Rushdy A A, Wall R, Seng C, Wall P G, Stuart J M, Ridley A M, Threlfall E J, Ward L R
PHLS Communicable Disease Surveillance Centre, London, UK.
J Hosp Infect. 1997 Jun;36(2):123-31. doi: 10.1016/s0195-6701(97)90118-3.
A nosocomial outbreak of Salmonella enteritidis phage type 4 occurred in July 1995. Seven definite cases were identified over 13 days affecting four wards in a London hospital. The outbreak strain was characterized by plasmid profile typing and pulsed-field gel electrophoresis (PFGE), and was unusual in that it did not possess a 38 MDa plasmid common to most isolates of S. enteritidis PT 4 made from humans and food animals in England and Wales. Seven asymptomatic excreters were identified on screening. No additional cases occurred on wards after standard isolation procedures were implemented. No common or continuing food or dietary source was identified. Results of epidemiological, microbiological and environmental investigations suggested that the outbreak was due to person-to-person transmission within the hospital. The source of the outbreak was not established but was probably due to admission of a patient with an unrecognized infection of S. enteritidis PT 4. The study highlights the importance of close collaboration between hospital staff, epidemiologists and microbiologists, and demonstrates the value of molecular techniques for strain subdivision in outbreak investigations.
1995年7月，一家伦敦医院发生了一起4型肠炎沙门氏菌医院感染暴发事件。在13天内共确认了7例确诊病例，涉及该医院的4个病房。通过质粒图谱分型和脉冲场凝胶电泳（PFGE）对暴发菌株进行了特征分析，该菌株不同寻常之处在于它不具有英格兰和威尔士从人类和食用动物分离出的大多数肠炎沙门氏菌PT4菌株所共有的38 MDa质粒。筛查发现了7名无症状排泄者。实施标准隔离程序后，病房内未再出现新增病例。未确定共同或持续的食物或饮食来源。流行病学、微生物学和环境调查结果表明，此次暴发是由于医院内的人际传播所致。暴发源头未明确，但可能是由于一名感染未被识别的4型肠炎沙门氏菌患者入院所致。该研究强调了医院工作人员、流行病学家和微生物学家密切合作的重要性，并证明了分子技术在暴发调查中进行菌株细分的价值。
