一起由鼠伤寒沙门菌引起食源性疾病的调查

目的探究一起群体性食源性疾病的病因。方法依据GB／T4789—2003、GB15984—1995、GB17012—1997、GB16002—1995进行调查和致病菌检测。结果7份患者肛拭样品检出鼠伤寒沙门菌,检出率33．3％;8份厨房工作人员肛拭中,5例检出鼠伤寒沙门菌,检出率62．5％。结论结合流行病学调查、临床资料和实验室检测结果进行分析,确认该次食源性疾病由鼠伤寒沙门菌所致。     

45株鼠伤寒沙门菌生化和血清学特性与分析

鼠伤寒沙门菌 (以下简称鼠伤寒菌 )过去对人类主要引起食物中毒 ,近年由鼠伤寒菌引起的医院内感染日益增加 ,已引起了人们的普遍重视。为给流行病学调查分析提供科学依据 ,我们把从不同标本中分离到的 4 5株鼠伤寒菌进行了系统生化和血清学鉴定。现将结果报告如下 :1　材料与方法1.1　菌株来源　 4 5株鼠伤寒菌分别从各县、区卫生防疫站和本站实验室、住院患者、食物中毒患者以及食品从业人员健康体检中获得。1.2　试剂和培养基1.2 .1　培养基　SS琼脂、半固体动力培养基均为北京陆桥技术有限公司产品。1.2 .2　生化试剂　枸橼酸盐、甘露醇…     

一起由食用皮蛋引起的食物中毒的病原学分析

目的:通过流行病学及实验室检测结果分析中毒原因。方法:参照GB/T4789.4-2008方法对病人肛拭、剩余食物进行病原学检测,对检出的致病菌进一步作血清学分型和生化鉴定。结果:从剩余食物皮蛋中检出1株鼠伤寒沙门菌。结论:虽然因为病人在采样前已使用了抗菌素我们没能从肛拭样品中分离出病原菌,但结合流调资料及临床表现我们判定本起食物中毒仍系食用被鼠伤寒沙门菌污染的皮蛋引起的。     

3株鼠伤寒沙门菌的检验

鼠伤寒沙门菌(S typhimurium)是一种常见的人畜共患病原菌,该菌引起的食物中毒在沙门菌食物中毒中占首位,而且经常引起严重的医院感染[1] 。在1起食物中毒事件中,从4份患者肛拭标本中检出的3株鼠伤寒沙门菌均存在菌体O抗原变异现象,现将结果报告如下。1　材料与方法1 1　标本来     

首次从腹泻病人粪便中检出3种鼠伤寒沙门氏菌生物变种

鼠伤寒沙门氏菌是一种常见的肠道病原菌，由该菌引起的食物中毒及医院感染的报告屡见不鲜。我们在鼠伤寒沙门氏菌调查研究中，从食物中毒病人及医院感染病人粪便检出3种鼠伤寒沙门氏菌生物变种（无动力变种，不产气变种，I相菌单相变种），这3种变种均为福建省首次检出，在全国也罕见报道’‘’。现将结果报道如下。1临床资料病例1患儿男性，11个月，泉州市人。因上呼吸道感染入院治疗。住院2天后突发腹泻，日泻5～10次，排出蛋花样带粘液的腥臭粪便，伴发热，体温38．gaC，经补液及氟吸酸等治疗后腹泻症状消失。从患儿粪便中检出鼠伤寒沙…     

福建省1975-2003年沙门菌监测结果分析

[目的]调查1975Ⅲ～2003年福建省沙门菌血清型分布特征及与疾病的关系。[方法]在全省50多个县(市、区)开展人、动物、食品及污水等外环境沙门菌调查。[结果]共检出3120株沙门菌．分属于20个群(亚群)的82个血清型(变种),其中7个血清型(变种)为国内首次检出,首次发现带有表面K抗原的沙门菌Ⅲb(48：a：Z55);B、C1、C2、D1和E1 5个群(亚群)是我省优势血清群(亚群);鼠伤寒沙门菌、德尔卑沙门菌和伤寒沙门菌等14个血清型为我省常见血清型。我省沙门菌以A～F群血清型为主,9(1年代以来非A～F群血清型检出有增多的趋势。从人体检出56个血清型(变种)2292株,其中病人占33个血清型1283株。鼠伤寒沙门菌和伤寒沙门菌10多年来对人们危害最大。[结论]我省沙门菌血清型别众多,是食物中毒及感染性腹泻的一种重要且常见的病原菌．做好沙门菌监测对防治工作有重要的理论意义和现实意义。     

