一起由副溶血性弧菌和变形杆菌引起的食物中毒调查报告

[目的]食物中毒的病原菌检测。[方法]采集食物中毒学生的肛拭子5份、剩余食物2份共7份标本按照GB/T4789-2003~[1]、WS/T9-1996~[2]、GB17012-1997~[3]进行检测。[结果]5份肛拭子中均检出副溶血性弧菌,其中4份肛拭子既检出副溶血性弧菌又检出奇异变形杆菌;1份肛拭子检出副溶血性弧菌,未检出奇异变形杆菌;1份肛拭子检出副溶血性弧菌、奇异变形杆菌、新港(纽波特)沙门氏菌和致病性大肠埃希菌;2份剩余食物均检出副溶血性弧菌和奇异变形杆菌。[结论]该起食物中毒是由副溶血性弧菌和变形杆菌混合感染引起的。     

一起因多种致病菌污染引发食物中毒的实验诊断和分析

目的:一起食物中毒的实验室调查分析.方法:采集病人肛拭8份、熟食砧板涂抹物2份,熟食菜刀涂抹物2份,操作台面涂抹物1份,熟食冰箱内壁涂抹物1份,剩菜3份,共17份样品进行检测.结果:8份肛拭中,检出3份副溶血性弧菌,其中1份肛拭同时检出奇异变形杆菌和河弧菌;1份熟食菜刀涂抹物中检出奇异变形杆菌;1份剩菜中同时检出副溶血性弧菌、奇异变形杆菌和溶藻弧菌.结论:本次食物中毒为致病性弧菌和奇异变形杆菌引起的食物中毒.     

一起2种致病菌引起食物中毒的检验分析

目的确定一起疑似细菌性食物中毒的病原菌。方法《食品微生物检验副溶血性弧菌检验》(GB4789.7-2013)、WS/T9-1996《变形杆菌食物中毒诊断标准及处理原则》。结果典型病例大便中都检出副溶血性弧菌和变形杆菌。结论根据流行病学调查和患者临床症状分析,结合实验室检测,证实此次食物中毒是由副溶血性弧菌和变形杆菌混合感染引起的。     

用PFGE方法鉴别分析同时检出副溶血性弧菌和变形杆菌的食物中毒

目的对一起可疑食物中毒的病原菌进行实验室诊断。方法按照国家标准检验方法GB/T4789-2003和WS/T9-1996附录A,对样品进行细菌分离培养,并对检出的两种致病菌分别用实时荧光PCR方法检测毒力基因和用脉冲场凝胶电泳(PFGE)进行分子分型。结果12份患者和食品、环境标本中,分离出4株副溶血性弧菌、7株奇异变形杆菌。检测4株副溶血性弧菌的毒力基因TDH,结果均为阳性;7株奇异变形杆菌的PFGE分型结果为不相关关系。结论结合流行病学资料、病原菌分离鉴定、毒力基因检测和分子分型结果分析,证实这是一起由副溶血性弧菌引起的食物中毒。     

2011-2013年广州市某区细菌性食物中毒病原菌分析

目的为了解广州市某区近几年引起细菌性食物中毒常见病原菌的种类、特点,为今后预防和控制细菌性食物中毒提供科学依据。方法按照国家或卫生部相关标准,对疑似细菌性食物中毒样本进行病原菌检测,资料采用Excel 2003等软件进行统计分析。结果 5种不同类型的样本中,病原菌检出率较高的是病人肛拭子或呕吐物(57.30%)和水样(45.50%)。502份细菌性食物中毒样本检出致病菌的共141份,检出率为28.10%。其中蜡样芽孢杆菌、奇异变形杆菌和副溶血性弧菌检出率较高,分别为10.00%、9.60%和6.40%。病人肛拭子或呕吐物中,检出率较高的病原菌是奇异变形杆菌(29%)和副溶血性弧菌(26%);水样检出率较高的病原菌是副溶血性弧菌(27%)和蜡样芽孢杆菌(18.00%);公用具、手涂抹棉拭子检出率较高的病原菌是蜡样芽孢杆菌(20.00%)和奇异变形杆菌(10.00%);食品中检出率较高的病原菌是蜡样芽孢杆菌(15.00%)。结论该区细菌性食物中毒以蜡样芽孢杆菌、奇异变形杆菌和副溶血性弧菌为主,今后可重点监测、预防上述致病菌引起的食物中毒。采样时要抽采病人和有针对性的样品,以防误检或漏检。蜡样芽胞杆菌呕吐毒素的检测方法有待开发和完善。     

