苏州某市一起肠炎沙门氏菌食物中毒事件调查分析
目的 用现场流行病学方法, 分析本次食物中毒事件的原因和可疑危险因素, 指导临床救治并提出预防措施。方法 通过查阅医院就诊记录和医务室门诊记录、考勤记录、员工订餐记录等主动搜索病例, 开展病例个案调查和现场卫生学调查, 采集相关样品进行实验室检测等, 判断引起本次食物中毒事件的可疑餐次和食物。结果 通过访谈、个案调查、实验室检查等共搜索到可能病例67人(包括确诊病例27人), 临床特征主要为腹泻(83.58%, 56/67)、发热(79.10%, 53/67)、腹痛(76.12%, 51/67)等。可疑食品是3月3日晚餐的回锅肉, 59份肛拭子分离到25份肠炎沙门氏菌, 其中一株分离自厨师。经脉冲场电泳(pulsed-field gel electrophoresis, PFGE)分型, 25株肠炎沙门氏菌同源性为100%。经药敏分析显示, 25株肠炎沙门氏菌对头孢噻肟、头孢他啶具有较好的药物敏感性; 对氨苄西林、氯霉素耐药性强。结论 食用被肠炎沙门氏菌污染的回锅肉是导致本次事件的主要原因, 建议监管部门加强对集体配餐单位的监督管理, 提高从业人员食品安全意识, 防范类似事件的发生。
Objective To analyze the causes and suspicious risk factors of this food poisoning event by epidemiological methods, in order to guide clinical treatment and propose preventive measures. Methods The investigations and on-site hygiene surveys were carried out, by actively searching for cases of consulting hospital visit records, medical office outpatient records, attendance records, employee order records, etc., then the relevant samples for laboratory testing were collected, and the suspicious meal and food caused by the food poisoning event were judged. Results Sixty-seven people (including 27 confirmed cases) were searched through interview, investigation and laboratory examination. The main clinical features were diarrhea (83.58%, 56/67), fever (79.10%, 53/67), abdominal pain (76.12%, 51/67) and so on. The suspicious food was double cooked pork of the dinner in 3rd March, 25 strains of Salmonella enteritis were isolated from 59 swabs and one of them isolated from the chef. The homology of 25 strains of Salmonella enteritis was 100% by pulse field gel electrophoresis (PFGE) type. The antibiotic susceptibility test showed that all the strains were susceptible to cefotaxime and ceftazidime, but resistant to ampicillin and chloramphenicol. Conclusion Double cooked pork contaminated by Salmonella enteritisis is the main cause of the event. It is suggested that the supervision department should strengthen supervision and management of the company of collective food supply, improve the safety awareness of the employees and prevent the occurrence of similar events.
标题：苏州某市一起肠炎沙门氏菌食物中毒事件调查分析
英文标题：Investigation and analysis of a Salmonella enteritidis food poisoning incident in a city of Suzhou
作者：
郑艳敏 苏州市疾病预防控制中心
滕臣刚 苏州市疾病预防控制中心
田礼钦 苏州市疾病预防控制中心
张建新 昆山市疾病预防控制中心
张丽芬 苏州市吴中区疾病预防控制中心
张义成 中国现场流行病学培训项目
许婕 中国现场流行病学培训项目
张梦寒 苏州市疾病预防控制中心
中文关键词:肠炎沙门氏菌,食物中毒,脉冲场电泳,调查分析,
英文关键词:Salmonella enteritidis,food poisoning,pulsed field gel electrophoresis,investigation and analysis,
发表日期：2018-12-18
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