一起鼠伤寒沙门菌引起的食物中毒事件调查

目的现场调查一起鼠伤寒沙门菌引起的食物中毒事件。方法对该起食物中毒事件的患者和事件发生餐馆进行流行病学调查,采集患者肛拭、就餐食物和食物加工环节涂抹物等28份标本进行实验室检测。结果 22名就餐者中,8例发病;潜伏期最短5 h,最长23 h;主要症状为头晕、恶心和呕吐等。28份标本检出沙门菌8株,主要来自患者肛拭、羊肉和砧板涂抹物;8株菌株生化试验及血清学鉴定结果一致,均为鼠伤寒沙门菌。结论该事件为一起食用鼠伤寒沙门菌污染的羊肉引起的食物中毒事件。     

无锡地区沙门菌血清型分布特征研究

目的 了解无锡地区沙门菌血清型分布特征。方法 对2017年无锡市食品行业从业人员分离出的220株沙门菌及食源性疾病患者分离出的87株沙门菌进行血清学鉴定,并对2组人群的血清型进行对比分析。结果 220株食品行业从业人员分离出的沙门菌检出46种血清型,优势血清型为山夫登堡沙门菌(20. 45%)、鼠伤寒沙门菌(15. 00%)。87株食源性疾病患者分离出的沙门菌检出24种血清型,优势血清型为肠炎沙门菌(24. 14%)、鼠伤寒沙门菌(24. 14%)。有15种血清型在2组人群中同时检出,鼠伤寒沙门菌为2组人群共同优势血清型。结论 无锡地区食源性沙门菌主要血清型与食品从业人员携带沙门菌主要血清型分布同中有异,提示无锡地区由沙门菌引起的食源性疾病与食品从业人员沙门菌携带者有密切联系。     

云浮市城市污水中沙门菌调查

目的 了解宾馆和饭店污水中沙门菌污染状况。方法 于2003年1-6月采集宾馆和饭店的327件污水样以及部分居民生活区的176件污水样按国家标准检验方法检测沙门菌。结果 宾馆和饭店污水沙门菌阳性率(3．67％)高于居民生活区(0.57％),经确切概率法检验,P=0．04,差异有统计学意义。宾馆和饭店污水检出沙门菌阳性的有12件,共12株菌,共有4个血清群,9个血清型;居民生活区污水检出沙门菌阳性的有1件,菌株是B群鼠伤寒型沙门菌。宾馆和饭店的327件污水水样中,1—3月沙门菌阳性率(5．47％)高于4-6月(0．79％),经确切概率法检验,P=-0．033,差异有统计学意义。结论 云浮市区内宾馆和饭店污水中沙门菌的污染及其对人潜在的致病危险性应引起重视。     

深圳市儿童医院儿童粪便分离的459株沙门菌分布特征及耐药性

目的了解儿童粪便分离沙门菌的分布特征及耐药情况。 方法分析2012年1月—2015年10月某院患儿粪便标本分离的沙门菌检出情况,以及沙门菌血清型和对常用抗菌药物的敏感性。 结果7 047例患儿送检粪便标本,459例患儿检出沙门菌,总检出率为6.51%。沙门菌肠炎患儿男女比为2.4︰1,其中3岁以下儿童352例（占76.69%）;459株沙门菌中5—10月份检出374株（占81.48%）,7、8、9月检出数量最多,分别为72、84、78株。沙门菌血清型主要为B群(69.06%)和D群（19.39%）,分别以鼠伤寒沙门菌和肠炎沙门菌血清型为主。未检出耐亚胺培南和厄他培南的菌株,沙门菌属对哌拉西林/他唑巴坦、头孢吡肟、头孢他啶、氨曲南和头孢曲松的敏感率均＞70%,肠炎沙门菌对头孢类抗生素的敏感率低于鼠伤寒沙门菌,但对复方磺胺甲口恶唑的敏感率高于鼠伤寒沙门菌。结论该院儿童粪便检出的沙门菌主要分离自3岁以下婴幼儿,夏秋季节高发,血清型以鼠伤寒和肠炎沙门菌为主,抗菌药物治疗要结合血清型及药敏结果慎重选择。     

Eggshells as a source for occupational exposure to airborne bacteria in hatcheries