一起混合菌引起食物中毒的检测与分析

目的一起集体进餐后引起的食物中毒病因的查找。方法采集病人的肛拭子、剩余食物及用具容器的涂抹样共26份样本,按食品卫生微生物检验学方法《GB/T4789-2003》和《变形杆菌食物中毒诊断标准和处理原则》WS/T9-1996方法,并参考《卫生防疫细菌检验》进行检测。结果26份样品中有15份样本检出副溶血性弧菌（Vibrio parahaemolyticus）,有21份样本中检出奇异变形杆菌,其中有15份样品同时检出副溶血弧菌和奇异变杆菌。结论该次食物中毒事件,根据实验室检验结果,结合流行病学调查和病人的临床症状,确认是一起由奇异变形杆菌和副溶血性弧菌混合污染引起的食物中毒。     

一起由多种致病菌引起食物中毒的调查分析

目的 :对食物中毒的原因进行调查分析。方法 :对中毒场所和人员进行现场调查、个案调查及采集样品进行实验室检查。结果 :在留样饭菜中检出奇异变形杆菌、溶藻弧菌及副溶血性弧菌 ;中毒人员的大便肛拭检出副溶血性弧菌、气单孢菌和溶藻弧菌。结论 :该起食物中毒是一起因食品加式经营环境受到广泛性严重污染而引起的以副溶血性弧菌为主、多种致病菌同时污染的细菌性食物中毒。在加强学校食堂卫生监督力度的同时 ,应制定一套应对突发污染事件的预案 ,以防止和杜绝食物中毒的发生     

深圳市福田区副溶血性弧菌食物中毒的流行病学特征

目的了解深圳市福田区副溶血性弧菌食物中毒的流行病学特征,为该类食物中毒的预防控制提供依据。方法查阅2007年以来副溶血性弧菌食物中毒的档案资料,副溶血性弧菌食物中毒样品的分离根据国标GB/T 4789.7-2003进行,用GNID革兰阴性菌鉴定板进行生化鉴定,用血清玻片凝集实验进行血清学分型,用法国梅里埃ATB Fungs酵母菌药敏反应板进行药敏实验。结果副溶血性弧菌食物中毒主要发生在8、9月,中毒食物以凉拌菜和未彻底加热的熟肉食品为主。血清型主要以O3∶K6型为主,占50.0%。副溶血性弧菌对氨苄西林(AMP)、替卡西林(TIC)、头孢唑啉(KZ)的耐药率分别为61.5%、50.0%和42.3%。结论要重点防制O3∶K6型副溶血性弧菌食物中毒,在治疗时应合理用药。     

一起奇异变形杆菌食物中毒调查

[目的]调查分析某企业食堂暴发的一起食物中毒事件,探讨大型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,采集食堂留样及加工食品的用具、餐具及半成品猪肉和患者肛拭物进行检测。[结果]该起食物中毒罹患率4.7%(69/1 480),部分肛拭样品中检出副溶血性弧菌和奇异变形杆菌阳性,餐具(饭盆)中检出奇异变形杆菌,半成品猪肉未检出致病菌。[结论]综合流行病学调查和临床症状、体征及实验室检测结果,认为食物和餐具受污染是引起食物中毒的主要原因。     

一起急性食物中毒病原学检验与分析

[目的]检测分析一起食物中毒的病原菌。[方法]采集食物中毒患者的肛拭子12份,剩余食物12份,呕吐物1份,按GB／T4789—2003《食品卫生检验方法微生物部分》等进行检验。[结果]从患者肛拭子与可疑食物中检出奇异变形杆菌和副溶血性弧菌。用2种细菌测定病人恢复期血清抗体比初期抗体呈4倍以上增长。[结论]本次食物中毒由副溶血性弧菌和变形杆菌混合感染引起。     

An investigation into in vitro methods for the detection of chlorhexidine resistance

