西昌市一起农村聚餐引起的沙门氏菌食物中毒事件调查分析

目的通过对一起农村聚餐引起的沙门氏菌病暴发事件进行调查分析,为采取防控措施、杜绝类似事件发生提供依据。方法2019-05-20西昌市某村发生一起农村聚餐引起的食物中毒事件,对事件进行详细的流行病学调查、现场卫生学调查,并采集剩余食品9份、调味品8份、碗、盘子、筷子各2份及患者肛拭子5份进行致病菌指标、理化指标检测,对调查数据和检测结果进行分析。结果此次事件共搜索到28例病例,均有一次共同聚餐史,在剩余食品、调味品、餐具及患者肛拭子中检测出沙门氏菌E群、伦敦沙门氏菌2种沙门氏菌。结论此次事件是一起同时由2种沙门菌污染食物引起的感染性腹泻,提示有关部门要加强对食源性疾病的监测和对农村家宴的管理等工作。     

猪霍乱沙门菌引起食源性疾病的病原学鉴定

目的了解一起食源性疾病病因,预防此类事件的再次发生。方法对就餐人群进行流行病学调查,对现场进行卫生学调查,对可疑食品、患者粪便及肛拭子进行致病菌培养分离,运用分离出的致病菌对患者血清进行凝集实验。结果就餐308人,发病43人,罹患率为13.96%,共采集19份样品,从2份患者粪便、3份肛拭子及1份凉拌猪耳朵样本中检出猪霍乱沙门菌。结论根据现场流行病学调查及实验室检测结果分析,确诊为一起猪霍乱沙门菌引起的食源性疾病。应加强食品安全宣传力度,提高人民群众食品安全意识,有效控制食源性疾病的发生。     

某宾馆奇异变形杆菌食物中毒调查

目的 调查分析某宾馆发生的一起食物中毒事件,探讨餐饮企业在预防此类事件的措施和对策.方法 对食物中毒者展开流行病学调查,采集宾馆剩余食品、餐具、工作人员和患者肛拭物进行检测.结果 该起食物中毒罹患率10％ (67/670),26名患者肛拭样品中检出奇异变形杆菌阳性和嗜水气单胞菌混合感染,采集10份食品,其中1份食品中检出奇异变形杆菌,其余检品未检出致病菌;26名患者阳性标本均对左氧氟沙星和丁胺卡那敏感.结论 该起食物中毒主要由食物受污染引起,加强对餐饮业的卫生监督,促其完善卫生条件,可有效预防食物中毒的发生.     

肠炎沙门菌食物中毒中PFGE的应用

目的对2014年武汉市某区一起食物中毒事件的病原体进行分离鉴定及同源性分析。方法参照GB4789-2012和WS/T 13-1996的方法进行病原菌的分离培养,对检出菌进行表型鉴定;采用脉冲场凝胶电泳(PFGE)分型方法对检出菌及实验室收集的其他肠炎沙门氏菌进行分子分型和流行病学特征分析;采用WHO推荐的改良K-B法对检出菌进行抗生素敏感试验结果流行病学调查及实验室病原学检测证实,本起事件是一起由肠炎沙门氏菌引起的食物中毒,共分离到18株肠炎沙门氏菌。分离自该事件可疑食物及患者肛拭子的肠炎沙门氏菌相似系数为100%,与同一时期散发临床患者分离的肠炎沙门氏菌相似系数约为90%,与2012年健康体检分离株及2013年、2014年临床患者分离株最小相似系数>90%。此次食物中毒株对所检测药物敏感性较好。结论此次食物中毒病原菌为本地区流行的肠炎沙门氏菌优势株。PFGE可用于细菌性食物中毒的溯源分析。     

1起ST19型鼠伤寒沙门氏菌引起的食物中毒调查、溯源分析与探讨

目的 分析武汉市某区1起食物中毒事件的致病原因,探讨分离菌株之间的分子流行病学关系,为食源性疾病暴发溯源和临床诊治提供参考依据。方法 采集食物中毒相关样本20份,提取样本总DNA进行18种食源性致病菌多重PCR检测,同时按时GB4789.4-2016进行病原菌分离鉴定;应用传统玻片凝集法和微量肉汤稀释法对阳性菌株进行血清型分型和耐药性检测,并提取所有菌株核酸进行全基因组测序组装,利用Abricate和SeqSero在线预测每株菌的血清型和耐药基因,然后与传统方法进行比较分析。对分离的9株沙门氏菌分别采用脉冲场凝胶电泳(PFGE)和全基因组序列方法(WGS)递进分析。结果 共检出12株沙门氏菌(菌株编号DXH001～DXH012),其中病例肛拭子样本7份、病例粪便样本2份,工作人员肛拭子样本3份。常规血清型分型均为B群鼠伤寒沙门氏菌,与全基因组测序鉴定分型结果一致。12株菌株耐药谱完全一致,对阿米卡星、氨苄西林、头孢唑啉、庆大霉素、哌拉西林、四环素均耐药。基于全基因组预测的氨基糖苷类、头孢菌素、青霉烷、四环素的耐药性与耐药表型结果完全一致。选取DXH001～DXH009开展PFGE和WG...     