Occupational exposure to high concentrations of airborne bacteria in poultry production is related to an increased risk of respiratory disorders. However, potential sources and formation of hatchery bioaerosols are rarely characterized. In this study, bacterial multiplication on fresh shell fragments from turkey hatching eggs under conditions present in a hatcher incubator was investigated. A 10⁵-fold amplification was observed both by colony count and total cell count gaining 4 × 10⁷ cfu/cells per gram eggshell within 30 hr of incubation. Furthermore, the bacterial community present on eggshells was analyzed by generation of 16S rRNA gene clone libraries and identification of eight isolates. RFLP analysis revealed no shift in community composition during incubation and Enterococcus faecalis and Enterococcus gallinarum were found as the predominant species on turkey eggshells, both have been classified as risk group 2 microorganisms (German TRBA 466). Since Enterococcus spp. were found as predominant species on turkey eggshells, contribution of this genus to bioaerosol formation was demonstrated. During different work activities with poult and eggshell handling concentrations of airborne enterococci up to 1.3 × 10⁴ cfu m^?3 were detected. In contrast, no enterococci were identified at a day without poult or eggshell processing. In conclusion, turkey hatching eggs carry a viable specific microflora from breeder flocks to hatcheries. After hatching of turkey poults, hatcher incubators and eggshell fragments provide appropriate conditions for excessive bacterial growth. Thus, high bacterial loads on eggshell fragments are a source of potential harmful bioaersols caused by air flows, poult activity, and handling of equipment.     

Source, carriers, and management of a Serratia marcescens outbreak on a pulmonary unit

An outbreak of Serratia marcescens was seen on a pulmonary ward from September 1999 until September 2000. During this period, there were two distinct clusters of S. marcescens isolation. In the first episode, September–October 1999, S. marcescens isolates with the same resistance pattern were isolated in 10 patients. PFGE (pulsed-field gel electrophoresis) following digestion with SpeI confirmed that these isolates were identical. After an initial decline in the number of isolates, the incidence rose again in March 2000. The resistance pattern of these isolates differed from that in 1999. PFGE showed that most of the isolates in 2000 were identical and had replaced the previous strain (strain 1). In the second episode, January–August 2000, 26 patients were colonized with the subsequent strain (strain 2). Three of these patients had serious clinical problems due to S. marcescens, two had bacteraemia and one empyema. In September 2000, strain 2 was also detected in stock solutions for inhalation therapy. After discontinuation of the use of stock solutions and emphasizing hygienic measures, the outbreak resolved. The majority (68%) of the patients positive for S. marcescens suffered from COPD (chronic obstructive pulmonary disease). PFGE results suggest that several COPD patients were carriers of the same strain of S. marcescens for a prolonged time. Re-admission of these patients could have lead to re-introduction of the epidemic strains.     

Effects of Japan Sea Proper Water on the growth ofLegionella pneumophila, Escherichia coli, andStaphylococcus aureus

Objective To assess whetherLegionella pneumophila serogroup 1 and serogroup 6,Escherichia coli, andStaphylococcus aureus can survive in Japan Sea Proper Water (JSPW). Methods The inhibitory effects of JSPW, surface seawater (SSW), phosphate buffer solution with 3.5% NaCl of pH 7.0 (3.5% NaCIPBS), and the 10²- and 10⁴-fold dilute solutions with purified water or phosphate buffer solution of pH 7.0, and purified water were investigated. Survival cells were counted immediately after the water and the bacteria were mixed, and at 1,3,5, and 7 days after incubation at 37°C. If the number of surviving cells was decreased more than 2 log units compared with the starting value, we judged the medium to have had an inhibitory effect on the growth of the bacteria. Results The survival cells of the bacteria in JSPW had decreased more than 2 log units compared with the starting value at 1 day after incubation. After 1 day of incubation, the cells ofLegionella pneumophila serogroup 6 andStaphylococcus aureus were found to have decreased more than 2 log units in purified water (PW) used as a control. Furthermore,Legionella pneumophila serogroup 1 in the 10²-fold dilute solution of JSPW was only 1.04 log units lower than the starting value at 7 days after incubation. In the 10²- and 10⁴-fold dilute solutions of JSPW,Escherichia coli survived for 7 days after incubation. These results were almost similar to the results in SSW and 3.5% NaCIPBS. Conclusions The present findings demonstrate thatLegionella pneumophila serogroup 1 andEscherichia coli cannot survive in undiluted JSPW for over a day at 37°C, suggesting the inhibitory effects may be due to the sodium chloride contained in JSPW.     