During an outbreak of catheter-related urinary tract infection, due to Proteus mirabilis, it was suggested that the epidemic strain was resistant to chlorhexidine. In this study, the minimum inhibitory concentrations (MICs) of chlorhexidine to the epidemic Pr. mirabilis and other laboratory isolates were tested in different media. Results were compared with killing times using 1/4 strength Ringers solution, normal human urine and the in vivo killing times in two patients' catheter bags. It was found that the MIC test was unreliable in the assessment of chlorhexidine resistance as it was dependent on the medium used, the inoculum size, and the age of the culture. The test which gave results closest to the in vivo experiments was the killing curve in normal human urine. It is concluded that chlorhexidine resistance is a complex phenomenon which is difficult to evaluate. If in vitro tests are to be used to evaluate the clinical relevance of reduced sensitivity to chlorhexidine, they must mimic the in-use conditions as closely as possible.     

一起布利丹沙门菌食物中毒的调查

目的 查明导致本次食物中毒事件的食物种类、致病因子及传染源.方法 在临床诊断病例中,随机抽取50例作为病例组,随机选择参加宴席且无任何临床症状的50人作为对照组,开展病例对照研究,并分析导致本次事件的危险食物.结果 本次食物中毒的罹患率为43.4%(132/304),86.0%(43/50)的病例和34.0%(17/50)的对照食用过猪头肉凉拌粉条(OR=12.0,95%CI:4.4～32),进一步对食用过猪头肉凉拌粉条者分析其剂量反应关系,趋势x2=21.06,P=0.00.94.0%(47/50)的病例和68.0%(34/50)的对照食用过蘑菇炖鸡(OR=7.4,95%CI:2.0～27),不存在剂量反应关系.病例组和对照组食用其余食物的差异无统计学意义(P>0.05).对猪头肉凉拌粉条和蘑菇炖鸡与发病之间的关系进行叉生分析,以两种食物均未食用者作为参照,结果 表明,单食用两种食物之一者发病危险度的点值估计均升高,但差异均无统计学意义;而两种食物均食用者发病风险大大增加(OR=38,95%CI:4.5～320),差异有统计学意义.19份标本检测肠道致病菌中3份病例肛拭子和1份猪头肉凉拌粉条检出布利丹沙门菌.结论 该事件是因参加宴席的人食用被布利丹沙门菌污染的猪头肉凉拌粉条或蘑菇炖鸡引起的细菌性食物中毒,其原因可能为食品加工过程不规范所致.

Abstract：

objective To identify the bacterial pathogen in food and the source of infection that might be responsible for a food poisoning outbreak.Methods All the probable cases that had attended the banquet in a villige of Sichuan province who had developed fever(≥37.5℃),diarrhea (≥3 times/dav)and vomiting since August 1,2009,were identified.A case-control study was conducted to identify the foods that might be responsible for this food poisoning event.50 cases were randomly selected from the probable cases and 50 controls were randomly selected from those without the symptoms.Results The attack rate of this food poisoning event was 43.4%(132/304).86.0%(43/50)of the cases and 34.0%(17/50)of the controls had eaten pork-mixed-vermicelli(OR=12.0,95%CI:4.4-32).Data from further tests showed that dose-effect relation existing between eating pork mixing vermicelli behavior and the incidence rates(Chi-square trend:x2=21.06,P=0.00)of the disease.94.0%(47/50)of the cases and 68.0%(34/50)of the controls had eaten mushroom braising chicken(OR=7.4.95%CI:2.0-27).Data from the crossover analysis showed that there appeared an effect modification between behaviors of eating pork-mixed-vermicelli and eating mushroom braising chicken.Three cases were detected carrying Salmonella blegdam from their anus swabs and the same bacteria type was also detected in the pork-mixed-vermicelli. Conclusion This outbreak of salmonellosis was caused by Salmonella blegdam contaminated pork-mixed-vermicelli or mushroom braising chicken during food processing.     

