一起肠聚集性大肠埃希氏菌食源性疾病事件调查分析

Investigation and Analysis of an Eneteroaggregative Escherichia coliFoodborne Disease Incident

摘要: 目的：针对某餐厅爆发的食源性疾病事件，开展流行病学调研与病原学分析工作，明确引发疾病的致病因子、受污染食品及具体污染原因，从而为制定科学有效的食源性疾病防控策略、妥善应对及预防同类事件提供实践参考。方法：运用现场流行病学调查手段，对该事件中的病例情况进行详细核查。选取肛拭子、剩余餐食、食材原料、环境表面擦拭样本等共计40件标本，采用实时荧光聚合酶链式反应(PCR)技术初筛并进行菌株分离培养，随后对分离得到的菌株实施生化鉴定与PCR复核验证，同时结合食品卫生学调查结果及病例的临床症状表现，开展多维度综合判定。结果：本次食源性疾病事件共确认病例9人，所有病例的临床症状与体征具有一致性，核心表现为腹泻、腹痛与呕吐。在40件采集的标本中，实验室检测结果显示，9件病例肛拭子、2件餐厅留存食品样本(分别为香卤小鸡腿与红烧豆腐)以及1件冰箱内壁涂抹样本中，均检测出肠聚集性大肠埃希氏菌，该菌的总体检出率为30.00%。结论：综合流行病学调查数据、病例临床资料及实验室检测结果可判定，此次餐厅食物中毒事件的致病原因，为肠聚集性大肠埃希氏菌污染所致。

Abstract: Objective: In view of the outbreak of foodborne diseases in a restaurant, epidemiological investigation and etiological analysis were carried out to clarify the pathogenic factors, contaminated food and specific causes of pollution, so as to provide practical reference for formulating scientific and effective prevention and control strategies of foodborne diseases and properly coping with and preventing similar events. Methods: By means of field epidemiological investigation, the case situation in the event was checked in detail. A total of 40 specimens such as anal swabs, leftover meals, raw materials of food materials, and environmental surface wiping samples were selected. Real-time fluorescent polymerase chain reaction (PCR) technology was used for primary screening and strain isolation and culture. Subsequently, the isolated strains were subjected to biochemical identification and PCR verification. At the same time, combined with the results of food hygiene survey and the clinical symptoms of the cases, multi-dimensional comprehensive judgment was carried out. Results: A total of 9 cases were confirmed in this foodborne disease event. The clinical symptoms and signs of all cases were consistent, and the core manifestations were diarrhea, abdominal pain and vomiting. Among the 40 collected specimens, the laboratory test results showed that 9 cases of anal swabs, 2 cases of food samples retained in restaurants (spiced chicken legs and braised tofu, respectively) and 1 case of refrigerator inner wall smear samples were detected in the Eneteroaggregative Escherichia coli, the overall detection rate of the bacteria was 30.00%. Conclusion: Based on the epidemiological survey data, clinical data and laboratory test results, it can be determined that the cause of the food poisoning incident in the restaurant was caused by Eneteroaggregative Escherichia coli contamination.