一起GⅠ型诺如病毒混合感染多克隆蜡样芽胞杆菌致急性胃肠炎暴发事件实验室分析

甄国新 范佳欣 袁凯丽 林帆 李颖 王苗 康颖 闫爱霞 张爽 荆红波 马红梅 王园园 张茂俊

甄国新, 范佳欣, 袁凯丽, 林帆, 李颖, 王苗, 康颖, 闫爱霞, 张爽, 荆红波, 马红梅, 王园园, 张茂俊. 一起GⅠ型诺如病毒混合感染多克隆蜡样芽胞杆菌致急性胃肠炎暴发事件实验室分析[J]. 疾病监测, 2021, 36(8): 845-850. doi: 10.3784/jbjc.202104200223
引用本文: 甄国新, 范佳欣, 袁凯丽, 林帆, 李颖, 王苗, 康颖, 闫爱霞, 张爽, 荆红波, 马红梅, 王园园, 张茂俊. 一起GⅠ型诺如病毒混合感染多克隆蜡样芽胞杆菌致急性胃肠炎暴发事件实验室分析[J]. 疾病监测, 2021, 36(8): 845-850. doi: 10.3784/jbjc.202104200223
Zhen Guoxin, Fan Jiaxin, Yuan Kaili, Lin Fan, Li Ying, Wang Miao, Kang Ying, Yan Aixia, Zhang Shuang, Jing Hongbo, Ma Hongmei, Wang Yuanyuan, Zhang Maojun. Laboratory study for one gastroenteritis outbreak caused by norovirus GⅠ and Bacillus cereus[J]. Disease Surveillance, 2021, 36(8): 845-850. doi: 10.3784/jbjc.202104200223
Citation: Zhen Guoxin, Fan Jiaxin, Yuan Kaili, Lin Fan, Li Ying, Wang Miao, Kang Ying, Yan Aixia, Zhang Shuang, Jing Hongbo, Ma Hongmei, Wang Yuanyuan, Zhang Maojun. Laboratory study for one gastroenteritis outbreak caused by norovirus GⅠ and Bacillus cereus[J]. Disease Surveillance, 2021, 36(8): 845-850. doi: 10.3784/jbjc.202104200223

一起GⅠ型诺如病毒混合感染多克隆蜡样芽胞杆菌致急性胃肠炎暴发事件实验室分析

doi: 10.3784/jbjc.202104200223
详细信息
    作者简介:

    甄国新,男,河北省唐山市人,硕士研究生,副主任医师,主要从事食源性疾病研究工作,Email:zgxinhw@126.com

    范佳欣,河北省邢台市人,河北北方学院实习生,从事病原微生物检验工作,Email:2640183350@qq.com

    通讯作者:

    王园园,Tel:010–69420876,Email:415809126@qq.com

    张茂俊,Tel:010–58900754,Email:zhangmaojun@icdc.cn

  • 中图分类号: R211;R511

Laboratory study for one gastroenteritis outbreak caused by norovirus GⅠ and Bacillus cereus

More Information
  • 摘要:   目的  通过一起急性胃肠炎暴发事件的实验室检测,分析暴发相关病原特征。  方法  对患者粪便、呕吐物标本以及可疑污染食品样本进行相关病原及毒力基因的实时荧光PCR筛查以及阳性菌的培养检测,对分离菌株进一步进行毒力基因分布分析和脉冲肠凝胶电泳分型分析。  结果  25例患者的粪便标本诺如病毒荧光PCR阳性,检出率为71.43%(25/35),均为GⅠ型;5例患者的6份标本中蜡样芽胞杆菌荧光PCR和病原培养均为阳性,1名厨师粪便标本蜡样芽胞杆菌荧光PCR和培养结果均为阳性。 7件可疑食品样本中4件检出蜡样芽胞杆菌,其中5份食品样本ces基因阳性。 19株蜡样芽胞杆菌分离株脉冲场凝胶电泳(PFGE)分为14种带型,5例患者分离株中有2株PFGE带型相同且与厨师来源菌株分型一致,相同食品来源分离株的PFGE带型不完全一致。 19株分离株均不携带ces基因。  结论  诺如病毒和蜡样芽胞杆菌可能是导致本次急性胃肠炎暴发事件重要病原,以多病原快速筛查为指导的实验室检测对于病原的识别具有重要意义。
  • 图  1  蜡样芽胞杆菌脉冲场凝胶电泳聚类结果