脉冲场凝胶电泳技术对一起变形杆菌引起的食物中毒的分型研究

目的：运用脉冲场凝胶电泳（PFGE）技术对变形杆菌进行分析。方法：对本地区一起由奇异变形杆菌引起的食物中毒进行常规鉴定后,对分离到的菌株进行PFGE分析,观察引起食物中毒的菌型是否为同一菌株引起。结果：此次食物中毒共分离到6株奇异变形杆菌,其中4株肛拭子中分离,2株剩余食品中分离,除一株从肛拭子分离的外,其余5株的PFGE型别相同。结论：此次食物中毒的爆发为同一株奇异变形杆菌引起,PFGE可以作为食物中毒中对细菌进行鉴定的分析技术。     

A hospital outbreak caused by a chlorhexidine and antibiotic-resistant Proteus mirabilis

An outbreak of urinary-tract infection involving a strain of Proteus mirabilis resistant to gentamicin and several other antibiotics affected 90 patients in Southampton between July 1980 and May 1985. The outbreak strain was also resistant to chlorhexidine and this, in combination with the antibiogram and Dienes' test, permitted differentiation from other P. mirabilis strains. The outbreak had features in common with other Enterobacteriaceae outbreaks, although certain aspects of the population involved have made it particularly difficult to control. The outbreak commenced shortly after the introduction of a catheter care policy which involved the use of chlorhexidine, and although the majority of the cases were colonized before this policy was enforced, chlorhexidine had been used extensively for other procedures within the district. Preliminary evidence suggests that there is no genetic linkage between the chlorhexidine and multiple antibiotic resistance.     

食物中毒中不同血清型副溶血性弧菌基因特征分析

目的对2起食物中毒中不同血清型的副溶血性弧菌进行基因特征分析。方法第1起食物中毒发生在2010年5月17日深圳市某食堂,感染人数20人左右,采集到病人肛拭子9份,可疑食品3份,每份样本挑取20个可疑菌落;第2起食物中毒发生在2010年7月1日深圳市某配餐中心,感染人数10人左右,采集到病人肛拭子7份,可疑食品2份,涂抹样3份,每份样本挑取10个可疑菌落。对可疑菌落分别进行盐耐受试验、生化试验和血清学鉴定。从2起食物中毒的每份样本中挑取不同血清型进行tdh、trh、GS—PCR、orf8基因检测和脉冲场凝胶电泳分析（PFGE）。结果第1起食物中毒分离到副溶血性弧菌180株,其中03：K6107株,02：K2870株,04：K34、03：K25、04：K12各1株;第2起食物中毒分离到副溶血性弧菌80株,其中03：K644株,04：K8、011：K36、011：K19各10株,01：K566株。03：K6、01：K56、04：K8、011：K36携带tdh基因,不携带砒基因,其他血清型（02：K28,04：K12,03：K25,04：K34,011：K19）均不携带tdh和f砘基因。03：K6和011：K362种血清型的GS-PCR和orf8基因阳性,其他血清型阴性。PFGE结果显示第1起食物中毒中食品和病人肛拭分离的02：K28（分别3、2株）的PFGE带型基本一致,属高度相关菌株。第2起食物中毒中病人肛拭分离的4株03：K6与卤鸡蛋盘涂抹样分离的1株03：K6PFGE带型一致。2起食物中毒的03：K6带型基本一致。来自相同样本不同血清型的副溶血性弧菌的PFGE带型不一致。结论第1起食物中毒与食用污染了副溶血性弧菌的食品有关,第2起食物中毒与污染了副溶血性弧茵的卤鸡蛋盘有关。通过血清分型和分子生物学分析,可认为相同样本中分离的不同血清型副溶血性弧菌未发现遗传学证据,为遗传不相关菌株。     

2011年山东聊城市食源性致病菌检测结果分析

目的了解聊城市食源性致病菌污染的状况,为食品安全监管和预防控制食源性疾病提供依据。方法依照《食品卫生标准检验方法》GB/T 4789-2003、《食品卫生标准检验方法》GB 4789-2010标准要求进行检验。结果调查采集12类食品301份样品,共检出致病菌49株,总检出率16.28%。其中金黄色葡萄球菌检出率6.67%,沙门菌检出率1.33%,单增李斯特菌检出率4.40%,阪崎杆菌检出率40.00%,副溶血弧菌检出率8.00%,大肠埃希菌O157检出率4.67%;未检出空肠弯曲菌、蜡样芽孢杆菌和志贺菌。结论食源性致病菌在聊城市流通领域食品中有不同程度的污染,特别是婴幼儿配方奶粉受到较严重的污染,存在安全隐患,应加强监督管理,防止食源性疾病暴发。     

