一起由丁酸梭菌引起的婴儿E型肉毒中毒的实验室诊断  

Laboratory confirmation of an infant botulism case caused by type E BoNT producing Clostridium butyricum

作　　者：李孟寒 白莉 李凤琴 胡豫杰 赵帅[2] 林肖惠 李鑫 江涛 董银苹 LI Menghan;BAI Li;LI Fengqin;HU Yujie;ZHAO Shuai;LIN Xiaohui;LI Xin;JIANG Tao;DONG Yinping(NHC Key Laboratory of Food Safety Risk Assessment,China National Center for Food Safety Risk Assessment,Beijing 100021,China;Tianjin Centers for Disease Control and Prevention,Tianjin 300011,China;College of Food Science and Bioengineering,Tianjin Agricultural University,Tianjin 300384,China)

机构地区：[1]国家食品安全风险评估中心,国家卫生健康委员会食品安全风险评估重点实验室,北京100021 [2]天津市疾病预防控制中心,天津300011 [3]天津农学院食品科学与生物工程学院,天津300384

出　　处：《中国食品卫生杂志》2024年第12期1305-1310,共6页Chinese Journal of Food Hygiene

基　　金：北京市自然科学基金(7212146)。

摘　　要：目的对1例疑似婴儿肉毒中毒病例的粪便、相关食品和环境样品等44份样品进行实验室检测。方法参照国家标准检测方法GB 4789.12—2016,对采集到的样品进行肉毒毒素检测及产毒素梭菌的分离鉴定。结果患儿双手涂抹样品及尿布涂抹样品、患儿母亲双手涂抹样品、多次采集的患儿粪便及灌肠液样品经培养后,其培养物可使实验小鼠出现典型肉毒毒素中毒症状,继而死亡。培养物经胰酶处理后毒性增强。混合型及单价E型肉毒毒素诊断血清可对小鼠起到保护作用。从上述肉毒毒素呈阳性的样品中均分离到梭状芽孢杆菌,该菌经表型、PCR及荧光定量PCR检测后,结果为产E型肉毒毒素的丁酸梭菌。结论患儿的中毒原是由丁酸梭菌引起的E型肉毒中毒。Objective Laboratory confirmation was conducted on 44 stool,food and environmental samples from a suspected case of infant botulism.Methods According to the National Standard GB 4789.12—2016,Clostridium spp.isolation,identification and botulinum neurotoxins(BoNTs)determination were carried out.Results Mice injected with the culture supernatant of infant’s and mother’s hand swabs,infant’s diaper swab,infant’s stool and enema samples exhibited the typical signs of botulism before death.The toxicity of culture was enhanced after the treatment by trypsin.The polyvalent BoNTs antitoxin and the monovalent BoNT type E antitoxin could protect mice from death.Also,Clostridium was isolated from the above samples and further characterized by morphological characteristics,virulence gene PCR and strain identification qPCR.The result showed that Clostridium isolated from these samples were C.butyricum that harbors bont/e gene.Conclusion The patient was diagnosed with type E BoNT poisoning that produced by C.butyricum.

关 键 词：肉毒毒素 丁酸梭菌 婴儿肉毒中毒 E型肉毒中毒 

分 类 号：R155[医药卫生—营养与食品卫生学]