Thomas M, Noah N D
Lancet. 1977 May 14;1(8020):1046-8. doi: 10.1016/s0140-6736(77)91272-7.
An outbreak of Clostridium perfringens (C.welchii) food-poisoning affected a third of the patients in a large hospital, and one frail patient died. C.perfringens type A, serotype 1, was isolated from 46 (61 per cent) of 76 patients examined and from food, and a new serotype (61) was isolated from 16. The attack-rate among patients who ate a minced-ham dish was 78 per cent. The cooking and storage of this mince was faulty: cuts of meat were much too large, they were kept at room temperature too long before refrigeration, and after cooking they were put into mincers used also for raw meat. C.perfringens type A, serotype 1, was isolated from meat scraps in a mincer. Final reheating was inadequate to destroy even vegetative bacteria, and multiplication may have occurred during slow distribution to the wards. Outbreaks of C.perfringens fool-poisoning are common in hospitals, and some underlying problems are discussed. A plea is made for the Food Hygiene Regulations to apply to National Health Service premises and for simple but effective reforms in institutional catering management.
一次产气荚膜梭菌(韦氏梭菌)食物中毒事件影响了一家大型医院三分之一的患者,一名体弱患者死亡。从76名接受检查的患者中的46名(61%)以及食物中分离出了A型1型产气荚膜梭菌,从16名患者中分离出了一种新的血清型(61型)。食用碎火腿菜肴的患者中的发病率为78%。这种碎肉的烹饪和储存存在问题:肉块太大,在冷藏前在室温下放置时间过长,烹饪后又放入也用于生肉的绞肉机中。从绞肉机中的肉屑中分离出了A型1型产气荚膜梭菌。最后的再加热不足以杀死甚至是营养型细菌,并且在缓慢分发给病房的过程中可能发生了细菌繁殖。产气荚膜梭菌食物中毒事件在医院中很常见,并对一些潜在问题进行了讨论。呼吁食品卫生法规适用于国民医疗服务体系场所,并对机构餐饮管理进行简单而有效的改革。