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目的对1例反复腹泻的4月龄婴儿进行病原学检测和溯源分析,为临床治疗和预防由此引起的食源性疾病提供依据。方法根据流行病学调查资料,采集患儿粪便样本4次,食用奶粉、米粉及饮食相关器皿及环境样本进行肠道病原菌分离培养,对检出的病原菌进行药敏试验和脉冲场凝胶电泳(pulsed-field gel electrophoresis,PFGE)分子分型,根据药敏结果指导临床用药。结果前3次采集的患儿粪便和患儿家中放置奶瓶的桌面涂抹样中均检出阪崎肠杆菌,4株分离株PFGE型别一致,患儿经敏感性治疗康复。结论阪崎肠杆菌可通过环境污染感染致病,快速准确的诊断及敏感性治疗能及时治愈阪崎肠杆菌感染。
Objective To analyze the pathogenicity and traceability of a 4-month-old infant with recurrent diarrhea to provide the basis for clinical treatment and prevention of food-borne diseases. Methods According to the epidemiological survey data, the stool samples of children were collected for 4 times, the milk powder, rice flour, food-related utensils and environmental samples were collected for the isolation and culture of intestinal pathogens. The pathogenic bacteria were detected by drug sensitivity test and pulsed-field gel electrophoresis pulsed-field gel electrophoresis, PFGE) molecular typing, according to the drug susceptibility results to guide clinical medication. Results Enterobacter sakazakii was detected in the feces collected from the first three times and from the desktop smear placed in the home. The PFGE patterns of the four isolates were identical. The children were rehabilitated by sensitive treatment. Conclusion Enterobacter sakazakii can cause infection by environmental pollution, rapid and accurate diagnosis and sensitive treatment can promptly cure Enterobacter sakazakii infection.