基于流行病学调查报告对甘肃省食源性疾病事件实验室证据及相关问题的分析

王玉明; 崔燕; 李拥军

doi:10.3784/jbjc.202205130215

基于流行病学调查报告对甘肃省食源性疾病事件实验室证据及相关问题的分析

doi: 10.3784/jbjc.202205130215

王玉明^1,,
崔燕²,
李拥军^2, ,

1.
甘肃中医药大学, 甘肃兰州 730000
2.
甘肃省疾病预防控制中心, 甘肃兰州 730000

基金项目: 甘肃省科技计划项目（No. 20CX4ZA022）

详细信息

作者简介:
王玉明，女，甘肃省陇西县人，主任医师，从事食源性疾病监测及应急处置工作，Email：1092978145@qq.com

通讯作者:
李拥军，Tel：18189510208，Email：646343850@qq.com

中图分类号: R211; R155
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出版历程
- 收稿日期: 2022-05-13
- 网络出版日期: 2023-03-28
- 刊出日期: 2023-04-30

Laboratory evidence of foodborne disease events and related problems in Gansu based on epidemiological survey reports

Wang Yuming^1
,,
Cui Yan²,
Li Yongjun^{2
, ,}

1.
Gansu University of Traditional Chinese Medicine, Lanzhou 730000, Gansu, China
2.
Gansu Provincial Center for Disease Control and Prevention, Lanzhou 730000, Gansu, China

Funds: This study was supported by the fund for Science and Technology Program of Gansu Province (No. 20CX4ZA022)

More Information

Corresponding author: Li Yongjun, Email: 646343850@qq.com

摘要

摘要: 目的分析甘肃省食源性疾病事件中实验室检验对其结论的支持力度，以及影响实验室检出的部分因素，为提升甘肃省食源性疾病事件调查结论的质量提供依据。方法收集2018—2020年甘肃省发病≥5例的食源性疾病事件的流行病学调查报告，对实验室检验或影响检出的有关信息进行整理，按照相关指南及标准的要求对结论进行评价。结果共收集102起事件的流行病学调查报告，47起明确致病因子种类，但仅有15起（31.91%）事件中致病因子获得充分的实验室证据支持，其中化学性事件占83.33%，细菌性和植物性及毒蘑菇中毒事件分别占24.00%和25.00%；另外55起诊断为不明原因事件，分析认为疾病预防控制中心接报及时性对事件处置中样品的可获得性有影响，且该类事件仅有23.08%的检测项目选择恰当。结论应重点加强细菌性、植物性及野蘑菇中毒事件处置中实验室检验工作，从加强事件调查中的采样工作和提高检测项目选择准确性两方面着手可降低不明原因事件比例。
- 食源性疾病事件 /
- 实验室证据 /
- 流行病学调查
Abstract: Objective To evaluate the laboratory evidence support in the identification of foodborne disease events and related factors in Gansu province, and provide evidence for improving the quality of investigation results of food-borne disease events. Methods Epidemiological survey reports of food borne disease events involving more than 5 patients in Gansu from 2018 to 2020 were collected, and information about laboratory tests or related factors were analyzed, and the conclusions of the reports were evaluated according to the requirements of relevant guidelines and standards. Results A total of 102 survey reports of foodborne disease events were collected, of which 47 had clear etiological conclusions, but only 15 (31.91%) had sufficient laboratory evidences. Chemical events accounted for 83.33%, and the proportions of bacterial and botanical or mushroom poisoning events were only 24.0% and 25.0%, respectively. The other 55 foodborne disease events were unexplained. The analysis suggested that the timely reporting to centers for disease control and prevention had an impact on the collection of samples in the event response, and only 23.08% of test items were appropriate. Conclusion It is necessary to strengthen the laboratory testing for bacterial and botanical or wild mushroom poisoning cases. The proportion of unexplained events can be reduced by improving the sample collection and detection item selection.
- Food-borne disease events /
- Laboratory evidence /
- Epidemiological survey

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表 1 25起细菌性事件实验室检测情况

Table 1. Laboratory testing of 25 bacterial events

实验室检测　结果	检出微生物	事件数（起）
实验室检测　结果	检出微生物	证据充分	证据欠充分	无证据	总计
致病菌阳性	沙门菌	3	7	0	10
	志贺菌	2	0	0	2
	金黄色葡萄球菌	0	2	0	2
	蜡样芽孢杆菌	1	0	0	1
	大肠埃希菌	0	1	0	1
	变形杆菌和大肠埃希菌	0	1	0	1
致病菌阴性		0	0	1	1
未采样		0	0	7	7
合计		6	11	8	25

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表 2 55起食源性不明原因事件中未采样原因分析

Table 2. Reasons for sampling failure for 55 unexplained foodborne disease events

事件分类	未采样原因	起数	占比（%）
未采集生物样（n=43）	未提及采样事宜	25	58.14
	报告晚或样本已清理	11	25.58
	医院未采到	5	11.63
	已使用抗生素	2	4.65
未采集食物样（n=38）	未提及采样事宜	26	68.42
	无剩余食物	9	23.68
	因故未采	3	7.89

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