    Figure  1.  PFGE clustering of B. cereus

    表  1  28例病原检测阳性病例临床表现和病原检测结果

    Table  1.   Clinical manifestations and pathogen detection result of 28 patients

    病例编号标本编号发病日期(年-月-日)发病时间临床症状样本类型病原检测结果
    诺如病毒GⅠ型蜡样芽胞杆菌
    培养法16S rDNA基因ces基因
    Patient 1 Patient 1-F2018-09-0406∶30呕吐、腹痛、恶心粪便+++
    Patient 2 Patient 2-F2018-09-0408∶00呕吐、腹泻、腹痛、恶心粪便+
    Patient 3 Patient 3-F2018-09-0415∶00呕吐、恶心粪便+
    Patient 4 Patient 4-F2018-09-0415∶00呕吐、腹泻、腹痛粪便+
    Patient 5 Patient 5-F2018-09-0417∶00呕吐、腹泻、恶心、发热粪便+++
    Patient 6 Patient 6-F2018-09-0420∶00呕吐、腹痛、恶心粪便+
    Patient 7 Patient 7-F2018-09-0422∶00呕吐、腹痛、恶心、头晕、乏力、发热粪便++
    Patient 8 Patient 8-F2018-09-0505∶30呕吐、腹泻、腹痛、恶心、头晕粪便++
    Patient 8 Patient 8-V2018-09-0505∶30呕吐、腹泻、腹痛、恶心、头晕 呕吐物++
    Patient 9 Patient 9-F2018-09-0506∶00呕吐、腹泻粪便+
    Patient 10 Patient 10-F2018-09-0507∶00呕吐、腹泻粪便+
    Patient 11 Patient 11-F2018-09-0508∶00呕吐、腹泻、恶心、头晕粪便+
    Patient 12 Patient 12-F2018-09-0508∶00呕吐、腹泻、腹痛、恶心、头晕、发热粪便+
    Patient 13 Patient 13-F2018-09-0516∶00呕吐、腹泻、腹痛、恶心、乏力粪便+
    Patient 14 Patient 14-F2018-09-0516∶00呕吐、恶心粪便+
    Patient 15 Patient 15-F2018-09-0516∶00呕吐、腹痛粪便+
    Patient 16 Patient 16-F2018-09-0518∶00腹泻、乏力粪便+
    Patient 17 Patient 17-F2018-09-0518∶00腹泻、腹痛粪便+
    Patient 18 Patient 18-F2018-09-0519∶00腹泻、恶心粪便+++
    Patient 19 Patient 19-F2018-09-0604∶00腹泻、腹痛、恶心、发热粪便+
    Patient 20 Patient 20-F2018-09-0605∶00呕吐粪便+
    Patient 21 Patient 21-F2018-09-0610∶00呕吐、腹泻、腹痛粪便+
    Patient 22 Patient 22-F2018-09-0804∶00呕吐、发热粪便+
    Patient 23 Patient 23-F2018-09-0913∶00腹泻、恶心、头晕粪便+
    Patient 24 Patient 24-F2018-09-0920∶00腹泻、恶心、头晕、乏力粪便+
    Patient 25 Patient 25-F2018-09-1004∶30呕吐、腹泻、腹痛、头晕、发热粪便+
    Patient 26 Patient 26-F2018-09-1006∶00呕吐、发热粪便+
    Patient 27 Patient 27-F2018-09-1008∶00呕吐、腹泻、腹痛粪便+
    Patient 28 Patient 28-F2018-09-1023∶00腹泻、腹痛、头晕粪便+
    Cook 1 Cook 1-F///粪便++
    下载: 导出CSV

    表  2  可疑污染食品ces基因检测和蜡样芽胞杆菌平板计数

    Table  2.   Result of ces gene test and plate count of B. cereus for suspected contaminated food

    食品编号可疑食品名称餐次平板计数(CFU/g)ces基因(实时荧光PCR检测Ct值)
    Food 1肥肠面9月3日午餐<1036.78
    Food 2小笼包a9月3日午餐1027.55
    Food 3红烧肉9月3日晚餐<1025.81
    Food 4黄焖鸡9月3日晚餐<10
    Food 5鸡肉炒饭a9月4日午餐500028.68
    Food 6南厅麻辣烫a9月4日午餐16000027.03
    Food 7北厅麻辣烫a9月4日午餐8100
      注:a. 从蜡样芽胞杆菌阳性样本分离平板中挑取3个单克隆进行ces基因检测,结果均为阴性;−.无结果
    下载: 导出CSV
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  • 收稿日期:  2021-04-20
  • 网络出版日期:  2021-07-09
  • 刊出日期:  2021-08-31

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