金黃色葡萄球菌引發學童之食物中毒事件

本研究係為探討81年5月26日台北縣某國中學童集體食物中毒事件之病因及發生始末，所進行的流行病學調查。結果顯示：(1)所有中毒學童均攝食同一家便當廠供應之午餐。(2)統計卡方檢定發現，在唯一的送驗便當中只有荷包蛋一項與該次中毒有顯著相關；另衛生署藥物食品檢驗局也僅在荷包蛋一項中檢出金黃色葡萄球菌(2.7×10^4CFU/g)及臘狀桿菌(1.4×10^6CFU/g)。(3)患者的中毒症狀包括嘔吐、腹痛、腹瀉、噁心、頭暈、寒顫等，發病的潛伏期中位數是3小時41分，與金黃色葡萄球菌或臘狀桿前嘔吐型中毒所致者相近。(4)經衛生署預防醫學研究所抽驗30名中毒患者之嘔吐物或肛門擦拭檢體，其中檢出9件為金黃色葡萄球菌陽性及A型腸毒素。根據以上所述，可以推論便當中之荷包蛋受金黃色葡萄球菌污染是此次食物中毒的主因之一。但由於病患檢體未作臘狀桿茵檢測，故亦不排除金黃色葡萄球菌及臘狀桿菌聯合污染導致中毒的可能性。基於此類事件之患者數甚眾，期望衛生主管機關能加強對群體膳食業者之稽查管理與宣導教育，並落實品管合格簽證制度，以提高國內的食品衛生水準。

關鍵字

食物中毒；金黃色葡萄球菌

並列摘要

This study aims to explore the etiology of a food-poisoning outbreak occurred in a junior high school in May 1992. One hundred and seventy-one of the investigated 502 students who ate the same company supplied lunch box containing boiled rice, sparerib, poached egg, sausage and bean sprouts became ill. Only the poached egg was noted to have significant correlation with food-poisoning in Chi-square test. The disease pattern was similar to the food-poisoning caused by Staphylococcus aureus and Bacillus cereus. The median of incubation peroid was 3 hours and 41 minutes. The main symptoms included vomiting, abdominal pain, diarrhea, nausea and dizziness. S. aureus was detected only in the poached egg (2.7×10^4 CFU/g), and this food item was also displayed a high B. cereus count (1.4×1.06 CFU/g). Meanwhile, the cultured rectal swab or vomit samples of 30 patients were found no enteric pathogens with the exception of S. aureus and its enterotoxin-A. But none were examined for B. cereus, since this organism was not included in the routine panel of patient specimens. Based on the above mentioned, we concluded that the outbreak of food- poisoning was associated with the poached egg contaminated by S. aureus or by the crossing effects of S. aureus and B. cereus probably. Because the occurrence of lunch-box-related food-poisoning is not uncommon in Taiwan, safeguards should be employed to prevent future ones.

並列關鍵字

Food-poisoning ； Staphylococcus aureus

國際替代計量

金黃色葡萄球菌引發學童之食物中毒事件

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