2016-2021年上海市儿童感染性腹泻哨点监测分析

目的了解2016-2021年上海市儿童感染性腹泻的流行特征及病原谱特征, 为上海市儿童感染性腹泻防控策略的制定提供科学依据。方法采用多阶段系统抽样方法, 在上海市5家儿童感染性腹泻监测点医疗机构的儿科肠道门诊或儿科门/急诊中开展腹泻症状监测, 收集患者人口学信息和流行病学资料等, 同时采集患者粪便标本, 送至医疗机构所在区CDC开展12种细菌和5种病毒的病原学检测, 分析比较2016-2021年不同人群、季节和时期的病原谱等特征。统计学分析采用χ2检验。结果 2 456例感染性腹泻患者中, 常见肠道病原总阳性率为45.11%(1 108/2 456), 单一细菌感染阳性率为16.00%(393/2 456), 单一病毒感染阳性率为20.81%(511/2 456), 混合感染为8.31%(204/2 456)。以致病性大肠埃希菌(12.95%, 318/2 456)、诺如病毒(10.91%, 268/2 456)、轮状病毒(7.49%, 184/2 456)、沙门菌(5.82%, 143/2 456)和空肠弯曲菌(4.68%, 115/2 456)为主。儿童感染性腹泻病患者病原谱呈现明...     

Use of organic amendments as a bioremediation strategy to reduce the bioavailability of chlorpyrifos insecticide in soils. Effects on soil biology

The sorption capacity of both an organic municipal solid waste by-product (MSW) and a cow manure (CM) in a soil polluted with chlorpyrifos, as well as its effect on soil microbial activity, and weight, reproductive parameters and glutathione-S-transferase activity of two earthworm species (Eisenia fetida and Lumbricus terrestris) were studied. Chlorpyrifos was added at the recommended application rate (5 L ha⁻¹; 768 mg chlorpyrifos kg⁻¹) and treated with MSW at a rate of 10% and CM at a rate of 5.8% in order to apply the same amount of organic matter to the soil. An unamended polluted soil was used as control. Earthworm cocoon number, average weight of cocoon, and number of juveniles per cocoon were measured after 30 days of incubation, whereas soil enzymatic activities, earthworm weight, and glutathione-S-transferase activity of earthworms were measured after 3, 45 and 90 days. Soil enzymatic activities, reproductive and glutathione-S-transferase activity in both worms decreased in polluted soil. The inhibition percentage of soil enzymatic activities, reproductive and glutathione-S-transferase activity in both worms was lower in MSW-amended soil than for CM-amended soil. The toxic effect of chlorpyrifos on E. fetida was lowest compared to L. terrestris. This suggested that the addition of organic wastes with higher humic than fulvic acid concentration is more beneficial for remediation of soils polluted with chlorpyrifos.     

杭州市2014年一起金黄色葡萄球菌肠毒素所致食源性疾病暴发调查

目的 运用现场流行病学手段,分析2014年杭州市某大学发生的一起食源性疾病暴发原因。方法 通过查阅学校附近医院就诊记录和校医务室门诊日志开展病例个案调查,描述疾病分布特征,绘制流行病学曲线图,开展病例对照研究和危害因素调查。结果 本次食源性疾病暴发潜伏期为3.0（1.5~5.0） h。病例均有学校附近某小吃店就餐史,因可疑食物粉丝在不锈钢保温桶中存放时间过长（>3 h）,导致污染金黄色葡萄球菌后产生肠毒素;采集的18份样品中3份病例粪便和6份食物原料葡萄球菌肠毒素检测结果为阳性。结论 该起食源性疾病暴发为粉丝污染金黄色葡萄球菌导致的食物中毒。     

云南省元江县2010-2011年一起甲型副伤寒暴发调查与处置

目的 现场调查一起甲型副伤寒暴发疫情的原因并进行处置。方法 对2010-2011年发生在云南省元江县的一起甲型副伤寒暴发进行流行病学特征描述,采用病例对照研究、环境卫生学检测调查引起暴发的危险因素及污染源,对病例标本进行病原分离及耐药检测,针对流行病学及实验室检测结果采取控制措施。结果 全县10个乡镇均有甲型副伤寒病例发生,2010年4月至2011年8月期间共报告病例600例,各乡镇发病率不同且发病水平随着与城区受污染蔬菜地距离增加呈减弱趋势。病例对照研究结果发现,吃生蔬菜是甲型副伤寒暴发的主要危险因素（OR=65.3,P<0.001）。调查发现病例管理不规范,病例排泄物进入城区污水沟。医院和城区污水中分离到甲型副伤寒沙门菌。采取政府主导的禁售及禁种污染田蔬菜并加强医院污水消毒等措施后,暴发得到有效控制。结论 城区、医院污水用于蔬菜田灌溉和生吃蔬菜区域性习惯共同作用促成污水-蔬菜-人群的传播循环,导致该起大型暴发流行。以政府为主导的干预措施对控制暴发起到了关键作用。     

