台灣地區民眾糞便中產氣莢膜桿菌量及腸毒素基因盛行率之研究   全文下載

The Level of Fecal Carriage and the Toxic Potential of Clostridium perfringens in the Feces of a Taiwan Subpopulation

產氣莢膜桿菌是常見的食品中毒原因菌之一。目前為止，對此菌在台灣地區民眾糞便中之數量及腸毒素盛行率所知甚少。判斷產氣莢膜桿菌為食品中毒原因物質之判定標準之一為患者每克糞便檢體檢出菌量大於105。本研究之目的在檢驗台灣地區民眾糞便中此菌之孢子含量，並以逆向被動乳膠凝集試驗及聚合?鏈反應方法檢驗菌株產生腸毒素及攜帶腸毒素基因之比例。結果顯示50位健康民眾之糞便檢體中，30位（60%）帶有此菌，其孢子量介於50至2.5×108 CFu/g，平均孢子量為4.3×102 CFu/g；11個檢體之孢子量超過105 CFu/g。由糞便檢體中所分離之菌株中，3株（1.8%）攜帶腸毒素基因。逆向被動乳膠凝集試驗方法之結果與基因型檢驗結果相符。食品中毒案件發生時，建議除了由糞便檢體中分離此菌之外，亦需參考菌株產生腸毒素或攜帶腸毒素基因之情形，才能確定產氣莢膜桿菌是否為食品中毒案之病因物質。

Clostridium perfringens ranks among the most common agents of food poisoning in industrialized nations. Little is known about the level of fecal carriage and the toxic potential of this microorganism in Taiwan. One of the criteria to confirm that C. perfringens was the causative agent of food poisoning is to isolate 105 organisms/g from stools of food poisoning patients. The aim of the present study was to determine the carriage of C. perfringens in the feces of a Taiwan subpopulation. The percentage of strains that have toxic potential was also determined by using polymerase chain reaction (PCR) assay and reverse passive latex agglutination (RPLA). As a result, 30 (60%) of the 50 fecal samples carried C. perfringens. The spore counts were between 50 and 2.5×108 CFU/g. The average spore count of all the test samples was 4.3×102 CFU/g. Eleven (22%) of the samples carried more than 105 spores per gram. Only three (1.8%) isolates from fecal samples were cpe gene positive. The RPLA results were in accordance with the genotypic results. Our findings emphasize that the culture of C. perfringens from fecal samples needs to be supplemented with presence of cpe gene or enterotoxin production in the outbreak situation.