Article(id=1325532761527968523, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325531848021140417, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025316, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1752508800000, receivedDateStr=2025-07-15, revisedDate=1756137600000, revisedDateStr=2025-08-26, acceptedDate=null, acceptedDateStr=null, onlineDate=1793961237555, onlineDateStr=2026-11-06, pubDate=1764000000000, pubDateStr=2025-11-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793961237555, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793961237555, creator=13701087609, updateTime=1793961237555, updator=13701087609, issue=Issue{id=1325531848021140417, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='11', pageStart='1521', pageEnd='1672', issueExtLink='null', onlineDate='null', pubDate='1764000000000', pubDateStr='2025-11-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793961019759, creator='13701087609', updateTime=1793961019759, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=1650, endPage=1652, ext={EN=ArticleExt(id=1325532764543673101, articleId=1325532761527968523, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Investigation of a food poisoning incident caused by Clostridium perfringens in a school, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigation and analyze the causes and characteristics of a food poisoning incident caused by Clostridium perfringens in schools, so as to provide a reference for prevention and control of food poisoning incidents.

Methods

From March 11 to 12, 2024, on-site epidemiological and hygienic investigations were conducted by using food poisoning case questionnaires and on-site hygienic investigation forms in Shenzhen. Information related to the poisoning incident was collected through field investigations and telephone interviews. A case-control study was used to analyze the suspected food responsible for the incident. Risk analysis in χ2 analysis was used to obtain OR values.

Results

The Clostridium perfringens food poisoning incident involved two schools, with a cumulative total of 52 cases. School A had an attack rate of 2.21%(45/2 040), school B had an attack rate of 1.29% (7/544). The main clinical symptoms were diarrhea (100.00%) and abdominal pain (84.62%), with a minority experiencing fever (3.85%). Analysis via the case-control study indicated that consuming mushroom and meat sauce during lunch on March 11, 2024, was a risk factor for the poisoning incident (OR=124.50, 95%CI=14.53-937.51, P < 0.05). On-site investigation revealed that the mushroom and meat sauce provided by the schools on March 11 was prepared by the catering company the previous day, stored without refrigeration, and not reheated before serving the next day. A total of 31 patient anal swabs, 16 food samples, and 14 kitchen staff anal swabs were sent for laboratory testing. Clostridium perfringens was isolated from 22 case samples. Among these, type A Clostridium perfringens (alpha toxin) was detected in 8 case samples, 4 kitchen staff anal swabs, and 2 retained samples of the mushroom and meat sauce.

Conclusions

The incident is a food poisoning outbreak caused by Clostridium perfringens contamination in schools. Avoiding cross-contamination and ensuring proper storage are key to preventing Clostridium perfringens food poisoning.

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目的

调查分析一起校园食物中毒事件的原因和特征,为食物中毒事件的防制提供参考。

方法

使用食物中毒个案调查表和现场卫生学调查表对深圳2024年3月11—12日发生的一起校园食物中毒事件进行现场流行病学和卫生学调查,通过现场调查和电话访问等方法收集中毒事件相关信息。使用病例对照研究分析事件发生的可疑食品,采用χ2分析中的risk分析获取OR值。

结果

此次产气荚膜梭菌所致食物中毒事件涉及2所学校,累计发病52例,其中A校罹患率2.21%(45/2 040);B校罹患率1.29%(7/544)。临床症状以腹泻(100.00%)、腹痛(84.62%)为主,少数发烧(3.85%)。通过病例对照研究分析发现,2024年3月11日午餐食用的香菇肉酱是中毒事件的可疑食品(OR=124.50,95%CI=14.53~937.51,P<0.05)。现场卫生学调查发现学校3月11日提供的香菇肉酱是供餐公司前一天制作,未冷藏保存,第二天供餐也未复热。采集31名患者肛拭子、16份食品留样、14名厨工肛拭子送实验室检测,发现22份病例分离出产气荚膜梭菌,其中8份病例检出A型气荚膜梭菌(α毒素基因),4份厨工肛拭子与2份香菇肉酱留样均检出A型产气荚膜梭菌(α毒素)。

结论

该事件为一起发生在学校的产气荚膜梭菌污染导致的食物中毒暴发事件;避免交叉污染和合理保存是预防产气荚膜梭菌食物中毒的关键。

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何林(1982-),男,江西抚州人,硕士,副主任医师,主要从事公共卫生及传染病防治工作