昆明地区2018-2020年腹泻患者中艰难梭菌感染特征分析

目的对2018-2020年昆明地区腹泻患者中艰难梭菌感染特征进行分析, 为后续监测和防治提供数据支持。方法收集2018-2020年云南省4家哨点医院腹泻患者粪便标本共388份, 使用实时荧光定量PCR方法进行艰难梭菌粪便毒素基因检测, 对结果阳性的粪便标本进行菌株的分离, 用基质辅助激光解析电离飞行时间质谱鉴定菌株。提取分离菌株的基因组DNA进行多位点序列分型(MLST)。分析毒素阳性和菌株分离阳性与患者的临床特征以及艰难梭菌阳性与其他病原共感染的情况。结果 388份粪便标本中, 艰难梭菌内参tpi基因阳性标本47份, 总阳性率为12.11%。其中, 非产毒艰难梭菌4份(8.51%), 产毒艰难梭菌43份(91.49%)。47份阳性标本分离得到18株艰难梭菌, 阳性标本的分离率为38.30%。其中tcdA、tcdB、tcdC、tcdR和tcdE基因均为阳性的菌株14株。18株艰难梭菌的二元毒素均为阴性。所有分离菌株的MLST结果共形成10种序列型(ST), 其中ST37型5株(27.78%);ST129、ST3、ST54和ST2型各2株;ST35、ST532、ST48、ST27和ST3...     

Metallo-β-lactamase expressing multi-resistant Acinetobacter baumannii transmitted in the operation area

Outbreaks of Acinetobacter baumannii demonstrating multiple antibiotic resistance, including meropenem resistance, have been described as severe therapeutic problems. Here we describe a monoclonal outbreak of infection and colonization with multidrug-resistant A. baumannii over a two-month period. Resistance to meropenem was mediated by expression of a metallo-β-lactamase enzyme. Four of 14 patients showed clinical signs of infection and two died. Contamination of the environment, water, or instruments were excluded as causes of the outbreak. All patients, except one, underwent surgery in a specific operation theatre where surgery of contamination class IV (infected, dirty) was performed. Although individual surgeon error was eliminated, analyses of the patients' histories suggested that bacterial transmission had occurred during surgery. Five patients showed signs of A. baumannii infection and two of these patients suffered from large abdominal wounds infected with a high density of A. baumannii requiring repeated revisions. Presumably, these revisions favoured the transmission of A. baumannii, which is remarkably resistant to various environmental stresses including soaps, disinfectants and dry conditions. No case of meropenem-resistant A. baumannii had been observed in the hospital before the outbreak. Interestingly, the resistant bacteria appear to have been imported by a patient returning from West Africa. This indicates that, similar to MRSA, multiresistant A. baumannii may be introduced by patients from foreign hospitals. The outbreak was stopped in the following months by reinforcing standard procedures and by taking all necessary precautions such as patient isolation, and finally only one new case was detected.     

宏基因组二代测序在耐碳青霉烯类鲍曼不动杆菌医院感染暴发中的应用

目的 探讨宏基因组二代测序(mNGS)技术在耐碳青霉烯类鲍曼不动杆菌(CRAB)医院感染暴发事件调查中的应用。方法 应用mNGS及传统病原学培养方法对某院重症监护病房(ICU)2023年6月8—22日5例检出CRAB患者进行病原学检测,对可能污染的环境进行微生物采样及细菌培养、鉴定和药物敏感试验,同时采取综合控制措施并评价其效果。结果 mNGS结果回报所需时间短于培养所需时间[(3.92±1.05)d VS (6.24±0.25)d,P<0.001]。5例患者的标本培养分离出CRAB,mNGS检测结果显示均检出OXA-23耐药基因,经专家综合判断4例患者为医院感染,1例患者为标本污染。依据《医院感染暴发控制指南》中的医院感染暴发定义,此事件考虑为医院感染暴发。环境卫生学监测结果显示,暴发时环境中CRAB检出率为51.30%(59/115),主要集中在医务人员手与呼吸机表面,实施多学科联合感染控制措施后,医生手卫生依从率及呼吸机消毒落实率分别由40.83%(49/120)、33.33%(16/48)提高至82.61%(95/115)、83.33%(30/36)。患者预后良好,后续监...