1 Public Health England, National Infection Service, 61 Colindale Avenue, London NW9 5EQ, UK.
2 National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Gastrointestinal Infections, University of Liverpool, Liverpool L3 5TR, UK.
J Food Prot. 2019 Jan;82(1):30-38. doi: 10.4315/0362-028X.JFP-18-206.
This article describes the identification and investigation of two extended outbreaks of listeriosis in which crabmeat was identified as the vehicle of infection. Comparing contemporary and retrospective typing data of Listeria monocytogenes isolates from clinical cases and from food and food processing environments allowed the detection of cases going back several years. This information, combined with the analysis of routinely collected enhanced surveillance data, helped to direct the investigation and identify the vehicle of infection. Retrospective whole genome sequencing (WGS) analysis of isolates provided robust microbiological evidence of links between cases, foods, and the environments in which they were produced and demonstrated that for some cases and foods, identified by fluorescent amplified fragment length polymorphism, the molecular typing method in routine use at the time, were not part of the outbreak. WGS analysis also showed that the strains causing illness had persisted in two food production environments for many years and in one producer had evolved into two strains over a period of around 8 years. This article demonstrates the value of reviewing L. monocytogenes typing data from clinical cases together with that from foods as a means of identifying potential vehicles and sources of infection in outbreaks of listeriosis. It illustrates the importance of reviewing retrospective L. monocytogenes typing alongside enhanced surveillance data to characterize extended outbreaks and inform control measures. Also, this article highlights the advantages of WGS analysis for strain discrimination and clarification of evolutionary relationships that refine outbreak investigations and improve our understanding of L. monocytogenes in the food chain.
本文描述了两起李斯特菌 Extended Outbreaks(延伸暴发)的鉴定和调查,其中蟹肉被确定为感染源。将临床病例和食品及食品加工环境中分离的李斯特菌单增李斯特氏菌的当代和回顾性分型数据进行比较,可以检测到多年前的病例。这些信息,结合常规收集的强化监测数据的分析,有助于指导调查并确定感染源。对分离株进行回顾性全基因组测序(WGS)分析,为病例、食品以及它们产生的环境之间的关联提供了强有力的微生物学证据,并表明对于一些通过荧光扩增片段长度多态性识别的病例和食品,当时常规使用的分子分型方法并不属于暴发。WGS 分析还表明,导致疾病的菌株在两个食品生产环境中已经存在多年,在一个生产者中,在大约 8 年的时间里,已经进化成了两个菌株。本文证明了一起李斯特菌病暴发时,回顾性地对临床病例和食品中的李斯特菌分型数据进行审查,以确定潜在的感染源和传播途径的价值。它说明了审查回顾性李斯特菌分型数据与强化监测数据相结合,以描述延伸暴发并为控制措施提供信息的重要性。此外,本文还强调了 WGS 分析在菌株鉴别和阐明进化关系方面的优势,这可以改进暴发调查并提高我们对食品链中李斯特菌的认识。