STAPHYLOCOCCUS AUREUS ENTEROTOKSINI ve BACILLUS CEREUS iLiŞKiLi OLARAK ÜÇ YURTTA GÖRÜLEN GIDA KAYNAKLI SALGIN

Abstract

13-14 Kasım 2014 tarihinde Kayseri ilinde üç ayrı yurtta bulunan 310 kişi arasında 121 kişinin zehirlenmesi ile sonuçlanan ve aynı mutfakta hazırlanan akşam yemeğinin tüketimi ile ilişkili bir salgın yaşanmıştır. Bu retrospektif kohort çalışmasını, olası nedenlerin ortaya konulması ve  koruma, kontrol önlemlerinin alınması için yürüttük. Olası vaka tanımını, “13 Kasım 2014 tarihinde, üç yurtta akşam yemeği yiyen ve  aynı tarihlerde bulantı, kusma, karın ağrısı, ve ishal şikayetlerinden  bir ya da daha fazlasını yaşayan kişiler” olarak belirdik.  285 kişi ile yüzyüze görüşme sağladık. Gıda elleyicilerinden burun sürüntüsü, içme sularından örnekler ve gıdalardan numuneler alınarak patojenler açısından test edildi. Erkekler kadınlardan iki kat daha fazla etkilenmişti (RR=1.6, 95%CI:1.3–2.1). Tavuk yemeyi ve cinsiyeti kontrol ederek bir lojistik regresyon modeli oluşturduk. Buna göre tam porsiyon patates püresi yiyenler hiç yemeyenlere göre 4 kat daha fazla (OR_adj3.6; 95% CI:1.6–7.8), yarım porsiyon yiyenler ise yemeyenlere göre 3 kat daha fazla (OR_adj=3.4; 95% CI:1.3–8.7) hastalık geliştirmişti. Staphylococcus aureus enterotoxin ve Bacillus cereus kalan patates püresinde üredi. Dolayısı ile bu salgın, kontamine patates püresinin tüketimi ile ilişkilidir. Bu salgın, Staphylococcal enterotoxin ve Bacillus cereus ile kontamine patates püresinden kaynaklanmıştır. Halk Sağlığı eylemi olarak mutfakta yönetmeliklere göre düzenlemeler yapıldı. Yurt yönetimine idari para cezası verildi. Gıda elleyicilerinin hijyen sertifikası eğitimi almaları sağlandı.

Keywords

• Gıda kaynaklı hastalıklar
• Staphylococcus aureus
• Bacillus cereus
• salgınlar

FOODBORNE OUTBREAK ASSOCIATED WITH STAPHYLOCOCCUS AUREUS ENTEROTOXIN AND BACILLUS CEREUS IN THREE STUDENT DORMITORIES

Abstract

On 13–14 November 2014 an outbreak associated with consumption of dinner prepared in the same kitchen resulted in intoxication of 121 persons out of 310 in three dormitories in Kayseri Province, Turkey. We conducted a retrospective cohort investigation to identify the cause and to implement the control measures. Probable case was “Onset on 13 November 2014 of ≥1 of the symptoms of nausea, vomiting, abdominal pain, and diarrhoea among persons who ate dinner in three dormitories. We conducted face-to-face interviews with 285 persons. Nasal swabs from food handlers, drinking water samples and food samples were tested for pathogens. Males were affected two times more than females (RR=1.6, 95%CI:1.3–2.1). We analyzed data by logistic regression in a model controlling chicken drumstick consumption and sex. People who ate full serve of mashed potatoes developed illness four times more (OR_adj=3.6; 95% CI:1.6–7.8);  and who ate half serve of mashed potatoes developed illness three times more than non-exposed (OR_adj=3.4; 95% CI:1.3–8.7). Staphylococcus aureus enterotoxin and Bacillus cereus was identified from the leftover mashed potatoes. In conclusion this outbreak was likely due to contaminated mashed potatoes. This outbreak is caused by mashed potatoes contaminated with Staphylococcal enterotoxin and Bacillus cereus. As public health actions arrangements in kitchen were done according to the regulations. Money penalty was given to dormitory. Food handlers were trained on certificate of hygiene.

Keywords

• Foodborne Diseases
• Staphylococcus aureus
• Bacillus cereus
• outbreaks

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