Cieslak P R, Noble S J, Maxson D J, Empey L C, Ravenholt O, Legarza G, Tuttle J, Doyle M P, Barrett T J, Wells J G, McNamara A M, Griffin P M
National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Ga 30333, USA.
Am J Public Health. 1997 Feb;87(2):176-80. doi: 10.2105/ajph.87.2.176.
This study sought to determine whether a multistate fast food hamburger-associated outbreak of Escherichia coli O157:H7 infection involved Las Vegas residents as well and, if so, why public health officials had not detected it.
A matched case-control study was conducted among persons with bloody diarrhea and their healthy meal companions. Hamburger production, distribution, and cooking methods were reviewed. Unused hamburger patties were cultured, and E. coli O157:H7 isolates were characterized. Local laboratory stool culture practices were reviewed.
Fifty-eight cases of bloody diarrhea were identified. Illness was associated with eating regular hamburgers (matched odds ratio [OR] = 9.0, 95% confidence interval [CI] = 1.02,433.4), but 25% of ill persons reported eating only jumbo hamburgers. Regular and jumbo hamburger patties yielded E. coli O157:H7 indistinguishable from the lone clinical isolate. No local laboratory cultured routinely for E. coli O157:H7 until after the outbreak.
A large outbreak of E. coli O157:H7 infections escaped timely notice in Las Vegas because local laboratories did not culture for this pathogen. Health officials should encourage laboratories to screen at least all bloody stools on sorbitol-MacConkey medium.
本研究旨在确定一起与多州快餐汉堡相关的大肠杆菌O157:H7感染暴发是否涉及拉斯维加斯居民，若涉及，公共卫生官员为何未检测到。
对患有血性腹泻的患者及其健康的用餐同伴进行配对病例对照研究。回顾汉堡的生产、配送和烹饪方法。对未使用的汉堡肉饼进行培养，并对大肠杆菌O157:H7分离株进行特征分析。回顾当地实验室粪便培养操作。
共确定58例血性腹泻病例。疾病与食用常规汉堡有关（配对比值比[OR]=9.0，95%置信区间[CI]=1.02,433.4），但25%的患病者报告仅食用巨型汉堡。常规和巨型汉堡肉饼培养出的大肠杆菌O157:H7与唯一的临床分离株无法区分。在此次暴发之前，当地实验室没有对大肠杆菌O157:H7进行常规培养。
拉斯维加斯的一起大规模大肠杆菌O157:H7感染暴发未被及时发现，原因是当地实验室未对该病原体进行培养。卫生官员应鼓励实验室至少在山梨醇麦康凯培养基上对所有血性粪便进行筛查。
