一起误诊为伤寒的肠炎沙门菌食物中毒的调查分析

An investigational analysis of an episode of food poisoning of Salmonella enteritis misdiagnosed as typhoid fever

目的探讨2005年增城市一起误诊为伤寒的肠炎沙门菌引起的学校食物中毒暴发特征。方法采用现场流行病学及病例对照方法进行调查,对采集的标本进行肠道致病菌培养和肥达反应检测。结果该起疫情共报告病例22例,其中11例患者肥达反应抗“O”、抗“H”抗体升高超过11∶60,19例患者进行粪便培养,检出4例肠炎沙门菌阳性。所有病例均有病前在学校食堂就餐史,未能采集到可疑中毒食物,通过病例对照调查分析鸡腿为可疑中毒食物,病例与对照的肥达反应结果有统计学意义。结论根据流行病学调查、病例临床表现和实验室检测结果,判定为一起肠炎沙门菌引起的食物中毒暴发,排除伤寒。

Objective The present study was conducted to investigate the characteristics of an episode of school food poisoning caused by Salmonella enteritis but misdiagnosed as typhoid fever in Zengcheng city in 2005. Methods Field epidemiological investigations and case-control study were conducted. The collected samples were cultured for the identification of intestinal pathogens with Widal reaction done. Results Among the 22 cases reported in the epidemic outbreak, 11 cases had increased antibodies of anti -＂O＂ and anti ＂H＂ over 1：160. Stool culture was done for 19 cases with Salmonella enteritidis positive in 4 of them. All the cases had a history of repast in the school cafeteria. The collection of the suspected poisonous foods failed. There was statistically a significant difference in the results of Widal reaction between the cases and the controls, suggesting that the chicken legs might be the suspected poisonous food. Conclusion According to the results of epidemiological investigation, clinical manifestation of the cases and the results of laboratory tests, it had been established as outbreak of food poisoning of salmonella enteritis.