Li Y, Dong Y P, Zhang D, Li F Q
Children's Hospital Affiliated to Capital Institute of Pediatrics, Beijing 100020, China.
Key Lab of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing 100021, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Feb 6;52(2):129-133. doi: 10.3760/cma.j.issn.0253-9624.2018.02.003.
Laboratory-based characterization and traceability were performed on an outbreak of necrotising enterocolitis (NEC) happened in a maternal and child health care hospital in China. Thirty-seven samples were collected from 3 NEC cases, that the clinical manifestations was bloody stools. . isolation and identification were carried out on stool, breast milk, milk-based infant powder and environmental swab samples collected during NEC outbreak from October to November in 2016. Meanwhile, twenty-four swabs samples from ward environmental, staffs' hand as well as articles for neonates daily use were also collected and tested for . after disinfection following outbreak. Pulsed-field gel electrophoresis (PFGE) analysis was performed on all strains obtained. 46% (17/37) samples were positive for a presumptive . during the outbreak of NEC. One type of . isolates was cultured from 10 samples including the hands of medical staffs, some medical equipments in the ward and milk-based infant powder ingested by the case, it was identified as . Another type of . isolates was cultured from 2 samples including breast milk and inner wall of breast milk fresh-keeping bag, it was identified as . Both of these two types isolates were cultured from 5 samples including inner wall of breast milk box, inner wall of refrigerator, the handle of case's incubator and the case's stool. PFGE analysis showed that all 15 strains of and 7 strains of isolated from the samples mentioned above produced indistinguishable pulsotypes respectively. No NEC cases were found after disinfection following the outbreak and all samples collected after outbreak were negative for . The outbreak of NEC was highly related to contamination within the hospital.
对中国一家妇幼保健院发生的坏死性小肠结肠炎（NEC）疫情进行了基于实验室的特征分析和溯源。从3例NEC病例中采集了37份样本，这些病例的临床表现为便血。对2016年10月至11月NEC疫情期间采集的粪便、母乳、以牛奶为基础的婴儿配方奶粉和环境拭子样本进行了分离和鉴定。同时，还采集了24份来自病房环境、工作人员手部以及新生儿日常用品的拭子样本，并在疫情爆发后的消毒后进行检测。对所有获得的菌株进行了脉冲场凝胶电泳（PFGE）分析。在NEC疫情期间，46%（17/37）的样本对一种推定的……呈阳性。从10份样本中培养出一种……分离株，包括医务人员的手、病房中的一些医疗设备以及病例摄入的以牛奶为基础的婴儿配方奶粉，鉴定为……从2份样本中培养出另一种……分离株，包括母乳和母乳保鲜袋内壁，鉴定为……这两种分离株都从5份样本中培养出来，包括母乳盒内壁、冰箱内壁、病例培养箱的把手和病例的粪便。PFGE分析表明，从上述样本中分离出的所有15株……和7株……分别产生了无法区分的脉冲型。疫情爆发后的消毒后未发现NEC病例，疫情爆发后采集的所有样本对……均为阴性。NEC疫情与医院内的……污染高度相关。
