摘要
目的对一起食源性疾病暴发疫情进行病原学分子流行病学调查和细菌学检测，以便明确病因，进行有效的预防控制。方法2010年5月12日，徐州市第二人民医院和徐卅I市儿童医院接收135名由于胃肠道感染就诊的某幼儿园儿童病例，采集患儿粪便标本34份和呕吐物标本4份，采用real—timePCR快速检测、常规病原学分离培养、噬菌体裂解试验、ATB细菌半自动鉴定系统等方法进行病原学的检测及鉴定。对分离菌株进行PFGE分型，并与当地散发沙门菌感染病例的PFGE图谱进行聚类分析。结果该幼儿园21个班级中有20个班级有学生发病，班级分布无明显聚集性。在135例患儿中，男性76例（56．3％），女性59例（43．7％），患儿主要症状为发热（38℃以上）、腹痛、腹泻伴呕吐。经过real—timePCR快速检测与病原分离培养鉴定后，在34份粪便标本中共检出19株肠炎沙门菌，检出率为56％；4份呕吐物未检出致病菌。19株肠炎沙门菌的血清学分型、生化性状、药物敏感性、噬菌体裂解模式均相同。PFGE图谱带型完全一致（相似度为100％），并且与当地散发病例PFGE图谱不同。结论综合流行病学调查、临床资料和实验室病原学检测及分子分型，证实本起疫情系一起由同一来源的肠炎沙门菌引起的食源性疾病暴发疫情。
Objective To conduct an etiological molecular epidemiological survey and laboratory test on a foodborne disease epidemic outbreak to make clear of the cause and implement effective prevention and control on it. Methods On May 12th 2012, 135 kindergarten children were sent to Xuzhou City People＇s Hospital and Children＇s Hospital with gastrointestinal infection disease. A total of 34 anus swab samples and 4 vomit samples were collected from the patients. Real-time PCR rapid detection, strains separation and cultivation, phagelysis experiments, ATB automated identification system were used to make etiological detection and identification. The genomic DNA of salmonella enteritidis were typed with the pulsed- field gel electrophoresis （ PFGE ）, cluster analysis were carried out together with the patterns of local Salmonella infections. Results Children in 20 classes were suffered from the gastrointestinal infection among the 21 classes. There were no significant aggregation of class distribution. Among the 135 patients ,76 were boys （56. 3% ） and 59 were girls （43.7%）. The main symptoms were fever（ above 38 ℃ ） , diarrhea and bellyache. Through real-time PCR detection and strains separation, 19 salmonella enteritidis were isolated from 34 anus swab samples of suspected cases and the detection rate was 56%. There were no strains detected from vomit samples. All of the 19 salmonella enteritidis showed the same serological subtype, biochemical reaction, drug sensitivity and phage lysis pattern. The salmonella enteritidis had the identical PFGE pattern （100% similarity ）, and were different from the pattern of local sporadic infection cases. Conclusion It was confirmed that this was an epidemic outbreak of foodborne disease caused by homologous salmonella entertidis by epidemiological survey, clinical information, lab etiological test and molecular typing.
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2013年第2期160-163,共4页
Chinese Journal of Preventive Medicine
基金
基金项目：国家科技重大专项（2009zxlo004-201）
江苏省预防医学科研课题（Y200722）
关键词
沙门菌
肠炎
聚合酶链反应
电泳
凝胶
脉冲场
疾病暴发流行
Salmonella enteritidis
Polymerase chain reaction
Electrophoresis, gel, pulsed- field
Disease outbreaks
