一例孕产妇单核细胞增生李斯特菌感染的溯源调查及发病机制探讨
作者:
作者单位:

1.北京市丰台区疾病预防控制中心,北京 100071;2.北京市疾病预防控制中心, 北京市预防医学研究中心, 食物中毒诊断溯源技术北京市重点实验室, 北京 100013

作者简介:

肖贵勇 男 副主任医师 研究方向为营养与食品卫生工作 E-mail: xiaogy818@163.com

通讯作者:

陈倩 女 主任技师 研究方向为食源性致病菌检测溯源 E-mail: cchenqian@263.net

中图分类号:

R155

基金项目:

食品微生物检验相关参考物质体系研究及评价(2017YFC1601400);北京市丰台区卫生健康委科研项目基金(2019-130)


Tracing investigation and pathogenesis of a maternal Listeria monocytogenes infection
Author:
Affiliation:

1.Fengtai District Center for Disease Prevention and Control, Beijing 100071, China;2.Beijing Center for Disease Control and Prevention, Beijing Center for Preventive Medicine Research, Beijing Key Laboratory of Diagnostic and Traceability Technologies for Food Poisoning, Beijing 100013, China

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    摘要:

    目的 针对一例孕产妇李斯特菌病开展病例调查和溯源分析,探讨感染来源和单增李斯特菌病的发病机制,为防控李斯特菌病提供依据。方法 开展现场流行病学调查,收集病例信息,采集病例血液标本、家庭冰箱内食品及厨房环境样本、家庭附近农贸市场的食品样本,针对不同来源样本中的单增李斯特菌进行检测。结果 病例经常食用从农贸市场购买的中式凉拌菜(5~7次/周),在家自制或二次加工中式凉拌菜。其家庭冰箱冷藏室储存食物生熟不分,且生食水果在冰箱中出现腐烂现象。厨房的两块菜板生熟不分、清洗消毒不及时,厨房操作面存在交叉污染。检测结果显示,11份样本中共分离出3株单增李斯特菌,1株来自该病例的血液标本,2株来自厨房冰箱内食品涂抹和菜板涂抹。提示该病例由于食用污染食品导致感染并通过胎盘屏障感染胎儿。结论 本起事件是丰台区首次在食品和环境中尝试溯源单增李斯特菌病的感染来源。病例家庭冰箱内生肉和胡萝卜、厨房环境涂抹样本中均检出单增李斯特菌,明确了食品与环境交叉污染导致病例单增李斯特菌感染发病;医院的早期识别及处置是避免新生儿不良结局出现的重要保障。

    Abstract:

    Objective To investigate the source of infection and the pathogenesis of listeriosis monocytosis in a case of maternal listeriosis, and to provide evidence for the prevention and control of listeriosis.Methods Field epidemiological investigation was carried out to collect case information, blood samples of patients, food samples in refrigerators and kitchen environment of families, food samples from farm product markets near families were collected, and Listeria monocytogenes in samples from different sources were detected.Results Patient often ate Chinese cold dishes purchased from farm product markets (5~7 times a week), and made Chinese cold dishes at home or cut again. The food stored in the refrigerator of his family was not cooked, and the raw fruit roted in the refrigerator. Of the kitchen two chopping board unripe did not divide, clean disinfect not in time, kitchen operating surface existed cross pollution. The results showed that a total of 3 strains of Listeria monocytogenes were isolated from the 11 samples, one from the patient’s blood sample and two from food smear and cutting board smear in the kitchen refrigerator. It was suggested that this case was caused by the consumption of contaminated food and infected the fetus through the placental barrier.Conclusion This case was the first successful attempt to trace the source of listeriosis monocytosis infection in food and environment in Fengtai District. Listeria monocytogenes were detected in the raw meat, carrots, and kitchen samples in the refrigerator of the patient’s family. It was clear that the cross-contamination of food and environment caused the infection of listeria monocytogenes in the patient. Early recognition and treatment in hospitalis was an important guarantee to avoid adverse outcomes in neonates.

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肖贵勇,马晓曼,王佳佳,王焱焱,赵敬敬,訾天琪,陈倩.一例孕产妇单核细胞增生李斯特菌感染的溯源调查及发病机制探讨[J].中国食品卫生杂志,2022,34(2):287-291.

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  • 收稿日期:2021-11-24
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  • 在线发布日期: 2022-05-18
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