沙門氏菌食物中毒臨床及流行病學特點

Characteristics Case Analysis of Salmonella Foodborne Poisoning

目的回顧分析經本院急診科就診的沙門氏菌食物中毒病人的臨床與流行病學特點,為本地區沙門氏菌食物中毒的診治及預防提供參考。方法收集2020年1月1日~12月31日期間到本院急診科就診,經病原學化驗或疾病控制中心確認為沙門氏菌食物中毒個案,根據性別、年齡、就餐場所與食品、臨床症狀、治療、轉歸等進行登記和分析。結果納入116例病人,其中男性51例,女性65例;年齡為38.1(±16.8)歲;大便沙門氏菌檢測率31%,檢測體陽性率72.2%;上下半年大便沙門氏菌檢測陽性率存在統計學差異(χ^(2)=4.75,P<0.05)。主要症狀為發熱、腹痛、嘔吐及腹瀉,症狀與大便沙門氏菌檢測陽性相關性沒有統計學差異(P>0.05)。116名病人均為外出就餐;分析顯示曾進食蛋製品佔65.5%、水產製品佔20.7%、肉類佔41.4%。大便檢出沙門氏菌對Ampicillin耐藥率為87%,同時對Ciprofloxacin及Levofloxacin L耐藥率為6%;大便沙門氏菌陽性與住院天數有統計學差異(U=58.5,P<0.05)。結論建議市民儘量避免進食生或未經徹底煮熟的蛋和蛋類製品,臨床加強對疑似病例的流行病學資料篩查,及早收集病原學資料,合理使用抗生素,做好相關感染控制及健康教育。

Objective To review and analyze the clinical and epidemiological characteristics of Salmonella foodborne poisoning,patients visited the emergency department of KiangWu Hospital,so as to provide information for diagnosis and treatment of Salmonella poisoning in Macao local region.Methods Data of the visited cases of Salmonella foodborne poisoning were collected.Cases were confirmed by pathogenic test results or the Center for Disease Control from January 1 to December 31 in 2020.Analysis was based on gender,age,dining place,food source,clinical symptoms,outcome,and length of hospital stay,etc.Results A total of 116 patients,including 51 males and 65 females,were included.The mean age was 38.1±16.8 years old.The testing rate of Salmonella in stool was 31%,and the positive rate was 72.2%.The positive Salmonella test results were significantly different in terms of the first and second half of the year(χ^(2)=4.75,P<0.05).The main symptoms were fever,abdominal pain,vomiting and diarrhea.There was no significant difference from the positive Salmonella stool test results among symptoms(P>0.05).All patients were dining out.For the food source analysis,65.5%of patients had egg products,20.7%had seafood and 41.4%had meat.The rate of resistance to Ampicillin was found in 87%,and the resistance rate to Ciprofloxacin and Levofloxacin was 6%.The positive Salmonella test results were significantly different in terms of the length of hospital stay(U=58.5,P<0.05).Conclusion It is recommended to avoid eating raw or incompletely cooked eggs and egg food products.It emphasized the collection of clinical epidemiological and pathogenic data of suspected cases as early as possible.The initiation of antibiotics treatment,relevant infection control strategies,and public health education were also important.