南京市一起疑似克罗诺杆菌引起食源性疾病暴发的病原学鉴定及分子分型
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1.南京市疾病预防控制中心;2.江苏省疾病预防控制中心;3.雨花台区疾病预防控制中心

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南京市卫生科技发展专项资金项目(YKK23196)


Etiological identification and molecular typing analysis of a foodborne disease outbreak case caused by Cronobacter spp. in Nanjing
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Affiliation:

1.Jiangsu Provincial Center for Disease Control and Prevention;2.Nanjing Municipal Center for Disease Control and Prevention;3.Yuhuatai District Center for Disease Control and Prevention

Fund Project:

Nanjing Health Science and Technology Development Special Fund Project (YKK23196)

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    摘要:

    目的 对南京市某学校发生的一起疑似食源性疾病暴发事件进行溯源分析,探讨致病菌株病原特征及分子流行病学关系,为食源性疾病暴发事件溯源及处置提供参考依据。方法 采集食源性疾病暴发事件相关样本共47份,提取样本DNA进行食源性致病菌及腹泻病毒核酸检测,同时按照常规细菌分离培养方法进行病原菌分离鉴定。应用微量肉汤稀释法对分离到的克罗诺杆菌菌株进行耐药性检测,同时提取所有菌株核酸进行全基因组测序(WGS) 并进一步进行菌株的致病性预测和基于直系同源基因簇的多位点序列分析(cogMLST)。结果 从30份样本中检测出克罗诺杆菌核酸阳性,未检测到其他常见肠道致病菌及腹泻病毒核酸。共分离得到9株克罗诺杆菌菌株(BQ1~BQ9),其中患者肛拭子6份,供餐企业工作人员肛拭子2份、食品留样1份。9株菌株的耐药谱基本一致。PathogenFinder在线预测这9株菌株均大概率具有致病性。MLST分型结果显示9株克罗诺菌株分属5个ST型,其中BQ3、BQ4和BQ9为ST8型。cogMLST分析发现,从患者肛拭子中分离出的BQ3和从食品留样中分离出的BQ9在进化树上聚为1支,并且只有2个ST位点的差异,两者高度同源。结论 本次食源性疾病暴发事件仅分离到克罗诺杆菌菌株,且分子流行病学分析结果显示来源于食品留样和一例患者的菌株高度同源。尽管克罗诺杆菌通常被认为是一种侵犯婴幼儿及免疫力低下人群的条件致病菌,但本次研究数据提示克罗诺杆菌作为条件致病菌有可能成为健康成人及青少年急性肠胃炎的致病因子,需重新评估其在食源性疾病中的致病风险,加强对克罗诺杆菌在食源性疾病人群和除婴幼儿奶粉及辅食以外食品中的监测。

    Abstract:

    Objective To trace the pathogenic cause of a foodborne disease outbreak case occurred in a primary school in Nanjing and analyze the pathogen characteristics and molecular epidemiological relationship, providing reference data for the source tracing and management of foodborne disease outbreaks. ?Methods A total of 47 foodborne disease outbreak related samples were collected. DNA nucleic acids of all the samples were extracted and performed by Real-time PCR to detect the foodborne pathogens and diarrheal viruses, while the routine bacterial isolation and culture methods were used to isolate and identify pathogenic bacteria. Drug susceptibility testing was conducted with the broth microdilution method. The isolated strains were subjected to whole genome sequencing (WGS) and further pathogenicity prediction and cogMLST analysis. Results Thirty samples were detected Cronobacter spp. nucleic acid positive, and all the other common foodborne pathogenic bacteria and diarrhea virus nucleic acids were negative. Nine Cronobacter spp. isolates (BQ1~BQ9) were obtained, including 6 anal swabs from patients, 2 anal swabs from the staff of the catering enterprise and 1 food retention sample. The drug resistance spectra of the 9 strains were basically the same. Online PathogenFinder predicted that all 9 strains have a high probability of pathogenicity. MLST typing showed 5 different ST types, and the BQ3, BQ4 and BQ9 strains belong to ST8 type. The cogMLST analysis found that BQ3 isolated from a patient anal swab and BQ9 isolated from a food retention sample were clustered tightly, and performed only 2 ST sites differences, indicating these two isolate were highly homologous. Conclusion Cronobacter spp. strains were isolated from this foodborne disease outbreak case and molecular epidemiological analysis showed that the strains from food retention sample and one patient anal swab were highly homologous. Although Cronobacter spp. is generally considered to be an opportunistic pathogen affecting infants and immunocompromised populations, the data from this study suggest that Cronobacter spp. has a high potential as a causative agent of acute gastroenteritis in healthy adults and adolescents, and its risk in foodborne diseases needs to be reevaluated. It is necessary to strengthen the surveillance of Cronobacter spp. in people with foodborne disease and foods other than infant milk powder and complementary foods.

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  • 收稿日期:2024-03-27
  • 最后修改日期:2024-08-29
  • 录用日期:2024-09-18
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