一起巴西龟引起幼儿长湾泥沙门菌感染的调查研究

目的了解罕见菌型—长湾泥沙门菌感染的临床表现和病原学特征,查明感染来源.方法利用系统生化、血清学和药敏检测对病原菌进行表型特征研究.对患儿的诊治经过进行回顾性总结并进行病家回访、流行病学调查.对高危因素进行连续病原检索,利用PFGE分型对不同来源长湾泥沙门菌进行溯源分析.结果患儿血中分离病原菌经API20E生化鉴定为沙门菌属(id=99.9%),抗原结构为17∶a∶1.5,为长湾泥沙门菌.调查结果显示,本例出血性腹泻,继发菌血症感染,宠物巴西龟为可能污染来源.连续3次病原检索中,4份巴西龟样品中检出长湾泥沙门菌.不同来源菌株的PFGE图谱、生化谱呈现100%一致,耐药谱高度一致,提示巴西龟分离株与患儿分离株来源于同一克隆.5株分离菌株对常见的25种抗生素敏感,对磺胺异恶唑耐药,四环素、头孢唑啉中度耐药.结论本例菌血症患儿为江苏地区首次检出的长湾泥沙门氏菌感染,并且此次感染与宠物巴西龟接触有关.

Invsetigation of Salmonella Jangwani infection caused by Brazilian tortoise in a young child

In order to understand the clinical manifestations and etiological characteristics of the rare bacterial type of Salmonella Jangwani infection, and to pinpoint the source of the infection. Phenotypic characteristics of pathogenic bacteria were studied by systematic biochemistry, serology and drug sensitivity test. The diagnosis and treatment of the child were retrospectively reviewed and the patient’s return visit and epidemiological investigation were conducted. Continuous pathogen retrieval was performed on high-risk factors, and PFGE typing was used to trace the source of Salmonella Jangwani from different sources. The pathogens isolated from the blood of the children were identified as Salmonella (id=99.9%) by API 20 E, and the antigen structure was 17∶a∶1.5, which was the Salmonella Jangwani. The results of the investigation showed that this case of hemorrhagic diarrhea, secondary bacteremia infection, pet Brazilian tortoise is a possible source of pollution. In three consecutive pathogen searches, Salmonella Jangwani was detected in four Brazilian tortoise samples. The PFGE and biochemical profiles of strains from different sources were 100% consistent, and the drug resistance spectrum was highly consistent, suggesting that the isolates of the Brazilian tortoise and the isolates of the children were derived from the same clone. Five isolates were sensitive to 25 common antibiotics, resistant to sulfisoxazole, and moderately resistant to tetracycline and cefazolin. The child with bacteremia in this case is the first detected Salmonella Jangwani infection in Jiangsu Province, and the infection is related to the contact of pet Brazilian tortoise.