一起空肠弯曲菌食源性疾病事件的实验室检测分析

Laboratory detection and analysis of a foodborne disease event of Campylobacter jejuni

目的 对一起空肠弯曲菌食源性疾病事件进行病原学鉴定,为突发公共卫生事件的处置提供实验室依据。方法 收集事发单位的患者肛拭子、厨工肛拭子、食堂留样食品以及加工环境棉拭样,采用FilmArray多重PCR系统对22种常见胃肠道病原体进行快速鉴定,并结合实时荧光定量PCR(real time fluorescent quantitative PCR,RT-PCR)技术初步确定目标病原体,对分离培养出的可疑菌株进行培养、生化鉴定及药敏试验,同时利用基质辅助激光解析电离飞行时间质谱(matrix-assisted laser desorption ionization-time of flight mass spectrometry, MALDI-TOF-MS)技术对可疑菌株进行鉴定。结果 经上述方法进行病原学鉴定,5份厨工肛拭子和3份患者肛拭子检出空肠弯曲菌核酸,最终在4份厨工肛拭子和2份患者肛拭子中分离出空肠弯曲菌。6株空肠弯曲菌均对环丙沙星和萘啶酸耐药,对克林霉素、红霉素、泰利霉素、氟苯尼考敏感,对庆大霉素、四环素、阿奇霉素存在不同程度的耐药。结论 此次事件为空肠弯曲菌引起的食源性疾病事件。快速、准确的实验室检测分析可为疫情处置争取宝贵的时间并提供有效的依据,在疫情防控中发挥至关重要的作用。

Objective To provide laboratory basis for disposal of public health emergencies by identifying the pathogen of a suspected foodborne disease event.Methods The anal swabs of patients and canteen workers, leftover food and swab samples of processing environment were collected.Rapid identification on 22 common gastrointestinal pathogens was conducted by FilmArray multiple PCR system, target pathogens were preliminarily identified by combining the real time fluorescent quantitative PCR(RT-PCR).The suspicious strains isolated and cultured were subject to culture, biochemical identification and drug resistance analysis, and matrix-assisted laser desorption ionization-time of flight mass spectrometry(MALDI-TOF-MS) was used to identify the suspicious strains.Results The pathogens were identified by the above methods, Campylobacter jejuni nucleic acid was detected in anal swabs of 5 canteen workers and 3 patients, and Campylobacter jejuni was isolated from anal swabs of 4 canteen workers and 2 patients finaly.The 6 Campylobacter jejuni strains were resistant to ciprofloxacin and nalidixic acid, sensitive to clindamycin, erythromycin, telithromycin and florfenicol, and showed drug resistance to gentamicin, tetracycline and azithromycin at varying degrees.Conclusion This event is a foodborne disease event caused by Campylobacter jejuni.Rapid and accurate laboratory detection and analysis supports fighting for valuable time and providing effective basis for epidemic disposal, and playing a vital role in epidemic prevention and control.