Department of Prevention - AUSL Pescara, Pescara, Italy.
Department of Infectious Diseases, Istituto Superiore di Sanità, Rome, Italy.
J Med Microbiol. 2021 Mar;70(3). doi: 10.1099/jmm.0.001262. Epub 2021 Jan 20.
In May-June 2018, an outbreak of campylobacteriosis involved students and school staff from kindergartens and primary schools in Pescara, southern Italy. We present details of the epidemiological and microbiological investigation, and the findings of the analytical study, as well as the implemented control measures. To identify possible risk factors associated with the observed outbreak, a case control study was conducted using a questionnaire to collect information on the date of symptoms onset, type and duration of symptoms, type of healthcare contact, school attendance, and food items consumed at school lunches during the presumed days of exposure. Attack rates were calculated for each date and school. Logistic regression models were used to estimate the odds ratios of being a case and the odds of illness by food items consumed, respectively. Moreover, we carried out a comparative genomic analysis using whole genome multilocus sequence typing (wgMLST) of strains isolated during the outbreak investigation to identify the source of the outbreak. Overall, 222 probable cases from 21 schools were identified, and was successfully isolated from 60 patients. The meals in the schools involved were provided by two cooking centres managed by a joint venture between two food companies. Environmental and food sampling, epidemiological and microbiological analyses, as well as a case control study with 176 cases and 62 controls from the same schools were performed to identify the source of the outbreak. The highest attack rate was recorded among those having lunch at school on 29 May (7.8 %), and the most likely exposure was 'caciotta' cheese (odds ratio 2.40, 95 % confidence interval 1.10-5.26, =0.028). was isolated from the cheese, and wgMLST showed that the human and cheese isolates belonged to the same genomic cluster, confirming that the cheese was the vehicle of the infection. It is plausible that a failure of the pasteurization process contributed to the contamination of the cheese batches. Timely suspension of the catering service and summer closure of the schools prevented further spread.
2018 年 5 月至 6 月，意大利南部佩斯卡拉的幼儿园和小学学生和教职员工爆发了一起弯曲杆菌病疫情。我们介绍了流行病学和微生物学调查的细节，以及分析研究的结果，以及实施的控制措施。为了确定与观察到的疫情相关的可能危险因素，我们采用病例对照研究方法，使用问卷收集了症状发作日期、症状类型和持续时间、医疗接触类型、学校出勤率以及在假定暴露日在学校午餐中食用的食物等信息。我们计算了每个日期和学校的发病率。使用逻辑回归模型分别估计了作为病例的几率和因食用食物而患病的几率。此外，我们对疫情调查期间分离的菌株进行了全基因组多位点序列分型（wgMLST）的比较基因组分析，以确定疫情的源头。总共确定了 21 所学校的 222 例疑似病例，从 60 名患者中成功分离出 。涉及的学校餐食由两家食品公司的合资企业管理的两个烹饪中心提供。为了确定疫情的源头，我们进行了环境和食物采样、流行病学和微生物学分析以及一项涉及同一学校的 176 例病例和 62 例对照的病例对照研究。发病率最高的是 5 月 29 日在学校吃午餐的人群（7.8%），最有可能的暴露源是“卡乔塔”奶酪（比值比 2.40，95%置信区间 1.10-5.26，=0.028）。从奶酪中分离出 ，wgMLST 显示，人类和奶酪分离株属于同一基因组群，证实奶酪是感染的媒介。奶酪批次污染可能是巴氏消毒过程失败所致。及时暂停餐饮服务和学校暑期关闭阻止了疫情进一步蔓延。
