一例由阪崎肠杆菌感染引起腹泻患儿的溯源分析

Source trace of Enterobacter sakazakii infection in an infant with repeated diarrhea

目的对1例反复腹泻的4月龄婴儿进行病原学检测和溯源分析,为临床治疗和预防由此引起的食源性疾病提供依据。方法根据流行病学调查资料,采集患儿粪便样本4次,食用奶粉、米粉及饮食相关器皿及环境样本进行肠道病原菌分离培养,对检出的病原菌进行药敏试验和脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)分子分型,根据药敏结果指导临床用药。结果前3次采集的患儿粪便和患儿家中放置奶瓶的桌面涂抹样中均检出阪崎肠杆菌,4株分离株PFGE型别一致,患儿经敏感性治疗康复。结论阪崎肠杆菌可通过环境污染感染致病,快速准确的诊断及敏感性治疗能及时治愈阪崎肠杆菌感染。

Objective To detect and trace the pathogen causing repeated diarrhea in a 4-month-old infant and provide evidence for the treatment and prevention of related foodborne illness. Methods According to the epidemiological data, 4 stool samples were collected from the infant, the milk powder, rice flour and utensils for the infant were sampled, and environmental samples were collected too for the purpose to conduct pathogen isolation. Drug susceptibility test and pulsed-field gel electrophoresis（PFGE）were conducted for the pathogens isolated. Antibiotic was used according to the result of drug susceptibility test. Results Four strains of Enterobacter sakazakii were isolated from 3 stool samples of the infant and a smear sample of desktop for feeding bottle. Four strains shared the same PFGE pattern. After the treatment with effective antibiotic, the infant recovered. Conclusion E. sakazakii can cause infection through environment contact. Rapid and accurate diagnosis and timely effective antibiotic use are essential in the treatment of E. sakazakii infection.