一起学校F型产气荚膜梭菌食物中毒事件分析

郁旷明; 彭健; 杨素青; 方叶珍; 黄世旺; 蒋思清; 王书菁; 金轶卉

doi:10.16835/j.cnki.1000-9817.2025296

一起学校F型产气荚膜梭菌食物中毒事件分析

doi: 10.16835/j.cnki.1000-9817.2025296

杭州市上城区疾病预防控制中心(杭州市上城区卫生监督所)，浙江 310004

基金项目:

浙江省疾病预防控制科技计划项目 2025JK052

详细信息

作者简介:
郁旷明(1978-)，男，浙江杭州人，大学本科，副主任医师，主要从事学校食源性疾病防控工作

通讯作者:
黄世旺，E-mail：hshw2003@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G478 R155 R181.3⁺²
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出版历程
- 收稿日期: 2025-03-28
- 修回日期: 2025-07-14
- 刊出日期: 2025-10-25

Analysis of food poisoning event by type F Clostridium perfringens in a school

Hangzhou Shangcheng District Center for Disease Control and Prevention (Hangzhou Shangcheng District Health Supervision Institution), Hangzhou 310004, Zhejiang Province, China

摘要

摘要: 目的了解浙江省杭州市某校发生的一起食物中毒事件的流行病学及病原学特征，为相关突发性事件的科学处置提供参考依据。方法通过流行病学调查确定2024年5月浙江省杭州市某校一起食物中毒事件，开展病例对照研究以查找可疑食物，采用卫生学调查发现风险因素，采集患者和从业人员肛拭、食堂留样、环节涂抹等标本进行病原体快速初筛，根据筛查结果进行可疑病原体产气荚膜梭菌(CP)分离鉴定，对分离菌株进行毒素基因检测和全基因组测序分析。结果此次食物中毒事件共造成45人出现腹泻、腹痛等胃肠道症状，可疑食物为5月29日中餐学生食堂番茄炒蛋和玉米排骨。卫生学调查发现，该食堂在食物加工、制备、贮存环节存在污染风险。46份肛拭和10份食堂留样CP 16 S阳性，27份样本中分离出59株CP，10例病例和1名从业人员分离株的CPE(cpe)阳性(F型)、全基因组进化分析为同一来源。结论该起食物中毒事件由携带CPE(cpe)的F型CP感染引起，从业人员带菌为可能的暴发源头。建议食堂从业人员应加强培训并进行常见食源性病原体的定期监测。
- 梭菌，产气荚膜 /
- 食物中毒 /
- 基因 /
- 学生
Abstract: Objective To understand the epidemiological and etiological characteristics of food poisoning event occurred in a school in Hangzhou, Zhejiang, so as to provide reference for the scientific management of related emergencies. Methods By determining the nature of the event through epidemiological investigation, a case-control study was carried out to spot suspicious food in May 2024. The hygienic investigation was conducted to find out possible pollution links and factors, patients and canteen practitioners' anal swab, canteen retention samples, catering link daub and other specimens were collected, for rapid pathogen screening. And the suspected pathogen Clostridium perfringens (CP) were isolated and identified according to the screening results, and toxin gene detection and whole genome sequencing and cluster analysis of CP isolated strains were carried out. Results The incident resulted in 45 people experiencing gastrointestinal symptoms, such as diarrhea and abdominal pain. The suspicious food was tomato scrambled eggs and corn ribs provided by the student canteen for lunch on May 29. A hygiene investigation found that there was a risk of contamination in the food processing, preparation and storage. A total of 46 anal swabs and 10 canteen retention samples were positive for CP 16 S, 59 strains of CP were isolated from 27 samples, 10 cases and 1 practitioner isolate were positive for CPE (cpe) (F mode), and their whole genome evolution analysis was conducted based on the same source. Conclusions The food poisoning event is caused by CP infection carrying CPE (cpe) (F mode), and the possible sources of outbreak are the carriers of the CP by employees. It is recommended that cafeteria staff strengthen training on common foodborne diseases and conduct regular monitoring of pathogens.
- Clostridium perfringens /
- Food poisoning /
- Genes /
- Students
注释:

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HTML全文

图 1 基于24株产气荚膜梭菌的全基因组系统发育进化树

注：共设24株CP，其中23株来自本事件[11株CPE(cpe)阳性]、12株CPE(cpe)阴性，另1株为CP参考菌株; CP 204-1中204代表样本号，-1代表菌落号，其他依此类推; 进化树节点处标注的数字为自检值，反映了拓扑分支结构准确性。

Figure 1. Whole genome phylogenetic tree of 24 CP perfringens strains

下载: 全尺寸图片幻灯片

参考文献(20)

