Schuchat A, Deaver K A, Wenger J D, Plikaytis B D, Mascola L, Pinner R W, Reingold A L, Broome C V
Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Ga 30333.
JAMA. 1992 Apr 15;267(15):2041-5.
To identify dietary risk factors for sporadic listeriosis.
Case-control study with blinded telephone interviews.
Multistate population of 18 million persons, November 1988 through December 1990.
One hundred sixty-five patients with culture-confirmed listeriosis and 376 control subjects matched for age, health care provider, and immunosuppressive condition.
The annual incidence of invasive listeriosis was 7.4 cases per million population; 23% of the infections were fatal. Cases were more likely than matched controls to have eaten soft cheeses (odds ratio [OR], 2.6; 95% confidence interval [CI], 1.4 to 4.8; P = .002) or food purchased from store delicatessen counters (OR, 1.6; 95% CI, 1.0 to 2.5; P = .04); 32% of sporadic disease could be attributed to eating these foods. Sixty-nine percent of cases in men and nonpregnant women occurred in cancer patients, persons with the acquired immunodeficiency syndrome, organ transplant recipients, or those receiving corticosteroid therapy. Among these immunosuppressed patients, eating undercooked chicken also increased the risk of listeriosis (OR, 3.3; 95% CI, 1.2 to 9.2; P = .02).
Foodborne transmission may account for a substantial portion of sporadic listeriosis. Prevention efforts should include dietary counseling of high-risk patients and continued monitoring of food production.
确定散发性李斯特菌病的饮食风险因素。
采用盲法电话访谈的病例对照研究。
1988年11月至1990年12月期间，涉及1800万人的多州人群。
165例经培养确诊的李斯特菌病患者和376名年龄、医疗服务提供者及免疫抑制状况相匹配的对照者。
侵袭性李斯特菌病的年发病率为每百万人口7.4例；23%的感染是致命的。病例比匹配的对照者更有可能食用软奶酪（比值比[OR]，2.6；95%置信区间[CI]，1.4至4.8；P = 0.002）或从商店熟食柜台购买的食品（OR，1.6；95% CI，1.0至2.5；P = 0.04）；32%的散发性疾病可归因于食用这些食物。男性和非孕妇中的69%的病例发生在癌症患者、获得性免疫缺陷综合征患者、器官移植受者或接受皮质类固醇治疗的患者中。在这些免疫抑制患者中，食用未煮熟的鸡肉也会增加李斯特菌病的风险（OR，3.3；95% CI，1.2至9.2；P = 0.02）。
食源性传播可能占散发性李斯特菌病的很大一部分。预防措施应包括对高危患者进行饮食咨询以及持续监测食品生产。
