一起肠炎沙门菌引起的食物中毒调查分析
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(1.天津医科大学公共卫生学院,天津 30007 0;2.天津市东丽区疾病预防控制中心,天津 300300)

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彭立昌 男 硕士生 研究方向为流行病与卫生统计学E-mail:plc325@126.com通信作者:┣┣(中)通信作者┫┫马骏 男 教授 研究方向为卫生统计学E-mail:majun@tmu.edu.cn

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Investigation and analysis of an intestinal Salmonella enterica food poisoning incident
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(1.Tianjin Medical University School of Public Health,Tianjin 300070,China;2.Tianjin Dongli District Centers for Disease Control and Prevention,Tianjin 300300,China)

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    摘要:

    查明本次食物中毒事件的发生原因和可疑危险因素,同时对致病菌药物敏感性进行分析。方法 通过发病时间和用餐时间结合病例临床特征分析查找可疑餐次,采集可疑食物和病例等标本进行实验室检测,食物及病例阳性标本做脉冲场凝胶电泳(PFGE)同源性分析,同时对致病菌做耐药分析。结果 共确认81例病例,症状主要为发热≥38 ℃(100.00%,81/81)、腹痛(97.53%,79/81)、腹泻≥3次(100.00%,81/81)、呕吐(69.14%,56/81)等,食用被鸡蛋壳污染的蛋炒饭是发病的危险因素,厨师在制作蛋炒饭时,附有肠炎沙门菌的鸡蛋壳没有清洗干净,炒饭是将蛋液浇到米饭上,加热不彻底,最后导致肠炎沙门菌污染蛋炒饭。病例粪便检测为肠炎沙门菌阳性,和食物蛋炒饭中分离的肠炎沙门菌PFGE图谱完全一致,且与生鸡蛋壳涂抹样品中分离的肠炎沙门菌相似度达96%。头孢噻肟、环丙沙星、复方新诺明(TMP/SMZ)等对肠炎沙门菌具有较好的药物敏感性,萘啶酸耐药性强。结论 食用被肠沙门菌污染的蛋炒饭是导致本次食物中毒的主要原因,建议加强对餐饮机构厨师的监督管理,规范卫生操作流程,提高卫生安全意识,防止类似事件再次发生。

    Abstract:

    To identify the causes and suspected risk factors of the food poisoning incident, and analyze the drug resistant profile.Methods Combined with clinical characteristics and time of disease, the suspicious meals were identified, suspected food and case samples were collected for laboratory test, and pulsed-field gel electrophoresis (PFGE) and homology analysis was carried out on positive samples. Results A total of 81 cases were confirmed. The symptoms included fever ≥38 ℃ (100.00%, 81/81), abdominal pain (97.53%, 79/81), diarrhea ≥3 times (100.00%, 81/81), vomiting (69.14%, 56/81), etc. The consumption of egg fried rice contaminated by egg shell was a risk factor. The chef poured egg on the fried rice without fully heated, which leaded to the contamination. Stool samples and food solates were all positive for Salmonella enterica, and the PFGE patterns were the same. The similarity between case samples and smear samples from the egg shell was 96%. The strain was sensitive to cefotaxime, ciprofloxacin and TMP/SMZ, but was nalidixic acid-resistant. Conclusion Consumption of fried rice contaminated by Salmonella enterica was the main cause of the food poisoning, it was recommended to strengthen the supervision and management on institutional catering chef, standardize operational processes and to improve the health and safety awareness to prevent similar incidents.

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彭立昌,马骏.一起肠炎沙门菌引起的食物中毒调查分析[J].中国食品卫生杂志,2017,29(2):233-237.

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  • 收稿日期:2016-11-04
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  • 在线发布日期: 2017-05-03
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