[1]	SAITO K, KIMATA K, WATAHIKI M, et al. Investigation of an outbreak of clostridium perfringens in Toyama, Japan, 2023 using single-nucleotide polymorphism analysis for genotyping[J]. Jpn J Infect Dis, 2025, 78(1): 47-50.
[2]	GRASS J E, GOULD L H, MAHON B E. Epidemiology of foodborne disease outbreaks caused by Clostridium perfringens, United States, 1998-2010[J]. Foodborne Pathog Dis, 2013, 10(2): 131-136.
[3]	ALEX B, SARAN S, DAMON B, et al. Outbreak of Clostridium perfringens food poisoning linked to leeks in cheese sauce: an unusual source[J]. Epidemiol Infect, 2020, 148: e43.
[4]	KIM S, SON H. An outbreak of Clostridium perfringens infection on a training ship anchored in Busan, Korea[J]. Epidemiol Health, 2024, 46: e2024086.
[5]	庄茂强, 吴光健, 蒋玉艳, 等. 2010—2020年中国大陆学校食源性疾病暴发事件分析[J]. 中国食品卫生杂志, 2022, 34(5): 1022-1028. ZHUANG M Q, WU G J, JIANG Y Y, et al. Foodborne disease outbreaks in schools in China's mainland from 2010 to 2020[J]. Chin J Food Hyg, 2022, 34(5): 1022-1028. (in Chinese)
[6]	SCALLAN E, GRIFFIN P M, ANGULO F J, et al. Foodborne illness acquired in the United States-unspecified agents[J]. Emerg Infect Dis, 2011, 17(1): 16-22.
[7]	赵凤玲, 高翔, 邹林, 等. 2022年北京市一起产气荚膜梭菌引起的食源性疾病暴发事件病原学分析[J]. 疾病监测, 2024, 39(3): 382-387. ZHAO F L, GAO X, ZOU L, et al. Etiological analysis on an outbreak of foodborne disease caused by Clostridium perfringens in Beijing, 2022[J]. Dis Surveillance, 2024, 39(3): 382-387. (in Chinese)
[8]	张莉, 代华, 简洁, 等. 贵州省一起产气荚膜梭菌引起食源性疾病暴发事件的调查及病原体溯源[J]. 中国食品卫生杂志, 2024, 36(5): 557-563. ZHANG L, DAI H, JIAN J, et al. Investigation of a foodborne disease outbreak caused by Clostridium perfringens in Guizhou Province and pathogen tracing[J]. Chin J Food Hyg, 2024, 36(5): 557-563. (in Chinese)
[9]	弋英, 郭凯, 肖华, 等. 导致一起食物中毒的产气荚膜梭菌的病原学特征和全基因组序列分析[J]. 中华预防医学杂志, 2024, 58(11): 1789-1795. YI Y, GUO K, XIAO H, et al. Etiological characteristics and whole genome sequence analysis of Clostridium perfringens causing a food poisoning outbreak[J]. Chin J Prev Med, 2024, 58(11): 1789-1795. (in Chinese)
[10]	浙江省卫生厅. 浙江省卫生监督机构食物中毒调查处理指导意见[Z]. 杭州: 浙江省卫生厅, 2007. Zhejiang Provincial Department of Health. Guidance on investigation and handling of food poisoning by health supervision agency of Zhejiang Province[Z]. Hangzhou: Zhejiang Provincial Health Department, 2007. (in Chinese)
[11]	中华人民共和国卫生部. 食品安全国家标准食品微生物学检验产气荚膜梭菌检验: GB 4789.13—2012[S]. 北京: 中国标准出版社, 2012. Ministry of Health of the PRC. National food safety standard-microbiological examination of food examination of Clostridium perfringens: GB 4789.13-2012[S]. Beijing: Standards Press of China, 2012. (in Chinese)
[12]	WICK R R, JUDD L M, GORRIE C L, et al. Unicycler: resolving bacterial genome assemblies from short and long sequencing reads[J]. PLoS Comput Biol, 2017, 13(6): e1005595.
[13]	GUREVICH A, SAVELIEV V, VYAHHI N, et al. QUAST: quality assessment tool for genome assemblies[J]. Bioinformatics, 2013, 29(8): 1072-1075.
[14]	STAMATAKIS A. RAxML version 8: a tool for phylogenetic analysis and post-analysis of large phylogenies[J]. Bioinformatics, 2014, 30(9): 1312-1313.
[15]	XU S, LI L, LUO X, et al. Ggtree: a serialized data object for visualization of a phylogenetic tree and annotation data[J]. Imeta, 2022, 1(4): e56.
[16]	中华人民共和国卫生部. 产气荚膜梭菌食物中毒诊断标准及处理原则: WS/T 7—1996[S]. 北京: 中国标准出版社, 2000. Ministry of Health of the PRC. Diagnostic criteria and principles of management for food poisoning of Clostridium perfringens: WS/T 7-1996[S]. Beijing: Standards Press of China, 2000. (in Chinese)
[17]	FERREIRA M K, MOREIRA G M, CUNHA C E, et al. Recombinant alpha, beta, and epsilon toxins of Clostridium perfringens: production strategies and applications as veterinary vaccines[J]. Toxins (Basel), 2016, 8(11): 340.
[18]	ADAMS V, HAN X, LYRAS D, et al. Antibiotic resistance plasmids and mobile genetic elements of Clostridium perfringens[J]. Plasmid, 2018, 99: 32-39.
[19]	LI J, MCCLANE B A. NanH is produced by sporulating cultures of Clostridium perfringens type f food poisoning strains and enhances the cytotoxicity of c. perfringens enterotoxin[J]. mSphere, 2021, 6(2): e00176-00121.
[20]	LI J, PAREDES-SABJA D, SARKER M R, et al. Clostridium perfringens sporulation and sporulation-associated toxin production[J]. Microbiol Spectr, 2016, 4(3): 10.1128.