上海市首次宠物龟暴露致幼儿感染波摩那沙门菌病例调查

First report of Salmonella Pomona infection in a young child associated with pet turtle exposure in Shanghai

目的对2019年6月18日上海市1例腹泻伴发热患儿及家庭宠物龟样品进行病原分析,追踪感染源。方法收集调查病例临床信息并基于知情同意开展家庭入户的流行病学调查(流调),采集病例样品、宠物龟和养殖缸内水等流调样品进行病原检测,对不同来源的沙门菌分离株进行血清型、抗生素耐药和分子分型分析。结果病例粪便、宠物龟肛拭及龟壳表面涂抹拭子和养殖缸内水样中均分离到波摩那沙门菌,所有菌株的抗生素耐药谱(对四环素类抗生素耐药)和分子分型型别完全一致。结合病例特征和流调结果判断家庭饲养的宠物龟是导致幼儿感染的传染源。结论本案例系上海市首次溯源居家幼儿暴露宠物龟致沙门菌感染的案例,提示沙门菌某些血清型与宠物龟存在优势定殖,低年龄幼儿是行为生态型传染病的高危易感人群,政府部门应协防商业养殖宠物龟的污染,提升病例溯源能力,普及健康教育。

Objective To confirm the source of infection of a young child with diarrhea and fever by analyzing the pathogen isolated from samples of the child and pet turtle in his home. Methods Clinical information collection and epidemiological investigation were conducted based on informed consent. Samples from the patient and pet turtle(cloacal swab and bodysurface swab), turtle tank water and other samples were collected for pathogen isolation and detection. Serotype identification,antimicrobial susceptibility and molecular typing were conducted for Salmonella isolates. Results Salmonella Pomona was isolated from the patient’s stool sample, pet turtle’s cloacal swab and body-surface swab and turtle tank water. All the isolates shared the same antibiotic resistant pattern(tetracyclines) and molecular subtyping pattern. Epidemiological and microbiological investigations suggested that pet turtle was the source of infection. Conclusion It is the first report of S.Pomona infection in a young child associated with pet turtle exposure in Shanghai. Certain Salmonella serotype has dominant colonization in pet turtles. Young children are at high risk to behavioral and ecological infectious diseases. It is necessary to strengthen the prevention of the contamination of pathogen in pet turtle raising, improve case traceability and conduct public health education.