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目的查明一起食物中毒暴发原因,追溯感染来源和感染途径。方法制定病例定义进行病例搜索,开展现场流行病学和卫生学调查。对病例肛拭子、呕吐物、可疑中毒场所剩余食品/半成品、厨工/服务员样本及环境样本开展常规致病菌检测。对检出的副溶血性弧菌菌株进行血清分型和PFGE检测,金黄色葡萄球菌菌株进行肠毒素检测,并对肠毒素进行分型。结果 3例病例的肛拭子均检出副溶血性弧菌,血清型分别为O1∶K1、O3∶K6、O10∶K12;3份环境样本副溶血性弧菌阳性,分别为餐厅A半成品冰柜内壁(O3∶K6)、小炒位荷台(O1∶K1)和餐厅B砧板(O5∶K17)。病例和环境样本来源的2株O3∶K6菌株PFGE带型一致,2株O1∶K1菌株带型基本一致。1例病例的呕吐物检出金黄色葡萄球菌,经培养产E型肠毒素。3份厨工样本金黄色葡萄球菌阳性,分别为餐厅A厨工咽拭子2份(产B型肠毒素)和餐厅B厨工肛拭子1份(产E型肠毒素)。结论副溶血性弧菌和金黄色葡萄球菌混合感染导致了这起食物中毒的发生,建议监管部门加强对餐饮服务单位的监测和监管指导。
Objective To identify the causes of food poisoning outbreaks, trace the source of infection and the route of infection. Methods Case definitions were developed for case search and on-site epidemiology and hygiene surveys were conducted. Routine pathogenic bacteria tests were conducted on cases of anal swabs, vomitus, remaining food / semi-finished products at suspicious places of poisoning, cooks / waiter samples and environmental samples. Vibrio parahaemolyticus strains were detected by serotyping and PFGE detection, Staphylococcus aureus strains enterotoxin detection, and enterotoxin classification. Results Vibrio parahaemolyticus was detected in three cases of rectal swabs. The serotypes were O1: K1, O3: K6, O10: K12. Three samples were positive for Vibrio parahaemolyticus, namely, restaurant A semi-finished product freezer The inner wall (O3: K6), Stir fried Hokuto (O1: K1) and restaurant B chopping board (O5: K17). Two strains of O3: K6 were PFGE banding from case and environmental samples, and the two strains of O1: K1 banding were basically the same. Staphylococcus aureus was detected in 1 case of vomitus, and E-type enterotoxin was produced by culturing. Three samples of kitchen workers were positive for Staphylococcus aureus. They were 2 throat swabs (type B enterotoxin) in restaurant A and 1 part anal swab in restaurant B (produce type E enterotoxins). Conclusion The mixed infection of Vibrio parahaemolyticus and Staphylococcus aureus led to the occurrence of this food poisoning. It is suggested that the regulatory authorities should strengthen the monitoring and supervision of catering service units.