2021年安徽省阜阳市一起感染性腹泻暴发疫情的病原菌溯源分析

郭国侠; 孟昭倩; 高夏莲; 段然; 郭靓子; 卜戈

doi:10.3784/jbjc.202303030077

2021年安徽省阜阳市一起感染性腹泻暴发疫情的病原菌溯源分析

Infection source of an infectious diarrhea epidemic in Fuyang, Anhui province in 2021

摘要

摘要:
目的对2021年安徽省阜阳市某集中供餐学校发生的一起感染性腹泻暴发疫情进行病原学检测及溯源分析，为疫情处置和控制提供科学依据。
方法根据流行病学特征，采集患者肛拭子、粪便、呕吐物和食堂留样食品等进行病原体检测。对分离出的细菌进行鉴定、药敏试验、毒力基因检测、脉冲场凝胶电泳（PFGE）和全基因序列分析。
结果从患者和留样食品中分离出19株肠炎沙门菌，均携带毒力基因（invA、sopE、agfA、spvR、hilA、stn、pefA）。 19株肠炎沙门菌对萘啶酸均耐药，18株菌对氨苄西林、四环素、头孢噻肟、头孢他啶、氨苄西林/舒巴坦和链霉素耐药。全基因组测序的6株肠炎沙门菌均检测出7种获得性耐药基因和1个靶基因位点突变，分别为aac(6')-Iy、aph(3'')-Ib、aph(6)-Id、bla_TEM-1B、aac(6')-Iaa、sul2、tet(A)和gyrA (p.D87Y)。 19株肠炎沙门菌的PFGE带型相似度是100.00%，均为ST11型。
结论引起此次感染性腹泻暴发的病原体为肠炎沙门菌，感染来源为金丝脆鸡排。分离菌株对青霉素和头孢菌素高度耐药，耐药机制与携带bla_TEM-1B相关。

Abstract:
Objective To identify the pathogen and infection source of an infectious diarrhea epidemic in a school in Fuyang, Anhui province, in 2021, and provide scientific evidence for the epidemic management and control.
Methods According to the epidemiological characteristics, the anal swabs, stool samples and vomit samples from the cases and food samples from the canteen were collected for the detection of pathogens. The strain identification, drug susceptibility test, virulence gene detection, pulsed-field gel electrophoresis (PFGE) and whole genome sequence analysis were conducted.
Results A total of 19 strains of Salmonella Enteritidis were isolated from the cases and food samples, all carried virulence genes (invA, sopE, agfA, spvR, hilA, stn, pefA). All the S. Enteritidis strains were resistant to nalidixic acid, 18 strains were resistant to ampicillin, tetracycline, cefotaxime, ceftazidime, ampicillin/sulbactam, and streptomycin and 7 acquired resistance genes and 1 target gene mutation were detected in 6 strains of S. Enteritidis, including aac (6')-Iy, aph (3)-Ib, aph (6)-Id, bla_TEM-1B, aac (6')-Iaa, sul2, tet (A) and gyrA (p.D87Y). The PFGE pattern bands of 19 strains of S. Enteritidis showed 100.00% similarity, all were ST11.
Conclusion The pathogen causing the epidemic of infectious diarrhea was S. Enteritidis, and the isolated strains showed high resistance to penicillin and cephalosporin. The infection source was dish golden crispy chicken chops. The mechanism of drug resistance was related to the carriage of bla_TEM-1B.

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