Gallay Anne, Bousquet Vanina, Siret Virginie, Prouzet-Mauléon Valérie, Valk Henriette de, Vaillant Véronique, Simon Fernando, Le Strat Yann, Mégraud Francis, Desenclos Jean-Claude
Département Maladies Infectieuses, Institut de Veille Sanitaire, Saint-Maurice, France.
J Infect Dis. 2008 May 15;197(10):1477-84. doi: 10.1086/587644.
To better document the risk factors for sporadic Campylobacter infection in France, we conducted a national case-control study from September 2002 to June 2004.
Cases with confirmed Campylobacter infection were sampled through the national surveillance laboratory network. Cases and controls who were matched for age, as well as attending physicians, were interviewed about foods consumed, food preparation practices, travel history, contact with cases and animals during the 8 days before the onset of infection, and any antibiotic use occurring during the 30 days before onset. Matched odds ratios [ORs] were calculated using conditional logistic regression and multiple imputation methods.
A total of 285 pairs of cases and matched controls were enrolled. "Ate undercooked beef" (OR, 2.86; 95% confidence interval [CI], 1.65-4.95), "ate at restaurant" (OR, 2.20; 95% CI, 1.23-3.93), and "poor utensils hygiene in the kitchen" (OR, 2.12; 95% CI, 1.33-3.37) were the main independent risk factors for infection. Cases infected with a ciprofloxacin-resistant Campylobacter jejuni strain were more likely than controls to have used antibiotics in the month before onset.
Good hygiene practices in the kitchen remain a strong recommendation to avoid cross-contamination. However, studies are needed to explore the mechanism of contamination throughout the food chain. The use of antibiotics in humans may favor the development of a resistant infection.
为了更好地记录法国散发性弯曲杆菌感染的危险因素,我们在2002年9月至2004年6月期间开展了一项全国性病例对照研究。
通过国家监测实验室网络对确诊为弯曲杆菌感染的病例进行采样。对年龄匹配的病例和对照以及主治医生就感染发作前8天内食用的食物、食物制备方法、旅行史、与病例和动物的接触情况以及发作前30天内使用的任何抗生素进行了访谈。使用条件逻辑回归和多重插补方法计算匹配比值比(OR)。
共纳入285对病例和匹配对照。“食用未煮熟的牛肉”(OR,2.86;95%置信区间[CI],1.65 - 4.95)、“在餐馆就餐”(OR,2.20;95%CI,1.23 - 3.93)和“厨房用具卫生差”(OR,2.12;95%CI,1.33 - 3.37)是感染的主要独立危险因素。感染对环丙沙星耐药的空肠弯曲杆菌菌株的病例比对照在发作前一个月更有可能使用过抗生素。
仍强烈建议在厨房保持良好的卫生习惯以避免交叉污染。然而,需要开展研究以探索整个食物链中的污染机制。人类使用抗生素可能有利于耐药感染的发生。