沙门菌及志贺菌混合感染引起食源性疾病暴发疫情的调查

Foodborne disease outbreak caused by Salmonella and Shigella

目的查明引起本次食源性疾病暴发的原因,为食源性疾病暴发的处理提供科学依据。方法采集病人肛拭子和剩余芒果标本共16份标本,增菌后用PCR方法快速检测目标菌,再依照GB4789-2012方法分离鉴定沙门菌和志贺菌,分离鉴定出的菌株采用K-B法进行药敏试验;同时采集2名重症病人急性期和恢复期双份血清4份,与分离菌株进行相应抗体检测。结果 12份病人肛拭子标本中检出9株汤卜逊沙门菌和宋内志贺菌;4份剩余芒果标本中检出2株汤卜逊沙门菌和宋内志贺菌。2位病人恢复期比急性期血清中的汤卜逊沙门菌和宋内志贺菌抗体水平均有4倍以上增高。药敏显示汤卜逊沙门菌和宋内志贺菌对复方新诺明、四环素、氯霉素、氨苄西林、呱拉西林耐药,对头孢曲松、头孢吡肟、环丙沙星、诺氟沙星、亚胺培南、美罗培南、氨曲南敏感。结论根据流行病学调查和结合实验室检测结果,判定本次食源性疾病暴发是食用由汤卜逊沙门菌和宋内志贺菌混合污染芒果引起,应引起监管部门的重视。

Objective To investigate the cause of a foodborne disease outbreak, so as to provide the evidence for thetreatment of foodborne disease outbreak events. Methods Sixteen samples of anal swab and residual mango were collected,and the objective bacteria after being enriched were quickly detected by PCR method. Salmonella and Shigella were separatedand identified in accordance with the methods in GB4789-2010. Then, susceptibility tests were conducted by K-B methods forthe separated and identified strains. Meanwhile, 4 samples of paired sera at the acute stage and convalescence stage of 2 severepatients were collected, and the tests for relevant antibodies with separated strains were performed. Results Nine strains ofSalmonella thompson and Shigella sonnei were detected in 12 samples of anal swab of the patients. Two strains of Salmonellathompson and Shigella sonnei were detected in 4 samples of residual mango. Salmonella thompson and Shigella sonnei antibodylevels in 2 patients increased by 4 times at the convalescence stage than those at the acute stage. The susceptibility testsdemonstrated that the high drug resistant rates of Salmonella thompson and Shigella sonnei were found in SMZ- TMP,tetracycline, chloromycetin, ampicillin, and piperacillin, but ceftriaxone, cefepime, ciprofloxacin, norfloxacin, imipenem,meropenem and aztreonam were still sensitive. Conclusion This foodborne disease outbreak is resulted from mangocontaminated by Salmonella thompson and Shigella sonnei.