摘要
目的 明确静海区某镇某小区食源性疾病暴发事件的致病病原体及污染来源,为该类事件的快速处置与防控提供科学依据。方法 2024年9月采用流行病学调查方法,收集2例病例的基本信息、饮食暴露史及临床表现;采集5份样本(患者家中剩余红烧泥鳅1份,厨房菜板、菜刀、餐桌环境样本3份,首发病例父亲粪便样本1份),运用实时荧光聚合酶链式反应(PCR)技术检测14种食源性致病菌及5种病毒,结合细菌培养、生化鉴定及致泻性大肠埃希菌(DEC)分型检测明确病原体。结果 5份样本诺如病毒检测均为阴性;熟泥鳅样本阈值循环数(Ct)值显示C管诺如病毒为羧基荧光素(FAM)通道36.19、羧基-X-罗丹明(ROX)通道35.05,D管ROX通道27.21(内标),父亲粪便样本Ct值显示C管ROX通道22.36,D管ROX通道24.19(内标),二者均检出DEC,且DEC分型检测显示B管维克染料(VIC)通道24.18、ROX通道35.65,C管FAM通道36.48、VIC通道35.34、ROX通道32.42、花菁素5号通道23.90,判定为产肠毒素大肠埃希菌(ETEC);3份环境样本因清洗擦拭未检出致病菌;细菌培养结果显示,阳性样本均培养出符合DEC特征的菌株,PCR分型确认与核酸分型一致(ETEC)。患者临床表现为腹痛、呕吐、腹泻等,与ETEC致病导致的分泌性腹泻症状相符,事件发生后7d内无新增关联病例,2例患者均已痊愈。结论 本起食源性疾病暴发事件由患者食用受ETEC污染的未加热红烧泥鳅所致;实时荧光PCR技术可快速锁定致病菌,为事件处置争取时间;居民食品安全意识不足是重要诱因,需加强相关宣传教育。
Objective To identify the pathogenic agent and contamination source of a foodborne disease outbreak in a resi-dential community in Jinghai District,Tianjin,providing scientific evidence for rapid response and prevention.Methods Epidemiological investigation was conducted to collect basic information in September 2024,dietary exposure history,and clinical manifestations of two cases.A total of five samples were collected,including one leftover braised loach sample from the patient's home,three environmental samples(cutting board,kitchen knife,and dining table),and one fecal sam-ple from the father of the index case.Real-time fluorescence polymerase chain reaction(PCR)was used to detect 14 food-borne pathogens and five viruses.Bacterial culture,biochemical identification,and diarrheagenic Escherichia coli(DEC)typing were performed to confirm the pathogen.Results All five samples tested negative for norovirus.The cycle thresh-old(Ct)values of the braised loach sample showed 36.19 in the FAM channel and 35.05 in the ROX channel for norovir-us(tube C),and 27.21 in the ROX channel for internal control(tube D).The fecal sample from the father showed Ct values of 22.36 in the ROX channel(tube C)and 24.19 in the ROX channel for internal control(tube D).Both samples tested positive for DEC,with DEC typing revealing Ct values of 24.18 in the VIC channel and 35.65 in the ROX channel(tube B),and 36.48 in the FAM channel,35.34 in the VIC channel,32.42 in the ROX channel,and 23.90 in the Cy5 channel(tube C),confirming the presence of enterotoxigenic Escherichia coli(ETEC).The three environmental samples tested negative for pathogens due to prior cleaning.Bacterial culture isolated DEC-characteristic strains from positive sam-ples,and PCR typing confirmed the results(ETEC).The patients exhibited clinical symptoms including abdominal pain,vomiting,and diarrhea,consistent with ETEC-induced secretory diarrhea.No additional linked cases were reported with-in seven days of the outbreak,and both patients recovered fully.Conclusions This foodborne disease outbreak is caused by consumption of undercooked braised loach contaminated with ETEC.Real-time fluorescence PCR facilitated rapid pathogen identification,saving time for event response.Insufficient public awareness of food safety is a contributing fac-tor,requiring strengthened relevant publicity and education.
作者
崔华
CUI Hua(Microbiology Laboratory,Tianjin Jinghai District Center for Disease Control and Prevention,Tianjin 30l60o,China)
出处
《社区医学杂志》
2025年第17期589-593,共5页
Journal Of Community Medicine
关键词
食源性疾病
产肠毒素大肠埃希菌
实时荧光聚合酶链式反应
流行病学调查
静海区
foodborne disease
enterotoxigenic Escherichia coli
real-time fluorescence polymerase chain reaction
epidemiological investigation
Jinghai District
