Pinner R W, Schuchat A, Swaminathan B, Hayes P S, Deaver K A, Weaver R E, Plikaytis B D, Reeves M, Broome C V, Wenger J D
Meningitis and Special Pathogens Branch, Centers for Disease Control, Atlanta, Ga 30333.
JAMA. 1992 Apr 15;267(15):2046-50.
To evaluate the role of foods in sporadic listeriosis.
Microbiologic survey of foods collected from refrigerators of patients with listeriosis identified through active laboratory-based surveillance. Patient and food Listeria monocytogenes isolates were subtyped to identify foods contaminated with the same strain of L monocytogenes that caused illness in the patient; samples of these foods were obtained from the retail source.
Multistate population-based study conducted between 1988 and 1990.
Listeria monocytogenes grew from at least one food specimen in the refrigerators of 79 (64%) of 123 listeriosis patients; 11% of more than 2000 food specimens collected in the study contained L monocytogenes. Twenty-six (33%) of 79 refrigerators with foods that grew L monocytogenes contained at least one food isolate of the same strain as that in the corresponding patient, a frequency much higher than would be expected by chance (P less than .001). Multivariate analysis showed that of the food specimens that grew L monocytogenes, foods that were ready-to-eat, foods that grew L monocytogenes by a direct-plating method (a measure of the level of contamination), and foods that contained serotype 4b isolates were independently associated with an increased likelihood of containing the patient-matching strain.
We identified specific food and L monocytogenes isolate characteristics--ready-to-eat foods, foods containing higher concentrations of L monocytogenes, and foods containing serotype 4b--which were associated with disease-causing strains. These results can provide guidance to industry and regulatory agencies in developing strategies to prevent listeriosis.
评估食物在散发性李斯特菌病中的作用。
通过基于实验室的主动监测确定李斯特菌病患者冰箱中收集的食物的微生物学调查。对患者和食物中的单核细胞增生李斯特菌分离株进行亚型分析，以确定被与导致患者发病的相同单核细胞增生李斯特菌菌株污染的食物；这些食物的样本从零售来源获取。
1988年至1990年进行的多州人群研究。
123例李斯特菌病患者中，79例（64%）患者冰箱中的至少一份食物标本中培养出单核细胞增生李斯特菌；研究中收集的2000多份食物标本中，11%含有单核细胞增生李斯特菌。79台培养出单核细胞增生李斯特菌的冰箱中，有26台（33%）至少含有一种与相应患者分离株相同菌株的食物分离株，该频率远高于偶然预期（P<0.001）。多变量分析显示，在培养出单核细胞增生李斯特菌的食物标本中，即食食品、通过直接接种法培养出单核细胞增生李斯特菌的食物（污染程度的一种衡量指标）以及含有4b血清型分离株的食物，独立地与含有患者匹配菌株的可能性增加相关。
我们确定了特定的食物和单核细胞增生李斯特菌分离株特征——即食食品、单核细胞增生李斯特菌浓度较高的食物以及含有4b血清型的食物——这些特征与致病菌株相关。这些结果可为行业和监管机构制定预防李斯特菌病的策略提供指导。
