一起空肠弯曲菌导致急性胃肠炎暴发事件调查分析  

Investigation and analysis of an outbreak of acute gastroenteritis due to Campylobacter jejuni

作　　者：高彭[1] 李颖[1] 吕金昌[1] 陈东宛[1] 张雨桐 包丽娜 甄国新[1] 马晓晨[2] GAO Peng;LI Ying;LV Jinchang;CHEN Dongwan;ZHANG Yutong;BAO Lina;ZHEN Guoxin;MA Xiaochen(Beijing Shunyi District Center for Disease Control and Prevention,Beijing 101300,China;不详)

机构地区：[1]北京市顺义区疾病预防控制中心,北京101300 [2]北京市疾病预防控制中心

出　　处：《医学动物防制》2024年第10期1024-1028,共5页Journal of Medical Pest Control

基　　金：国家重点研发计划课题任务书——新发和重大食源性疾病标准化诊断;调查及处置技术体系研究(2017YFC1601502)。

摘　　要：目的对一起急性胃肠炎暴发事件进行调查分析,为制定预防控制措施提供依据。方法2021年8月5日采用个案调查方法,开展病例对照研究。采集6例急性胃肠炎病例和1名厨师的粪便或肛拭子标本进行肠道病原体实时荧光定量PCR检测和细菌培养,应用多位点序列分型(multilocus sequence typing,MLST)和脉冲场凝胶电泳(PFGE)方法进行细菌分子分型。采用琼脂稀释法进行分离菌株的抗生素敏感性分析。利用SPSS 25.0进行统计学分析。结果此次事件共搜索到6例疑似病例,病例临床症状为发热(100.0%,6/6)、腹痛(83.3%,5/6)、腹泻(66.7%,4/6)、头晕(66.7%,4/6)。采集6例病例的粪便或肛拭子标本进行实时荧光定量PCR检测,结果显示,该6例病例粪便或肛拭子标本空肠弯曲菌均为阳性,1名厨师肛拭子标本空肠弯曲菌和结肠弯曲菌实时荧光定量PCR均为阳性。6例病例和1名厨师的粪便标本分离到7株空肠弯曲菌,为ST11329型,具有相同PFGE带型,耐药表型均为萘啶酸(nalidixic acid,NAL)+环丙沙星(ciprofloxacin,CIP)联合耐药。厨师粪便标本同时分离到1株结肠弯曲菌。结论本次急性胃肠炎暴发事件由空肠弯曲菌所导致。厨师带菌和弯曲菌宿主相关食品均可能是此次事件暴发的污染源。Objective Investigation and analysis of an acute gastroenteritis outbreak,to provide a basis for the formulation of prevention and control measures.Methods A case-control study was carried out on 5 August 2021 using a case study methodology.A total of six cases of acute gastroenteritis and one specimen from a cook′s stool or anal swab were collected for real-time fluorescence quantitative PCR detection of enteric pathogens and bacterial culture.Multilocus sequence typing(MLST)and pulsed-field gel electrophoresis(PFGE)were used for molecular typing of bacteria.The agar dilution method was used for antibiotic susceptibility analysis of the isolated strains.SPSS 25.0 was used for statistical analysis.Results A total of six suspected cases were searched in this event,and the clinical symptoms of the cases were fever(100.0%,6/6),abdominal pain(83.3%,5/6),diarrhea(66.7%,4/6),and dizziness(66.7%,4/6).Stool or anal swab samples collected from six cases were positive for Campylobacter jejuni by real-time fluorescence quantitative PCR,and anal swab samples from one cook were positive for Campylobacter jejuni and Campylobacter coli by real-time fluorescence quantitative PCR.A total of seven Campylobacter jejuni strains were isolated from six cases and one cook,which were ST11329 type and had the same PFGE band type,all with the combination resistance phenotype of nalidixic acid(NAL)and ciprofloxacin(CIP).One strain of Campylobacter coli was aslo isolated from a cook′s fecal specimen.Conclusion This outbreak of acute gastroenteritis is caused by Campylobacter jejuni.Both cook-carried pathogenic bacteria and Campylobacter host-associated foods are possible sources of contamination in this outbreak.

关 键 词：急性胃肠炎 空肠弯曲菌 暴发 脉冲场凝胶电泳 多位点序列分析 调查 分析 

分 类 号：R155.3[医药卫生—营养与食品卫生学]