双毒力基因副溶血性弧菌引起食物中毒病原学分析

目的分析引起食物中毒的病原菌,掌握分离株生化、血清学、毒力基因、耐药性状况。方法采集患者肛拭子标本,进行分离鉴定、耐药性分析、血清学分型,实时荧光PCR法检测毒力基因tdh、trh。结果 3份肛拭子中分离出O3、O1 2株不同血清型的副溶血性弧菌;2株菌株均对氨苄西林耐药;1株同时携带毒力基因tdh和trh。结论这是一起由2种血清型副溶血性弧菌引起的食物中毒,菌株携带双毒力基因可能是导致此次食物中毒患者临床表现较重的原因。     

一起生活饮用水突发性污染事件的调查与分析

目的通过对新疆伊宁市一起生活饮用水污染事件调查,明确污染原因,采取有效措施消除污染,预防此类事件再次发生。方法采用现场流病学调查方法进行调查,采集的水样按《生活饮用水标准检验方法》进行检验,并依据《生活饮用水卫生标准》评价;肛拭子标本按照《新疆细菌性肠道传染病监测方案》（2012版）、《食品微生物学检验》、《食品卫生安全国家标准》,分离鉴定及评价。结果从40人份肛拭子标本中检出致病性大肠埃希氏菌O111∶K584份,检出福氏志贺氏1a型3、4群志贺氏菌2份;75份水样中菌落总数超标24份,超标率为32%,总大肠菌群超标22份,超标率29%,耐热大肠菌群超标21份,超标率28%;检出致病性大肠埃希氏菌O111∶K588份,检出福氏志贺氏1a型3、4群志贺氏菌3份。结论本起中毒事件为一起生活饮用水污染引发的群发性细菌性痢疾,应总结污染事件的经验教训,制定防范措施和对策,杜绝水源污染事故发生,保护农村居民的身体健康。     

一起医院内诺如病毒感染性腹泻事件的调查

目的调查分析一起医院内群体性感染性腹泻的原因，为制定防控措施提供科学依据。方法结合现场流行病学调查，采集粪便标本2份、肛拭子标本5份进行肠道致病菌、诺如病毒检测。结果本次疫情流行9d，发病22例（住院病人15例，护工1例，清洁工1例，医务人员5例），罹患率23．91％。2份粪便标本、4份肛拭子标本检出G11型诺如病毒核酸阳性。通过采取隔离治疗感染病例、消毒环境及物品、对医务人员及病人卫生宣教等综合措施，疫情得到及时控制。结论这是一起由诺如病毒感染所致的感染性腹泻事件，密切接触是本起疫情的主要传播途径。     

肠炎沙门菌食物中毒34例临床分析CSCD

沙门菌是人兽共患菌,有2500多个血清型,以鼠伤寒和肠炎沙门菌感染最常见。在我国,沙门菌是感染性腹泻最常见的细菌性病原,也是食物中毒暴发最常见的病原[1]。沙门菌在含盐高达10％～15％的肉类中能生存达数月,故进食受污染的腌制肉类可获得感染。为了进一步提高认识,本研究对2016年11月至12月宣城市人民医院感染科收治的一起肠炎沙门菌食物中毒事件中34例患者的流行病学、临床表现及诊疗过程进行分析。     

2012年新疆泽普县一起伤寒沙门氏菌引起的食物中毒调查报告

目的调查新疆泽普县一起伤寒沙门氏菌引起的食物中毒事件的发生原因和流行特点,为今后防治同类事件提供科学依据。方法采用流行病学调查方法查找本起食物中毒有关的可疑食品,对食品出售场所进行现场卫生学调查,了解出售场所卫生状况,并采集食用者的剩余食品、患者腹泻样本进行沙门氏菌检测。结果本次食物中毒事件中发生食物中毒患者199例,死亡2例,病死率1.01%;临床症状以腹泻(100.00%)、乏力(97.22%)、腹痛(94.44%)、头痛(94.44%)、恶心(94.44%)、呕吐(86.11%)、发热(75.00%)为主要表现;从1份烤鸡及3份患者腹泻样本中分离出伤寒沙门氏菌,其他检测结果均为阴性。结论结合临床表现、现场流行病学调查、食品卫生学调查及实验室检测结果综合判定为一起伤寒沙门氏菌污染烤鸡引起的食物中毒,经采取针对性的预防控制措施控制了事件的蔓延。     

