摘要
目的通过对榆林市某养老院1起食源性疾病事件的现场流行病学调查和实验室分析,为临床诊断治疗和做好食源性疾病调查工作提供科学依据。方法采用现场流行病学方法、梅里埃FilmArray全自动医用PCR分析系统、传统病原体分离鉴定、荧光定量PCR、药物敏感性实验和脉冲场凝胶电泳(PFGE)等方法对本次事件及样品进行分析。结果调查以腹痛、腹泻、水样便为主要症状的病例30例,罹患率为38.96%,以老人为主;采集标本68份(粪便标本30份、食品标本30份、环境标本6份、水样2份),5份标本(粪便标本2份、食品标本1份、环境标本1份、水样1份)中检出肠集聚性大肠埃希菌(enteroaggregative Escherichia coli,EAEC),均检出毒力基因aggR、astA、uidA、pic;耐药性分析显示2株菌对四环素、复方新诺明、氨苄西林、氨苄西林/舒巴坦、环丙沙星耐药,另外3株对氨苄西林、氨苄西林/舒巴坦、萘啶酸耐药;PFGE显示5株菌型别一致,同源性>85.00%。结论结合病例临床表现、流行病学信息、实验室检测结果,此次食源性疾病事件可能由EAEC引起,疑似水塔水污染所致。相关部门应加强对养老院生活饮用水及就餐环境的监管,改善老人就餐居住环境,减少类似事件再次发生。
Objective To provide a scientific basis for clinical diagnosis,treatment and follow-up investigation of foodborne diseases through the on-site epidemiological investigation and laboratory analysis of a foodborne disease incident in a nursing home in Yulin City.Methods The incident and samples were analyzed by on-site epidemiological methods,the Meriere FilmArray automatic medical PCR analysis system,traditional pathogen isolation and identification,fluorescent quantitative PCR,drug sensitivity test and pulsed field gel electrophoresis(PFGE).Results A total of 30 cases with main symptoms of abdominal pain,diarrhea,and watery stools were investigated,with an attack rate of 38.96%,predominantly in the elderly.Sixty-eight samples(30 fecal samples,30 food samples,6 environmental samples and 2 water samples)were collected,among which enteroaggregative Escherichia coli(EAEC)was detected in 5 samples(2 fecal samples,1 food sample,1 environmental sample and 1 water sample),and virulence genes aggR,astA,uidA and pic were detected in all of them.Drug resistance analysis showed that 2 strains were resistant to tetracycline cotrimoxazole,ampicillin,ampicillin/sulbactam,ciprofloxacin,and the other 3 strains were resistant to ampicillin,ampicillin/sulbactam,nalidixic acid.PFGE indicated that the 5 strains were of the same genotype and homology>85.00%.Conclusion Combined with the clinical manifestations,epidemiological information and laboratory test results,the foodborne disease incident is likely caused by EAEC,which is suspected to be caused by water tower pollution.Relevant departments should strengthen the supervision of drinking water and dining environment in nursing homes,improve the dining and residential environment for the elderly,and reduce the recurrence of similar incidents.
作者
王彩乔
王盼
钟笑
贺明丽
WANG Caiqiao;WANG Pan;ZHONG Xiao;HE Mingli(Department of Laboratory,Yulin Center for Disease Control and Prevention,Yulin,Shaanxi 719000,China;不详)
出处
《医学动物防制》
2024年第8期831-832,F0003,F0004,共4页
Journal of Medical Pest Control
基金
2022年陕西省科协青年人才托举计划(SWYY202218)。
