贵州省一起产气荚膜梭菌引起食源性疾病暴发事件的调查及病原体溯源  

Investigation of a foodborne disease outbreak caused by Clostridium perfringens in Guizhou Province and pathogen tracing

作　　者：张莉[1,2] 代华 简洁 黄靖宇 蒋家俊[4] 周亚娟[2] 田继贵[2] 朱姝 廖春[2] 李军[1] 李薇薇[3] 郭华 ZHANG Li;DAI Hua;JIAN Jie;HUANG Jingyu;JIANG Jiajun;ZHOU Yajuan;TIAN Jigui;ZHU Shu;LIAO Chun;LI Jun;LI Weiwei;GUO Hua(Department of Occupational Health and Environmental Health,School of Public Health,Guizhou Medical University,Guizhou Guiyang 550025,China;Institute of Public Health Surveillance and Evaluation,Guizhou Center for Disease Control and Prevention,Guizhou Guiyang 550004,China;National Center for Food Safety Risk Assessment,Beijing 100022,China;Guiyang Center for Disease Control and Prevention,Guizhou Guiyang 550000,China)

机构地区：[1]贵州医科大学公共卫生与健康学院劳动卫生与环境卫生学系,贵州贵阳550025 [2]贵州省疾病预防控制中心,贵州贵阳550004 [3]国家食品安全风险评估中心,北京100022 [4]贵阳市疾病预防控制中心,贵州贵阳550000

出　　处：《中国食品卫生杂志》2024年第5期557-563,共7页Chinese Journal of Food Hygiene

基　　金：国家重点研发计划(2017YFC1601805);贵州省科技支撑(黔科合支撑[2017]2972)。

摘　　要：目的对贵阳市某学校由产气荚膜梭菌引起发的食源性疾病暴发事件开展流行病学调查和病因食品和病原的溯源分析,探讨全基因组测序新技术在食源性疾病暴发溯源中的应用。方法采用现场流行病学分析,采集可疑生物样本,食品样本和外环境样本进行常规的实验室病原分离及沙门菌、致泻大肠埃希菌、金黄色葡萄球菌、蜡样芽胞杆菌和产气荚膜梭菌的病原鉴定。对分离的病原菌进行毒素基因检测和全基因组测序溯源分析。结果22名病例症状以腹痛(95.45%,21/22)、腹泻(95.45%,21/22)为主;流行曲线为点源暴露模式,潜伏期为6-15 h。在5份肛拭子样本、3份粪便样本和1份留样早餐肉末食品样本中分离出产气荚膜梭菌,且均检出肠毒素cpe基因,所有样本均未检出沙门菌、致泻大肠埃希菌、金黄色葡萄球菌和蜡样芽胞杆菌。其中早餐肉末食品样品中经全基因组测序分析对比发现产气荚膜梭菌为3.5×10^(5) CFU/g,经全基因组测序分析比对发现,来源于早餐肉末食品和肛拭子样本的产气荚膜梭菌,其分子分型为ST139型,菌株均携带cpe毒力基因。结论通过现场调查和溯源分析,判定产气荚膜梭菌污染早餐肉末是导致此次食源性疾病暴发的原因。全基因组测序新技术在食源性疾病暴发中可起到精准溯源作用。Objective Epidemiological investigation of a foodborne disease outbreak triggered by Clostridium perfringens in a school in Guiyang,traceability analysis of etiologic foods and pathogens,and exploration of the application of the new technology of whole genome sequencing in the traceability of foodborne disease outbreaks.Methods On-site epidemiological analysis was used to collect samples of suspected organisms,food samples and samples from the external environment for Salmonella,diarrhea-causing Escherichia coli,Staphylococcus aureus,Bacillus cereus,and Clostridium perfringens for routine laboratory pathogen isolation and identification,and isolates of pathogens for toxin gene detection and whole-genome sequencing traceability analyses.Results Symptoms in 22 cases were dominated by abdominal pain(95.45%,21/22),diarrhea(95.45%,21/22);the epidemiological profile was point source exposure pattern with an incubation period of 6 h to 15 h.Clostridium perfringens was isolated from 5 anal swabs,3 stool specimens and 1 retained sample of breakfast meat froth food,and the enterotoxin cpe gene was detected in all of them;Salmonella,diarrheacausing Escherichia coli,Staphylococcus aureus,and Bacillus cereus were not detected in any of the samples.Among them,Clostridium perfringens was 3.5×10^(5) CFU/g in the breakfast meat froth food,which was analyzed by whole genome sequencing to compare the molecular typing of Clostridium perfringens originating from the breakfast meat froth food and the anal swabs,which was ST139 type,and the strains all carried cpe virulence gene.Conclusion Through on-site investigation and traceability analysis,it was determined that Clostridium perfringens-contaminated breakfast meat froth was the cause of the foodborne illness outbreak,and that the new technology of whole genome sequencing could play an accurate traceability role in the foodborne illness outbreak.

关 键 词：产气荚膜梭菌 食源性疾病 暴发事件 毒素基因 溯源分析 食源性致病菌 

分 类 号：R155[医药卫生—营养与食品卫生学]