Recovery and its evaluation of Shigella bacilli or Salmonella from healthy food handlers in Tokyo (1961-1997)]

Since 1961, recovery of Shigella bachilli from healthy food handlers in Tokyo has been carrying out, and detection of Salmonella carriers has also been adding from 1980. Recovery rate of Shigella has decreased from 0.28% (589 cases) in 1961 to 0.01% (9 cases) in 1969, and 7 cases between 1971 and 1975 and only 3 carriers since 1976 have been detected. On the other hand, Salmonella has been detected from about 9,000 cases (0.07%) during 18 years. The isolates were typed into 150 serovars, in which the most frequent one was S. Enteritidis, following S. Litchfield, S. Thompson, S. Hadar, S. Typhimurium, S. Infantis, S. Tennessee, S. Montevideo, S. Agona and S. Braenderup. These serovars except S. Agona caused in 90% of 1,650 Salmonella food poisoning outbreaks which had occurred between 1980 and 1996. Recovery of S. Enteritidis from healthy subjects increased year by year since 1989, and this tendency was well consistent with the increase of food poisoning outbreak caused by this serovar. These results indicate that the recovery of carrier with enteropathogen from food handlars is significant as preventive measures or food hygiene.     

Isolation of enterotoxigenic Staphylococcus aureus from pet dogs and cats: a public health implication

Staphylococcus aureus is a globally distributed bacterium causing wide variety of illnesses in humans, which attributed to its ability to produce wide array of virulence factors, including enterotoxins that are responsible for staphylococcal food poisoning outbreaks. The current study was carried out to investigate the prevalence of enterotoxigenic S. aureus among pet dogs and cats and its public health implication. For this purpose, nasal, oral, and wound swabs were collected from 70 dogs and 47 cats, whereas nasal swabs were collected from 26 human contacts. All samples were examined for the presence of enterotoxigenic S. aureus by isolation of S. aureus in culture media and then tested by specific ELISA kits to detect the produced toxins in bacterial cultures. The prevalence of enterotoxigenic S. aureus was 10% and 2.1% for pet dogs and cats, respectively, whereas the nasal carriage rate in human contacts was 7.7%. The majority of animal isolates were obtained from mouth of the apparently healthy animals. All types of staphylococcal enterotoxins were detected in both animal and human isolates. High prevalence of enterotoxigenic S. aureus among pet dogs highlights the possibility of zoonotic transmission to human contacts leading to nasal and/or hand carriage of such strains; thus, pet animals may be incriminated in the epidemiology of household staphylococcal food poisoning outbreaks.     

河南省鹤壁市食源性和禽源性沙门氏菌耐药性研究

目的了解河南省食源性和禽源性沙门氏菌菌型分布和耐药性的关系。方法随机采集生鸡肉和大型养鸡场不同鸡龄的鸡肛拭子标本,按照GB/T4789.4 2008进行沙门氏菌的分离和鉴定,琼脂平板稀释法对分离株进行药敏测定,结果依照CLSI/NCCLS(2005版)进行判定。结果生鸡肉沙门氏菌检出率为81.5%;鸡肛拭子总体检出率为14.1％,其中种鸡检出率(18.4%)高于小鸡(15.3%),高于待宰成年鸡(2.0%)。不同鸡龄分离的沙门氏菌耐药谱明显不同,来自小鸡和成年待宰鸡的沙门氏菌耐药严重,而来自种鸡的沙门氏菌几乎不耐药;生鸡肉和鸡肛拭中沙门氏菌型别不同。食源性和禽源性沙门氏菌耐药谱明显不同,但均具有严重的多重耐药现象。结论河南省食源性和禽源性沙门氏菌菌型不同,耐药谱不同,但均存在严重的多重耐药现象,不同鸡龄检出沙门氏菌耐药谱存在较大差异,提示在鸡的饲养过程中,抗生素的不合理使用情况比较严重。     

A case of cervical abscess caused by Salmonella enteritidis after intestinal infection

Salmonella Enteritidis often causes food poisoning. In this study, an extremely rare case of cervical abscess caused by S. Enteritidis is reported. In January 2003, a 44-year-old man visited our hospital with swelling of the left submandibular region. He had been suffering from a severe diabetic condition but had neglected to seek medical attention. An incision was made at the abscess to drain the pus from which only S. Enteritidis was isolated. This finding led to the discovery that he had suffered from an episode of food poisoning 6 months earlier. However, the organism was not isolated from the stool. The patient recovered with the administration of panipenem/betamipron and gatifloxacin. The S. Enteritidis strain isolated from the pus obtained from this case and that detected from the samples originating from the other patients during the episode of food poisoning 6 months earlier were examined by using pulse-field gel electrophoresis (PFGE). The PFGE patterns of the strains were almost identical. The molecular epidemiological analysis by PFGE was useful in estimating the infection route. In an immuno-compromised host such as those suffering from diabetes mellitus, one must be reminded that unusual bacteria (including S. Enteritidis) may cause a cervical abscess.     

