold shredded pork from the suspicious food residue sample showed the same band type,and a similarity of 100.0%.The band pattern similarity between a strain isolated from the meat chopping board of the kitchen environment sample and other strains was 68.6%.Antimicrobial susceptibility test showed that the 10 EAEC strains isolated from the patient’s feces and suspected food leftover samples of cold shredded pork were resistant to ampicillin,piperacillin/tazobactam,ciprofloxacin,sulfamethoxazole,and cefazolin,and the extended-spectrum beta-lactamase(ESBL)phenotype was positive.Conclusions This food-borne i

关 键 词：肠聚集性大肠埃希菌 食源性疾病 多重PCR检测 脉冲场凝胶电泳 多重耐药菌 

分 类 号：R378.21[医药卫生—病原生物学]