一起食源性停乳链球菌类马亚型暴发感染调查

目的 调查一起食源性停乳链球菌类马亚型（streptococcus dysgalactiae subspecies equisimilis，SDSE） 暴发感染，为快速诊治SDSE 感染暴发积累经验。 方法 采集和分析驻京某部队2012 年9 月30 日- 10 月1 日暴发呼吸道感染70 例患者的流行病学资料、症状、体征，对比治疗前后实验室检查结果，进行流行病学和统计学分析。 结果 70 例患者中，表现为发热66 例（94.29%），咽痛62 例（88.57%）、扁桃体化脓36 例（51.43%）。其中38 例（54.29%） 咽拭子病原学培养结果为SDSE。患者治疗前后，白细胞计数（white blood cell count，WBC）、中性粒细胞比例（neutropenia leukocyte percent，N%）、C- 反应蛋白（C-reactive protein，CRP）、白细胞介素-6（interleukin-6，IL-6） 水平差异有统计学意义（P ＜ 0.01），降钙素原（procalcitonin，PCT） 阳性率差异无统计学意义（P ＞ 0.05）。 结论 食源性SDSE 致人群呼吸道暴发感染比较罕见，病原学分离鉴定是关键，血常规和IL-6 检测是较好的辅助检查和病情监测方法。

Infection with food-contaminated streptococcus dysgalactiae subspecies equisimUis during its outbreak

Objective To accumulate experience with the rapid diagnosis of infection with food-contaminated streptococcus dysgalactiae subspecies equisimilis （SDSE） during its outbreak. Methods Epidemiology data, symptoms, and signs of 70 patients with respiratory tract infection in a certain Chinese PLA unit stationed in Beijing during its outbreak from September 30, 2012 to October 1, 2012 were analyzed. Results Of the 70 patients, 66 （94.29%） were manifested as fever, 62 （88.57%） as sore throat, 36 （51.43%） as tonsillitis, and 38 （54.29%） were diagnosed with SDSE infection according to the cultured pharynx secretion. The number of white blood cells and neutrophils, the serum CRP and IL-6 levels were significantly lower after treatment than before treatment （P 〈 0.01）. However, no significant difference was found in serum procalcitonin level before and after treatment （P 〉 0.05）. Conclusion Respiratory tract infection with food-contaminated SDSE seldom occurs during its outbreak. Isolation and identification of SDSE are the key to its rapid diagnosis. Routine blood examination and serum IL-6 testing are the effective accessory examination and disease-monitoring methods.