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(2019-02-26)[2025-08-07]. https://www.samr.gov.cn/spjys/tzgg/art/2023/art_b34916e29ae945bf884d0fae61892402.html., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325532815705793325, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, awardId=null, language=CN, fundingSource=深圳市龙华区科技局医疗卫生基础性研究项目(2024060), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325532779550892815, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, xref=null, ext=[AuthorCompanyExt(id=1325532779655750416, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, companyId=1325532779550892815, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Center for Disease Control and Prevention of Longhua District (Health Supervision Institute of Longhua District), Shenzhen 518109, Guangdong Province, China), AuthorCompanyExt(id=1325532780360393489, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, companyId=1325532779550892815, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=深圳市龙华区疾病预防控制中心(深圳市龙华区卫生监督所),广东 518109)])], figs=[ArticleFig(id=1325532812308407083, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, language=EN, label=Tab.1, caption=

Case-control analysis of food intake of lunch in relation to food poisoning incident among students

, figureFileSmall=null, figureFileBig=null, tableContent=
暴露因素病例(n=52)对照(n=117)OR值(95%CI)
暴露人数暴露率/%暴露人数暴露率/%
莲藕红烧肉3975.007765.811.56(0.75~3.25)
泰香Q卷3465.386051.281.79(0.91~3.53)
土豆肉丝59.6265.131.97(0.57~6.77)
西红柿炒蛋4586.549782.911.33(0.52~3.36)
蔬菜2853.855446.151.36(0.71~2.62)
米饭5198.0811396.581.81(0.20~16.56)
水果3261.548774.360.55(0.28~1.11)
香菇肉酱5198.083429.06124.50(14.53~937.51)*
), ArticleFig(id=1325532813096936236, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325532761527968523, language=CN, label=表1, caption=

食物中毒午餐菜品进餐情况与学生发病关系的病例对照分析

, figureFileSmall=null, figureFileBig=null, tableContent=
暴露因素病例(n=52)对照(n=117)OR值(95%CI)
暴露人数暴露率/%暴露人数暴露率/%
莲藕红烧肉3975.007765.811.56(0.75~3.25)
泰香Q卷3465.386051.281.79(0.91~3.53)
土豆肉丝59.6265.131.97(0.57~6.77)
西红柿炒蛋4586.549782.911.33(0.52~3.36)
蔬菜2853.855446.151.36(0.71~2.62)
米饭5198.0811396.581.81(0.20~16.56)
水果3261.548774.360.55(0.28~1.11)
香菇肉酱5198.083429.06124.50(14.53~937.51)*
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一起学校产气荚膜梭菌食物中毒事件的调查
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何林 , 卿文静 , 罗铭宣
中国学校卫生 | 疾病控制 2025,46(11): 1650-1652
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中国学校卫生 |疾病控制 2025 , 46 (11) : 1650 -1652
一起学校产气荚膜梭菌食物中毒事件的调查
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何林(1982-),男,江西抚州人,硕士,副主任医师,主要从事公共卫生及传染病防治工作

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何林(1982-),男,江西抚州人,硕士,副主任医师,主要从事公共卫生及传染病防治工作

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何林, 卿文静, 罗铭宣
作者信息
  • 深圳市龙华区疾病预防控制中心(深圳市龙华区卫生监督所),广东 518109
作者简介:

何林(1982-),男,江西抚州人,硕士,副主任医师,主要从事公共卫生及传染病防治工作

Investigation of a food poisoning incident caused by Clostridium perfringens in a school
Lin HE, Wenjing QING, Mingxuan LUO
Affiliations
  • Center for Disease Control and Prevention of Longhua District (Health Supervision Institute of Longhua District), Shenzhen 518109, Guangdong Province, China
出版时间: 2025-11-25 doi: 10.16835/j.cnki.1000-9817.2025316
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目的

调查分析一起校园食物中毒事件的原因和特征,为食物中毒事件的防制提供参考。

方法

使用食物中毒个案调查表和现场卫生学调查表对深圳2024年3月11—12日发生的一起校园食物中毒事件进行现场流行病学和卫生学调查,通过现场调查和电话访问等方法收集中毒事件相关信息。使用病例对照研究分析事件发生的可疑食品,采用χ2分析中的risk分析获取OR值。

