2023年1-6月南區某縣市多重抗藥性Salmonella Typhimurium菌株群聚調查

Strain of multidrug-resistant Salmonella Typhimurium outbreak in a southern county, Taiwan, January–June 2023

衛生福利部疾病管制署監測2023年南部群聚出現新興多重抗藥性Salmonella Typhimurium (S. Typhimurium)，主為脈衝電泳基因型STX.1725。為了瞭解疾病嚴重度及尋找感染源，針對個案數最多A縣B醫院展開調查。病例定義為2023年1–6月B醫院檢送經疾病管制署鑑定為S. Typhimurium STX.1725型、年齡小於18歲者。進行兩次對照研究：(1)以某大學的研究計畫中全國5歲以下人口抽樣調查結果為對照，(2)以與病例同院，年齡和入院日相近且非腸胃疾病者為對照，問卷電訪收集發病前一周飲食史。共38例病例，主要症狀為腹瀉(97%)和發燒(92%)，1例有侵襲性感染，但無重症或死亡。病例組食用外食和散裝蛋的勝算比較高，但未達統計顯著差異。因未發現病例組的共同食用或購買地點，感染源或風險食品難以釐清。建議持續監測該菌株，尋求跨單位合作溯源調查。

The Taiwan Centers for Disease Control detected a novel multidrug-resistant strain of Salmonella Typhimurium (S. Typhimurium) in southern Taiwan in 2023, predominantly pulsed-field gel electrophoresis (PFGE) genotype STX.1725. We conducted an epidemiological investigation to understand the severity of infections caused by this strain and to identify possible sources of infection.
Cases were under the age of 18 years diagnosed with S. Typhimurium STX.1725 reported by Hospital B in County A during January to June 2023. Two case-control studies were conducted. The first study compared cases to a randomly sampled population under the age of five years nationwide as controls. The second was a matched pair case-control study. The controls were selected from children admitted to Hospital B for non-gastrointestinal illnesses, matched for age and admission date with the cases.
Of the 38 cases identified, predominant symptoms were diarrhea (97%) and fever (92%). One had invasive infection, but no severe cases or fatalities occurred, and severity was similar to typical Salmonella infections. Eating out, takeaway foods, and unpackaged eggs showed higher odds ratios but lacked statistical significance.
Identifying a common infection source was challenging due to lack of evidence. We recommended continued monitoring of this strain, and collaboration with stakeholders for future investigations.