2022年臺灣腸道出血性大腸桿菌感染症案例報告

Case report of enterohemorrhagic Escherichia coli infection in central Taiwan, 2022

2022年8月疾病管制署接獲2例腸道出血性大腸桿菌(enterohaemorrhagic E. coli, EHEC)感染症通報個案，為中部9歲女童（案一）及2歲女童（案二），經檢驗分別感染EHEC O157:H7及O157:NM。牛肉為EHEC透過食物感染之主要媒介，案一發病前曾食用牛肉類食品，推測牛肉為可能之病因食品；案二則未曾食用牛肉類食品。兩案之共食3及同住者糞便檢驗結果均為陰性，顯示同住者未感染，且個案未傳染給他人。EHEC傳統鑑定方法較耗費時間，建議醫療院所備有腸胃道病原體多標的核酸檢測，以便在較短的時間輔助診斷EHEC之感染，及早給予病患適當的治療。未適當處理的牛肉是感染EHEC的主要來源，而大腸桿菌於75°C加熱1分鐘以上即可被殺死，建議調理牛肉時應充分加熱，以降低EHEC感染之風險。

In August 2022, the Taiwan Centers for Disease Control received reports of two cases of enterohemorrhagic Escherichia coli (EHEC) infections, involving two females aged 9 (case 1) and 2 years (case 2). Laboratory tests identified EHEC O157:H7 and O157:NM strains, respectively. EHEC infections are commonly associated with beef consumption. Case 1 had a history of consuming beef products, implicating beef as a potential source of infection, but case 2 had not eaten any beef products. Stool tests for family members and contacts of the two cases were negative, indicating that the disease did not spread. Identification of EHEC using traditional methods is time-consuming. We recommended that hospitals use multiplex PCR to assist in the diagnosis of EHEC infection to provide patients with appropriate treatment as early as possible. Improperly prepared beef is the main source of EHEC. E. coli can be killed by heating at 75°C for more than 1 minute. It is recommended to cook beef thoroughly to reduce the risk of EHEC infection.