结果

此次产气荚膜梭菌所致食物中毒事件涉及2所学校,累计发病52例,其中A校罹患率2.21%(45/2 040);B校罹患率1.29%(7/544)。临床症状以腹泻(100.00%)、腹痛(84.62%)为主,少数发烧(3.85%)。通过病例对照研究分析发现,2024年3月11日午餐食用的香菇肉酱是中毒事件的可疑食品(OR=124.50,95%CI=14.53~937.51,P<0.05)。现场卫生学调查发现学校3月11日提供的香菇肉酱是供餐公司前一天制作,未冷藏保存,第二天供餐也未复热。采集31名患者肛拭子、16份食品留样、14名厨工肛拭子送实验室检测,发现22份病例分离出产气荚膜梭菌,其中8份病例检出A型气荚膜梭菌(α毒素基因),4份厨工肛拭子与2份香菇肉酱留样均检出A型产气荚膜梭菌(α毒素)。

结论

该事件为一起发生在学校的产气荚膜梭菌污染导致的食物中毒暴发事件;避免交叉污染和合理保存是预防产气荚膜梭菌食物中毒的关键。

梭菌, 产气荚膜  /  食物中毒  /  发病率  /  病例对照研究
Objective

To investigation and analyze the causes and characteristics of a food poisoning incident caused by Clostridium perfringens in schools, so as to provide a reference for prevention and control of food poisoning incidents.

Methods

From March 11 to 12, 2024, on-site epidemiological and hygienic investigations were conducted by using food poisoning case questionnaires and on-site hygienic investigation forms in Shenzhen. Information related to the poisoning incident was collected through field investigations and telephone interviews. A case-control study was used to analyze the suspected food responsible for the incident. Risk analysis in χ2 analysis was used to obtain OR values.

Results

The Clostridium perfringens food poisoning incident involved two schools, with a cumulative total of 52 cases. School A had an attack rate of 2.21%(45/2 040), school B had an attack rate of 1.29% (7/544). The main clinical symptoms were diarrhea (100.00%) and abdominal pain (84.62%), with a minority experiencing fever (3.85%). Analysis via the case-control study indicated that consuming mushroom and meat sauce during lunch on March 11, 2024, was a risk factor for the poisoning incident (OR=124.50, 95%CI=14.53-937.51, P < 0.05). On-site investigation revealed that the mushroom and meat sauce provided by the schools on March 11 was prepared by the catering company the previous day, stored without refrigeration, and not reheated before serving the next day. A total of 31 patient anal swabs, 16 food samples, and 14 kitchen staff anal swabs were sent for laboratory testing. Clostridium perfringens was isolated from 22 case samples. Among these, type A Clostridium perfringens (alpha toxin) was detected in 8 case samples, 4 kitchen staff anal swabs, and 2 retained samples of the mushroom and meat sauce.

Conclusions

The incident is a food poisoning outbreak caused by Clostridium perfringens contamination in schools. Avoiding cross-contamination and ensuring proper storage are key to preventing Clostridium perfringens food poisoning.

