一起肠炎沙门菌致食物中毒的病原学分析

Etiological analysis of a food poisoning caused by Salmonella enteritis

目的分析一起农家院食物中毒病原学原因,为处理食物中毒提供依据。方法对该农家院就餐人员进行流行病学调查,并采集患者标本和留样食品及操作间涂抹物等,参考GB 4789-2016《食品安全国家标准食品微生物学检验》等标准方法进行病原菌分离鉴定。结果 4名患者主要以腹泻、发热、腹痛为主,100.0%患者有腹泻,均为水样便,75.0%患者有发热,体温为38.8~39.3℃,75.0%患者有腹痛,为脐周和上腹绞痛,部分患者有恶心、呕吐等症状。1份患者粪便、2份留样食品(腱子肉、香肠)及熟食储存冰箱内壁涂抹物、熟食菜板涂抹物、熟食菜刀涂抹物、熟食菜墩涂抹物中检出肠炎沙门菌,检出率为53.8%。结论根据流行病学特征、现场卫生学调查、患者临床表现和实验室检测结果,判定本次事件为一起因患者食用了污染肠炎沙门菌的腱子肉和香肠引起的食物中毒。但本次检测未采集到某熟食店的标本,所以不能确定是厨房的环境污染了食品还是熟食店的食品污染了厨房,需要进一步追踪来源。

Objective To analyze the etiological causes of a food poisoning in a farmyard,in order to provide basis for dealing with food poisoning. Methods Epidemiological survey was conducted on the dining staff in the farmhouse,and patient specimens,food samples and smears in the operation room were collected,and pathogenic bacteria were isolated and identified by referring to standard methods such as GB 4789-2016 National food safety standard food microbiological examination. Results Four patients were mainly characterized by diarrhea,fever and abdominal pain. 100.0% of the patients had diarrhea,all with watery stool;75.0% of the patients had fever with a body temperature of 38.8-39.3 ℃;75.0% of the patients had abdominal pain,periumbilical and upper abdominal cramps;some patients had nausea and vomiting.Salmonella enteritis was detected in 1 portion of stool of patients,2 portions of sample food(tendon meat,sausage)and cooked food storage refrigerator wall daub,cooked food plate daub,cooked food knife daub and cooked food mound daub, with the detection rate of 53.8%. Conclusion According to the epidemiological characteristics,field hygiene investigation,clinical manifestations and laboratory test results,the case was determined to be a case of food poisoning caused by the patient’s consumption of the tendon meat and sausage contaminated with Salmonella enteritis. However,no sample was collected from a deli during this test, so it was impossible to determine whether the environment in the kitchen contaminated the food or whether food from the deli contaminated the kitchen,and the source needed to be traced further.