摘要
目的调查分析一起校园食物中毒事件的原因和特征,为食物中毒事件的防制提供参考。方法使用食物中毒个案调查表和现场卫生学调查表对深圳2024年3月11—12日发生的一起校园食物中毒事件进行现场流行病学和卫生学调查,通过现场调查和电话访问等方法收集中毒事件相关信息。使用病例对照研究分析事件发生的可疑食品,采用χ^(2)分析中的risk分析获取OR值。结果此次产气荚膜梭菌所致食物中毒事件涉及2所学校,累计发病52例,其中A校罹患率2.21%(45/2040);B校罹患率1.29%(7/544)。临床症状以腹泻(100.00%)、腹痛(84.62%)为主,少数发烧(3.85%)。通过病例对照研究分析发现,2024年3月11日午餐食用的香菇肉酱是中毒事件的可疑食品(OR=124.50,95%CI=14.53~937.51,P<0.05)。现场卫生学调查发现学校3月11日提供的香菇肉酱是供餐公司前一天制作,未冷藏保存,第二天供餐也未复热。采集31名患者肛拭子、16份食品留样、14名厨工肛拭子送实验室检测,发现22份病例分离出产气荚膜梭菌,其中8份病例检出A型气荚膜梭菌(α毒素基因),4份厨工肛拭子与2份香菇肉酱留样均检出A型产气荚膜梭菌(α毒素)。结论该事件为一起发生在学校的产气荚膜梭菌污染导致的食物中毒暴发事件;避免交叉污染和合理保存是预防产气荚膜梭菌食物中毒的关键。
Objective To investigation and analyze the causes and characteristics of a food poisoning incident caused by Clostridium perfringens in schools,so as to provide a reference for prevention and control of food poisoning incidents.Methods From March 11 to 12,2024,on-site epidemiological and hygienic investigations were conducted by using food poisoning case questionnaires and on-site hygienic investigation forms in Shenzhen.Information related to the poisoning incident was collected through field investigations and telephone interviews.A case-control study was used to analyze the suspected food responsible for the incident.Risk analysis inχ^(2)analysis was used to obtain OR values.Results The Clostridium perfringens food poisoning incident involved two schools,with a cumulative total of 52 cases.School A had an attack rate of 2.21%(45/2040),school B had an attack rate of 1.29%(7/544).The main clinical symptoms were diarrhea(100.00%)and abdominal pain(84.62%),with a minority experiencing fever(3.85%).Analysis via the case-control study indicated that consuming mushroom and meat sauce during lunch on March 11,2024,was a risk factor for the poisoning incident(OR=124.50,95%CI=14.53-937.51,P<0.05).On-site investigation revealed that the mushroom and meat sauce provided by the schools on March 11 was prepared by the catering company the previous day,stored without refrigeration,and not reheated before serving the next day.A total of 31 patient anal swabs,16 food samples,and 14 kitchen staff anal swabs were sent for laboratory testing.Clostridium perfringens was isolated from 22 case samples.Among these,type A Clostridium perfringens(alpha toxin)was detected in 8 case samples,4 kitchen staff anal swabs,and 2 retained samples of the mushroom and meat sauce.Conclusions The incident is a food poisoning outbreak caused by Clostridium perfringens contamination in schools.Avoiding cross-contamination and ensuring proper storage are key to preventing Clostridium perfringens food poisoning.
作者
何林
卿文静
罗铭宣
HE Lin;QING Wenjing;LUO Mingxuan(Center for Disease Control and Prevention of Longhua District(Health Supervision Institute of Longhua District),Shenzhen 518109,Guangdong Province,China)
出处
《中国学校卫生》
北大核心
2025年第11期1650-1652,1657,共4页
Chinese Journal of School Health
基金
深圳市龙华区科技局医疗卫生基础性研究项目(2024060)。
关键词
梭菌
产气荚膜
食物中毒
发病率
病例对照研究
Clostridium perfringens
Food poisoning
Incidence
Case-control studies