Clostridium perfringens  /  Food poisoning  /  Incidence  /  Case-control studies
何林, 卿文静, 罗铭宣. 一起学校产气荚膜梭菌食物中毒事件的调查. 中国学校卫生, 2025 , 46 (11) : 1650 -1652 . DOI: 10.16835/j.cnki.1000-9817.2025316
Lin HE, Wenjing QING, Mingxuan LUO. Investigation of a food poisoning incident caused by Clostridium perfringens in a school[J]. Chinese Journal of School Health, 2025 , 46 (11) : 1650 -1652 . DOI: 10.16835/j.cnki.1000-9817.2025316
2024年3月12日9:30,深圳市某区疾病预防控制中心(简称“疾控中心”)接深圳市市场监督管理局通报本辖区内某实验学校有聚集性肠炎事件舆情,多名师生出现腹泻症状。接报后,某区疾控中心联合深圳市疾控中心赶赴学校开展现场调查处置,发现病例均在3月11日中午进食了由深圳某餐饮集团有限公司提供的午餐后发病,事件共报告病例52名,无重症病例。事件经现场流行病学调查、卫生学调查和实验室检测,定性为一起产气荚膜梭菌污染导致的食物中毒暴发事件,为校外供餐引发。查明致病因子和污染环节,对于类似供餐所致校园产气荚膜梭菌食物中毒事件的防制具有参考意义,调查结果报道如下。
根据《产气荚膜梭菌食物中毒诊断标准及处理原则》(WS/T 7—1996)[1]中产气荚膜梭菌所致食物中毒的临床症状及潜伏期,结合《食品安全事故流行病学调查技术指南(2012版)》[2]中病例定义的制定要求,此次事件病例定义为:2024年3月10日14:00至3月13日7:00,涉事学校出现腹泻(24 h内≥3次伴粪便性状改变)症状者。
通过查阅深圳市食源性疾病监测系统、因病缺勤缺课系统、校医就诊记录,访谈病例、单位负责人,查阅涉事学校周边诊所诊疗记录等方式,在涉事学校全体学生和教职工范围内开展病例搜索。
根据《食品安全事故流行病学调查技术指南(2012年版)》[2]要求,采用自行设计的统一格式的“食物中毒个案调查表”“现场卫生学调查笔录、相关人员询问笔录”等对病例及现场开展调查,并于2024年3月12—15日收集2所涉事学校(A校和B校)和涉事餐饮机构(深圳某餐饮集团有限公司)的相关资料。个案调查表主要内容为患者发病日期、主要症状、发病前72 h内饮食史和临床检查等相关信息;现场卫生学调查主要针对餐饮机构调查其一般情况(资质、规模、许可范围等)、发病前3 d供餐食谱、饮用水、食品原料采购、从事食品加工或制备的人员信息、食品用具、制作配方、加工过程和成品保存条件等。
使用Excel软件录入并整理数据,使用SPSS 18.0软件进行统计学分析。计数资料采用频数和率描述,组间比较采用χ2检验;通过病例对照研究分析事件发生的可疑食品,采用χ2分析中的risk分析获取OR值。双侧检验水准α=0.05。
此次事件涉及2所学校,A校为某实验学校,由5栋5层建筑构成,共6个年级76个班,学生总人数3 922名,其中男生2 067名,女生1 855名;教职工249名。B校为某科技中学,由2栋4层建筑构成,共有2个年级12个班,学生总人数为581名,其中男生308名,女生273名;教职工65名。2所学校学生工作日午餐均由深圳某餐饮集团有限公司提供,学校教职工午餐均由学校食堂统一提供,但有少数陪餐老师与学生共同进食学生餐。
A校教职工及学生日常饮用水为学校使用滤水系统净化后的温开水,学校直饮水在效期范围内,检测结果均符合检测标准,最近检测报告日期为2024年3月5日。B校教职工及学生日常饮用水为学校使用反渗透净水饮水设备净化后的温开水,学校直饮水在效期范围内检测结果均符合检测标准,最近检测报告日期为2024年2月18日。
涉事配餐公司深圳某餐饮集团有限公司于2008年12月10日成立,为独立园区,封闭管理。公司车间分区清晰,分别有切配区、餐用具洗消区、烹调区、备餐区、食品库房,布局流程合理。公司有工作人员90名,均持有有效健康证,工作人员均否认近期身体不适,厨工手和皮肤未见破损。公司现场提供食品经营许可证和食品材料进货台账,食品原料未腐烂变质且索证索票齐全。公司食品原材料主要来自深圳市关山口农产品有限公司、东莞市信立国际贸易城等批发市场,食品加工用水为市政自来水。该公司目前在深圳某区服务包括A、B在内的8所学校。
共搜索到病例52例,其中A校45例(学生42例、教职工3例),B校7例(均为学生)。A校3月11日有2 023名学生在校进食午餐,发病42例,罹患率2.08%;教职工249名,进食学生餐的17名,发病3例,罹患率17.65%。B校3月11日在校进食午餐学生544名,发病7例,罹患率1.29%。
52名病例的主要症状为腹泻(100.00%,52例)、腹痛(84.62%,44例),少数发烧(3.85%,2例)。首发病例为学生易某某,男,14岁,自述于3月11日12:07进食学校午餐,14:15左右出现腹泻(糊状便)及上腹部绞痛症状。
52例病例的发病时间在3月11日14:15至12日7:00,发病高峰在3月11日23:00至12日3:00,呈点源暴发特征,最短潜伏期2 h,最长潜伏期19 h,潜伏期中位数为10 h。52例病例中,男性35名,女性17名。发病最多的年级为A校二年级(22名),罹患率最高的班级为A校四(7)班(32.25%,10/32)。