An outbreak of Bacillus cereus implicating a part-time banquet caterer

CONTEXT AND OBJECTIVES: In the aftermath of a party, 70% (25 of 36) of attendees had gastroenteritis. The objectives of this study were to identify a risk factor associated with the food during the banquet and to identify measures of control for avoiding this kind of outbreak in the future. METHOD: A retrospective cohort study was used. We tried to reach by telephone all guests who had attended this banquet. A standardized questionnaire was used to provide information about identification of a risk factor, especially in relation to food. RESULTS: The cohort study has shown that potato salad served at the party was significantly associated with the disease. The mayonnaise used to prepare the salad was analyzed and Bacillus cereus was isolated (10(3) bacteria per gram). DISCUSSION: Bacillus microorganisms are usually found in decaying organic matter, dust, soil, vegetables and water. The bacteria has a remarkable ability to survive strong environmental stresses. There are strains of B. cereus that can cause food poisoning episodes with infective doses as low as 10(3) to 10(4) bacteria per gram. B. cereus is an infrequently reported cause of foodborne illnesses in Quebec and in North America but this may be due to underreporting of episodes. In this outbreak, bacterial multiplication was facilitated at several points in the interval between the preparation of the meal and the consumption of the banquet by the guests. Because the spores are ubiquitous and resistant to inactivation with most food grade disinfectants, temperature control should be the main focus of B. cereus outbreak prevention. CONCLUSION: The meal was prepared by a restaurateur who was inexperienced in catering services and temperature control in particular when food is served outside the restaurant. This outbreak underscores the importance of maintaining meticulous hygienic procedures in food processing. Restaurateurs who offer catering services should be familiar with the constraints that are specific to this sector of the food industry.     

非典型致病性大肠埃希菌引起食物中毒病原学研究

目的:对一起食物中毒暴发流行的病原体进行分离鉴定和分子流行病学研究。方法:采集患者和厨工肛拭子、末梢水及物表涂抹拭子共90份。通过分离鉴定、生化试验和血清学试验,确定病原菌后采用实时荧光PCR方法分别检测病原菌毒力基因eaeAi、paHs、tl、ts、tx1与stx2存在情况。其中4株病原菌全基因组经限制性内切酶XbaI酶切后,通过PFGE获得电泳图谱并进行同源性分析。结果:90份标本中22份样品分离出携带eaeA基因的EPEC。BioNumerics分析结果显示4株EPEC PFGE带型完全相同,表明来源于同一克隆株。结论:这起食物中毒是由带eaeA基因非典型EPEC引起的暴发流行。     

A large outbreak of gastroenteritis associated with a small round structured virus among schoolchildren and teachers in Japan

In March 1989 a large outbreak of acute gastroenteritis occurred simultaneously among schoolchildren and teachers at nine elementary schools in Toyota City, Japan. Illness was observed in 3236 (41.5%) of 7801 schoolchildren and 117 (39.4%) of 297 teachers. The main clinical symptoms were diarrhoea, vomiting, nausea and abdominal pain. Gastroenteritis was significantly associated with the consumption of school lunch served by one particular lunch preparation centre. One food handler at the centre suffered from gastroenteritis during the outbreak. Small round structured virus (SRSV) was detected in 4 of 8 stool specimens from sick persons. The school lunch contaminated by the infected food handler is the most probable source of this outbreak due to SRSV.     

The problem of aflatoxic human disease in parts of India-epidemiological and ecological aspects

An outbreak of a disease characterised by jaundice, rapidly developing ascites and portal hypertension associated with 20 p. 100 mortality rate was investigated in 1974. Analysis of food samples revealed that the disease outbreak was due to the consumption of maize (corn) heavily infested with the fungus Aspergillus flavus. Unseasonal rains prior to harvest, chronic drought conditions, poor storage facilities and ignorance of dangers of consuming fungal contaminated food seem to have caused the outbreak. The level of aflatoxin in food samples consumed during the outbreak was ranging between 2.5 and 15.6 microgram/g. Anywhere between 2 and 6 mg of aflatoxin seems to have been consumed daily by the affected people for many weeks. In contrast, during 1975, analysis of corn samples from the same areas revealed very low levels of aflatoxin, viz., less than 0.1 microgram/g. This was in line with the absence of major outbreak in 1975.