Food poisoning in a hospital staff canteen

Eighty-two confirmed cases of salmonella food poisoning arose among hospital staff due to consuming contaminated tartar sauce served in the staff canteen. Many key personnel were affected and the hospital was closed to non-urgent admissions. In order to maintain the accident and trauma services, the normal policy of excluding infected persons from work had to be modified. Staff returned to work 48 h after they had become asymptomatic provided that they did not have contact with patients' mouths, food or drink. There were no secondary cases. During the investigation of the outbreak, lack of national guidelines for the preparation and handling of mayonnaise-based food products became apparent.     

2018-2021年南山区食物中毒中肠炎沙门氏菌与布利丹沙门氏菌遗传特征和耐药性分析北大核心CSCD

目的分析2018-2021年南山区食物中毒样品中分离的肠炎沙门氏菌(Salmonella Enteritidis S.Enteritidis)与布利丹沙门氏菌(Salmonella Blegdam.S.Blegdam),从遗传特征和耐药性角度了解细菌间的亲缘进化关系和耐药特征、为食源性疾病暴发溯源和临床诊治提供参考依据。方法分别对33株沙门氏菌采用脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)与全基因组序列方法(Whole genome sequencing,WGS)分析,同时测定30种药物的最小抑菌浓度(minimal inhibitory concentration,MIC)。结果33株菌分为8个PFGE型别,MLST型均为ST11型。全基因组k-mer系统发生树可见9簇。氨苄西林(AMP)、头孢唑啉(CFZ)、萘啶酸(NAL)、磺胺异噁唑(Sul)4种抗菌药物的检出率较高,均大于50%。20株菌对3类以上的药物耐药(60.60%),属于多重耐药,7株菌产ESBL酶。15株菌的耐药基因与耐药表型完全符合。结论2018-2021年,南山区由沙门氏菌引起的食物中毒事件中,沙门氏菌的总体遗传距离较近,但与数据库中其它肠炎沙门氏菌遗传距离较远,自成一簇。本研究中的沙门氏菌多重耐药现象严重,需加强对多重耐药株的监控及抗菌药物使用的监管。     

An infant with a mild SARS-CoV-2 infection detected only by anal swabs: a case report

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China and has spread rapidly worldwide. We present a mild SARS-CoV-2 infection in a baby with non-productive cough and normal chest computed tomography, in whom only anal swabs tested positive by real-time PCR testing for SARS-CoV-2. She was given atomization inhalation therapy with recombinant human interferon alfa-1b for 10 days. Her anal swabs remained positive for eight days, whereas her throat swabs were persistently negative by real-time PCR testing. Mild and asymptomatic cases, especially in children, might present with PCR negative pharyngeal/nasal swabs and PCR positive anal swabs. Those patients are potential sources of infection via fecal–oral transmission for COVID-19.     

Research note: Molecular subtyping of Salmonella enterica serovar Tshiongwe recently isolated in Malaysia during 2001-2002

Pulsed field gel electrophoresis (PFGE) and antimicrobial susceptibility analysis were undertaken on twenty-three strains of Salmonella enterica serovar Tshiongwe, an unusual serovar, which recently emerged in Malaysia. Antimicrobial susceptibility analysis showed that all the strains were sensitive to ampicilin, chloramphenicol, cotrimoxazole, and kanamycin. Twenty (87%) and 8 (3.5%) strains had resistance to tetracycline and streptomycin respectively. PFGE analysis subtyped 23 strains into 10 profiles (Dice coefficient of similarity, F = 0.7-1.0). The predominant profile, X1 was found in both clinical and environmental isolates and was widely distributed in different parts of Malaysia during the study period. In addition, isolates recovered from food, a hand-towel, apron and the surface of a table-top in one particular location had unique, indistinguishable profiles (X4/4a) and identical antibiograms. Similarly, isolates from cooked meat and a chopping board had PFGE profiles similar to some human isolates. These probably indicated cross-contamination and poor hygiene in food practices, hence contributing to Salmonellosis. Factors causing the emergence of this rare Salmonella serovar being responsible for food poisoning episodes during the study period remained unclear. The study reiterated the usefulness and versatility of PFGE in the molecular subtyping of this rare Salmonella serovar in Malaysia.