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目的对一例9月龄反复腹泻婴儿进行流行病学调查和实验室检测,为诊断提供依据。方法根据流行病学调查,采集患儿粪便、奶粉、米粉等食品及奶瓶等可疑样本,进行常见肠道病原菌的分离培养,对检出的病原菌进行脉冲场凝胶电泳分子分型和药敏实验。结果患儿断奶后以某品牌羊奶粉为主食,出现发热伴腹泻症状,反复近半个月,后经头孢噻肟和维生素C治疗得到康复。患儿的粪便、羊奶粉及两个奶瓶经检测均检出阪崎肠杆菌。分离菌株PFGE分型显示奶粉(1株)和奶瓶洗脱液样品中(2株)的3株阪崎肠杆菌具有相同的PFGE带型,与患者粪便中的分离株(1株)相似度为64.3%。药敏实验显示4株阪崎肠杆菌对氨苄青霉素、氯霉素、环丙沙星、阿奇霉素、亚胺培南、头孢西丁、庆大霉素、萘啶酸、复方磺胺甲恶唑和四环素10种抗生素敏感实验结果均为敏感。结论婴幼儿配方羊奶粉中阪崎肠杆菌的污染不容忽视,存在严重潜在危险。
Objective To carry out epidemiological investigation and laboratory test on a 9-month-old infants with recurrent diarrhea to provide evidence for diagnosis. Methods According to epidemiological investigation, suspicious samples such as feces, milk powder and rice noodles were collected and isolated from common gut pathogens. The pathogenic bacteria were identified by pulsed-field gel electrophoresis and susceptibility testing . Results After weaning in children with a certain brand of sheep milk as the staple food, fever and diarrhea symptoms, repeated nearly half a month after treatment by cefotaxime and vitamin C to be recovered. Children’s stool, goat milk powder and two bottles were detected after detection of E. sakazakii. The PFGE typing of isolates showed that the three strains of Enterobacter sakazakii in milk powder (1 strain) and in the sample of 2 bottles of elution bottle had the same PFGE pattern, which was similar to the isolates (1 strain) in the feces of the patients 64.3%. Susceptibility tests showed that four strains of Enterobacter sakazakii were resistant to ampicillin, chloramphenicol, ciprofloxacin, azithromycin, imipenem, cefoxitin, gentamicin, nalidixic acid, sulfamethoxazole and tetracycline Ten kinds of antibiotic sensitivity test results are sensitive. Conclusion The contamination of Enterobacter sakazakii in infant formula goat milk can not be neglected, which poses serious potential dangers.