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由森夫滕贝格沙门氏菌引起的医院内肠胃炎暴发。

Nosocomial outbreak of gastroenteritis due to Salmonella senftenberg.

作者信息

L'Ecuyer P B, Diego J, Murphy D, Trovillion E, Jones M, Sahm D F, Fraser V J

机构信息

Division of Infectious Diseases, Washington University School of Medicine, St. Louis, Missouri 63110-1093, USA.

出版信息

Clin Infect Dis. 1996 Oct;23(4):734-42. doi: 10.1093/clinids/23.4.734.

Abstract

We describe a prolonged nosocomial outbreak of Salmonella senftenberg, an uncommon human pathogen. We detected 22 cases of infection due to S. senftenberg that occurred from March 1993 through November 1994 and involved 18 patients and four healthy employees. All infected persons had consumed food prepared by the hospital kitchen. The estimated attack rate for the period of the outbreak was 0.19-0.23 cases per 100,000 meals served. Infection control interventions included observation of food preparation, disinfection of kitchen devices, and education of food handlers. The consumption of lettuce (11 of 15 patients who could recount extended dietary histories vs. 4 of 20 controls; P = .005), cauliflower (5 of 15 vs. 0/20; P = .02), cottage cheese (4 of 15 vs. 0/20; P = .03), and deli turkey (8 of 15 vs. 0/20; P < .001) was associated with S. senftenberg infection. The isolates had identical antibiograms and pulsed-field gel electrophoretic patterns. Cultures of stool samples from food handlers as well as food items, kitchen devices, and kitchen surroundings were negative for S. senftenberg. Interruption of the outbreak occurred coincidentally with the institution of infection control measures. This prolonged outbreak of salmonellosis was probably related to contamination in the kitchen from turkey, with cross-contamination via equipment.

摘要

我们描述了一起由罕见人类病原体森夫滕贝格沙门氏菌引起的长期医院感染暴发事件。我们检测到1993年3月至1994年11月期间发生的22例森夫滕贝格沙门氏菌感染病例,涉及18名患者和4名健康员工。所有感染者均食用了医院厨房制备的食物。此次暴发期间的估计发病率为每供应10万份餐食中有0.19 - 0.23例感染。感染控制措施包括观察食物制备过程、对厨房设备进行消毒以及对食品处理人员进行教育。食用生菜(15名能够详细描述饮食史的患者中有11名,而20名对照中有4名;P = 0.005)、花椰菜(15名中有5名,而20名对照中无;P = 0.02)、农家干酪(15名中有4名,而20名对照中无;P = 0.03)和熟食火鸡肉(15名中有8名,而20名对照中无;P < 0.001)与森夫滕贝格沙门氏菌感染有关。分离株具有相同的抗菌谱和脉冲场凝胶电泳图谱。食品处理人员的粪便样本以及食品、厨房设备和厨房环境的培养物中均未检测到森夫滕贝格沙门氏菌。感染暴发的中断与感染控制措施的实施同时发生。这起长期的沙门氏菌病暴发可能与厨房中火鸡肉的污染以及通过设备的交叉污染有关。

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