一起由宋内志贺菌引起感染性腹泻疫情的病原学分析

Aetiological analysis on an infectious diarrhea epidemic outbreak caused by Shigella sonnei

目的 对一起儿童感染性腹泻聚集性疫情进行病原学检测,以明确诊断.方法 采集病例粪便、水样、剩余食品、外环境、物表以及从业人员的肛拭子和手指涂抹液等66份样本,采用荧光定量PCR技术和细菌学分离方法,检测样本中的沙门菌、霍乱弧菌、副溶血弧菌、致泻性大肠埃希菌、诺如病毒、轮状病毒以及肠道腺病毒等主要感染性腹泻病原微生物,并对分离到的致病菌进行血清学分型、生化试验、药物敏感试验及脉冲场凝胶电泳（PFGE）分子分型.结果 在发病儿童粪便中分离到的4株宋内志贺菌（宋氏志贺菌）菌株,Ct值在28.4～32.7之间,菌落形态、血清型、生化试验和药敏试验结果均相同.PFGE分型结果显示,3株菌株间无差异,另1株菌株与其余3株存有3条条带差异,但相似度较高.结论 本起聚集性感染性腹泻疫情是由宋内志贺菌引起的.

Objective To clarify the pathogen of an infectious diarrhea epidemic outbreak.Methods A total of 66 samples were collected,including feces,water samples,remaining food,extracellular environment,physical properties,the anal swab and application fluid of finger from employees.Several major pathogenic microorganisms including Salmonella,Vibrio cholerae,Vibrio parahaemolyticus,Escherichia coli,norovirus,rotavirus and enteric adenovirus were detected by PCR and bacteriological method.The isolates were analyzed by serological detection,biochemical test,drug sensitive test and PFGE.Results A total of 4 strains of Shigella sonnei were isolated from the fecal samples of children （Ct：28.4-32.7）.The result in colony morphology,serotype,biochemical tests and drug susceptibility test of these strains were the same.PFGE showed that there were no differences among 3 isolates.The last one was different from the other three strains in 3 strips,but also showed high similarity.Conclusions The aggregation infectious diarrhea epidemic is induced by Shigella sonnei.