52例病例均为在校用餐人员。配餐公司仅为学校提供午餐,不提供早、晚餐。52例病例发病前3 d的共同进餐史仅为3月11日午餐(9—10日为周末)。推断为可疑餐次。
通过访谈发现1名A校体育老师3月11日仅食用了午餐提供的香菇肉酱,未进食供餐公司提供的其他餐食后出现明显腹泻腹痛症状,另2名陪餐教职工(A校校医)3月11日午餐也明确进食了供餐公司提供的午餐及配餐中的香菇肉酱后出现明显腹泻腹痛症状,提示食用香菇肉酱为暴露危险因素的可能性较大。为验证假设,选取117名与学生病例同班级在校进食午餐、未发病的学生作为对照,开展病例对照研究,结果提示食用香菇肉酱是此次食物中毒暴发事件的危险因素(OR=124.50,P<0.05),其余餐品无统计学意义。见表1。
可疑食物香菇肉酱由供餐公司于2024年3月10日15:19—16:15制作完成后室温储存于公司小厨房,3月10日共制作20 kg香菇肉酱,除食品留样(约1 kg)和工人自食(约1 kg)外,其余均于3月11日8:30左右由厨工直接将前一天制作好的香菇肉末酱用一次性透明塑料碗打包盛放,后由餐车送至学校,并于12:00食用,未复热(A校约15 kg、B校约3 kg)。
现场采集31例患者肛拭子、16份留样食品、14名厨工肛拭子和9份厨房环境样本,检测结果显示患者肛拭子、涉事公司厨工肛拭子及留样食品中均检出产气荚膜梭菌(α毒素基因,A型)。其中31例患者肛拭子中,有22例分离到产气荚膜梭菌,8例为A型产气荚膜梭菌(携带α毒素基因);其余样本未分离到有关致病菌。16份留样食品样本中,仅2份香菇肉酱中检出产气荚膜梭菌α毒素基因(A型)阳性。14名厨工肛拭子中,仅4名厨工肛拭子中分离到产气荚膜梭菌,均为A型产气荚膜梭菌(携带α毒素基因)。9份厨房环境样本未分离到有关致病菌。
根据患者潜伏期和临床表现,结合流行病学调查、现场卫生学调查和实验室检测,可确定该事件为一起由校外公司供给的被产气荚膜梭菌污染的香菇肉酱导致的食物中毒暴发事件。
从临床症状来看,腹泻占比100.00%、腹痛占比89.62%,是其主要症状,少有发烧和呕吐,与我国《产气荚膜梭菌食物中毒诊断标准及处理原则》(WS/T 7—1996)[1]描述的中毒表现一致,也与王玮等[3-4]调查的结果类似。潜伏期方面,此次事件病例发病2~19 h,潜伏期中位数10 h,符合《现代食品卫生学》[5]和部门标准的潜伏期时间。
本调查通过病原体毒素分型与分子溯源(病例、食物分离株均为A型α毒素阳性)的实验室检测手段,结合现场流行病学调查信息,建立了完整的证据链,可明确事件中毒的诊断。通过本次事件的调查也暴露出校园供餐链条中的多重隐患:其一,食品加工与储存环节未做好温度控制是直接诱因。产气荚膜梭菌芽孢在肉类加工过程中普遍存在,但其繁殖依赖12~50 ℃的“危险温度区间”及充足时间(通常>2 h)[5]。本案例中,供餐企业提前一日制作香菇肉酱后未冷藏保存(深圳市三月环境温度>20 ℃),且次日未复热即直接供餐,导致细菌大量增殖并产毒,与多项研究[6-8]相似。其二,中央厨房模式下的规模化供餐风险成倍增加。本次事件波及两校2 800余名师生,反映出集约化供餐一旦发生污染,危害范围呈指数级扩大。其三,企业主体责任与监管缺位并存。涉事企业违反《餐饮服务食品安全操作规范》[9]中“熟制食品在8~60 ℃存放时间不宜超过4 h”的规定,说明监管部门对校外供餐企业的飞行检查频率与处罚力度可能不足。
本次暴发事件揭示了校园供餐体系中温度控制失效与监管漏洞的协同风险,凸显产气荚膜梭菌在集约化供餐场景中的特殊危害性。建议相关部门从以下3个层面构建防控网络,以应对校园食品安全的新挑战:(1)市场监管部门要加强对学校供餐公司的监管和安全意识培训,重点加强食品加工与储存环节温度控制培训和检查,对于校园供餐企业可采取飞行检查形式进行不定期抽查。(2)供餐公司需落实主体责任,做好食品污染的关键环节控制,从制度上落实食品保存的温度控制,公司内部标准化供餐流程并做好员工安全宣贯。(3)学校要加强校医对食源性疾病信息报告的敏感度,及时做好发病人员统计,及早报告、及早处置。
  • 深圳市龙华区科技局医疗卫生基础性研究项目(2024060)
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2025年第46卷第11期
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doi: 10.16835/j.cnki.1000-9817.2025316
  • 接收时间:2025-07-15
  • 首发时间:2026-11-06
  • 出版时间:2025-11-25
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  • 收稿日期:2025-07-15
  • 修回日期:2025-08-26
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深圳市龙华区科技局医疗卫生基础性研究项目(2024060)
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    深圳市龙华区疾病预防控制中心(深圳市龙华区卫生监督所),广东 518109
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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