一起学校大肠埃希菌O153暴发疫情的流行病学调查

发布时间：2018-05-25 21:30

  本文选题：肠产毒性大肠杆菌 + 疾病暴发流行　； 参考：《中国学校卫生》2017年08期

【摘要】：目的探讨温州市洞头区某学校一起由大肠埃希菌O153感染引起的暴发疫情的流行病学特征,为类似疫情防控提供技术支持。方法采用统一的流行病学个案调查表进行现场调查,描述流行特征,采取病例对照研究探讨病因假设,采集患者、食堂工作人员的肛拭标本进行病原微生物培养,采用多重PCR技术确定毒力基因。结果 2016年10月16—31日,1 256名学生和教职工中累计发现病例126例,罹患率为10.03%(126/1 256),无重症和死亡病例。患者的临床表现为腹泻(≥3次/d)(100.00%),伴有腹痛(84.13%)、恶心(27.78%)、呕吐(13.49%)、发热(7.14%)等症状。学生、教师不同食堂就餐罹患率差异有统计学意义(χ~2=0.24,P=0.01)。病例对照研究提示饮用学生食堂未烧开的水是此次暴发疫情的危险因素(OR=5.33,χ~2=10.33,P=0.00),病原微生物培养和多重PCR技术毒力基因鉴定确认为肠产毒大肠埃希菌O153感染。结论本次疫情为由肠产毒大肠埃希菌O153引起学校感染性腹泻暴发,病例分布呈现明显的聚集性,发病曲线呈持续性暴露,饮用学生食堂未烧开的水是危险因素。建议学校严格执行因病缺课登记,完善校医制度,做好食堂卫生和饮用水管理。
[Abstract]:Objective to investigate the epidemiological characteristics of an outbreak caused by Escherichia coli O153 infection in a school in Dongtou District of Wenzhou City in order to provide technical support for the prevention and control of similar outbreaks. Methods A unified epidemiological case questionnaire was used to investigate the epidemic characteristics. The etiological hypothesis was investigated by case-control study. The anal swab specimens of patients and staff in canteen were collected for culturing pathogenic microorganisms. The virulence gene was identified by multiplex PCR. Results A total of 126 cases were found in 1 256 students and teaching staff from October 16 to 31, 2016, with an attack rate of 10.03126 / 1256. There were no severe or fatal cases. The clinical manifestations of the patients were diarrhea (鈮，

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