| 孟昭倩,段然,卜戈,郭国侠,郭靓子,胡允凯.一起由宋内志贺菌引起的寄宿学校细菌性痢疾暴发病原学和流行病学分析[J].中华流行病学杂志,2019,40(8):988-991 |
| 一起由宋内志贺菌引起的寄宿学校细菌性痢疾暴发病原学和流行病学分析 |
| Epidemiological and pathogenic features of a bacillary dysentery outbreak in a boarding school caused by Shigella sonneri |
| 收稿日期:2019-03-03 出版日期:2019-08-19 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.08.021 |
| 中文关键词: 宋内志贺菌 药敏试验 毒力基因 |
| 英文关键词: Shigella sonnei Drug susceptibility test Virulence genes |
| 基金项目:国家科技重大专项（2018ZX10713003-002-005） |
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| 中文摘要: |
| 目的 对安徽省阜阳市某寄宿学校感染性腹泻暴发开展流行病学调查与病原学分析，为有效控制和处置疫情提供科学依据。方法 根据病例流行病学特征对2017年9月13-15日发病病例溯源假设进行检验，采集患者和厨师粪便、肛拭子、水样和食堂食品等进行致病菌分离与检测，对可疑致病菌进行生化鉴定、毒力基因检测、药敏试验、PFGE和多位点序列分型。结果 浅水井供水范围内宿舍楼的罹患率（3.41%）高于深水井（0.98%），差异有统计学意义（χ2=17.215，P<0.001）。从患者样品中分离到16株宋内志贺菌，均携带ipaH基因且不携带set1基因，其中7株携带sen基因和ial基因。16株宋内志贺菌对氨苄西林、四环素、复方新诺明、头孢唑啉、头孢噻肟、庆大霉素、萘啶酸、链霉素高度耐药，9株宋内志贺菌对多西环素耐药。16株宋内志贺菌的PFGE带型相似度为100.0%，ST型均为ST152。结论 本次细菌性痢疾暴发的病原为宋内志贺菌，浅水井水可能为感染来源。 |
| 英文摘要: |
| Objective To investigate the etiologic and epidemiologic features of an infectious diarrhea outbreak in a boarding school in Fuyang city, Anhui province. Methods Traceability hypothesis of this study was tested according to the epidemiological characteristics of the cases. Feces, anal swabs, water samples and food residues related to the patients and chefs were collected for pathogen isolation and detection. Biochemical identification, virulence gene detection, drug susceptibility test, PFGE and multilocus sequence typing were performed. Results The incidence rate (3.41%) of different dormitory buildings within the water supply area by shallow wells was higher than that (0.98%) of the deep wells, with statistical significance (χ2=17.215, P<0.001). Sixteen strains belonged to the Shigella Sonneri family were isolated from the patient's samples, and all carrying the ipaH gene. Seven strains belonged to sen and ial genes. Set1 gene that did not appear in all the 16 strains were highly resistant to ampicillin, tetracycline, compound xinnomine, cefazoline, cefotaxime, gentamicin, naphthidinic acid and streptomycin, including 9 strains to doxycycline. The pulse field pattern of the 16 strains of Shigella sonneri appeared the same, with the ST type as ST152. Conclusion When combined data from the etiological and epidemiological investigation, it was confirmed that Shigella sonneri was the pathogen of this outbreak, and water from the shallow wells might be responsible for the source of infection. |
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