한국식품위생안전성학회지 (Journal of Food Hygiene and Safety)

  • 제39권2호
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  • Pages.102-108
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  • 2024
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  • 1229-1153(pISSN)
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  • 2465-9223(eISSN)
한국식품위생안전성학회 (The Korean Society of Food Hygiene and Safety)
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Bacillus cereus에 의한 대규모 집단식중독 원인 분석

Analysis of the Causes of a Large Food Poisoning Outbreak Attributable to Bacillus cereus

  • Hyunah Lee (Chungcheongnam-do Institute of Health and Environment Research) ;
  • Youngeun Ko (Chungcheongnam-do Institute of Health and Environment Research) ;
  • Dayeon Lee (Chungcheongnam-do Institute of Health and Environment Research) ;
  • KyungA Yun (Chungcheongnam-do Institute of Health and Environment Research) ;
  • Hyeonjeung Kim (Chungcheongnam-do Institute of Health and Environment Research) ;
  • Ok Kim (Chungcheongnam-do Institute of Health and Environment Research) ;
  • Junhyuk Park (Chungcheongnam-do Institute of Health and Environment Research)
  • 투고 : 2023.12.15
  • 심사 : 2024.03.29
  • 발행 : 2024.04.30
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초록

본 연구는 2020년 10월 중 충청남도내 단체 급식소에서 발생한 대규모 집단 식중독 원인에 대하여 분석하였다. 전체 급식원 135명 중 21명(15.6%)에서 음식을 섭취한 후 1시간 이내에 주로 매스꺼움과 구토 증상을 보였다. 유증상자 21명 중 11명과, 조리종사자 1명, 조리기구 2건과 보존식 8건에서 B. cereus가 검출됨에 따라 B. cereus에 의한 집단 식중독으로 판단하였다. 분리된 21개의 균주를 PFGE 분석한 결과, 19개의 균주가 동일한 것으로 판단되었고, 이들 균주가 가지고 있는 독소 유전자는 CER, nheA, entFM이었다. 실험결과, CER을 포함하고, 증상 발현 시간이 1시간 이내로 매우 짧아 B. cereus의 구토형 식중독으로 판단하였다. 집단식중독 원인으로 안전하지 않은 급식환경과 제대로 관리되지 않은 음식에 의한 것이라 조사되었다. 이러한 결과는 단체급식에서의 급식환경과 제공되는 음식이 철저하게 관리되어야 한다는 것을 보여준다. 이와 더불어 보존식에서 원인 병원체를 찾아내는 것은 식중독의 원인을 추정하는데 매우 중요하므로, 집단급식소에서 규정에 맞는 보존식 용기를 이용하여 이를 적정온도에 잘 보관해야한다. 또한 정밀한 식중독 역학조사를 기반으로 사례를 분석하고 결과를 전파함으로써 유사한 식중독이 재발하지 않도록 해야 한다.

This study was performed to establish the epidemiological features of a food poisoning outbreak that occurred in the cafeteria of a company in Chungcheongnam-do Province, Korea, in October 2020, and to recommend measures to prevent similar outbreaks. Twenty-one patients with acute gastroenteritis, three food handlers, seven cooking utensils, and 12 preserved food samples were subjected to viral and bacterial analyses based on procedures described in the "Manual for Detection of Foodborne Pathogens at Outbreaks". Among 135 individuals who had been served the meals, 21 (15.6%) showed symptoms of nausea and vomiting within an hour of consuming the food. Bacillus cereus were isolated from 11 (52.4%) of the 21 patients, one food service employee, one item of cooking ware, and 12 preserved food samples. In addition, we confirmed the toxin genes CER, nheA, and entFM from the isolated B. cereus strains. Pulsed-field gel electrophoresis results indicated that all of the isolated B. cereus strains were closely related, with the exception of strains obtained from one patient and one sample of preserved food. These findings provide evidence to indicate that the isolated B. cereus originated from preserved foods and an unhygienic eating environment. This outbreak highlights that the provision of food in non-commercial food systems must be thoroughly managed. In addition, it emphasizes the necessity for the correct and timely identification of causal pathogens for tracing the cause of food poisoning outbreaks, and the need to preserve food under appropriate conditions. To prevent similar cases of food poisoning, it is necessary to investigate cases based on an epidemiological approach and share the findings.

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참고문헌

  1. Hall, G.V., D'Souza, R.M., Kirk, M.D., Foodborne disease in the new millennium: out of the frying pan and into the fire?. Med. J. Aust., 177, 614-618 (2002).  https://doi.org/10.5694/j.1326-5377.2002.tb04984.x
  2. Ministry of Food and Drug Safety (MFDS), (2022, Dec 20). Food poisoning statistics. Retrieved from https://www.food-safetykorea.go.kr/portal/healthyfoodlife/foodPoisoning-Stat.do?menu_no=442 5&menu_grp=MENU_NEW02. 
  3. Ministry of Food and Drug Safety (MFDS), Korea Food & Drug Statistical Yearbook, MFDS, Cheongju, Korea (2018). 
  4. Kwun, J.W., Lee, C.H., Trends of recent food-borne disease outbreaks in Korea. J. Korean Med. Assoc., 50, 573-581 (2007).  https://doi.org/10.5124/jkma.2007.50.7.573
  5. Lee, H.A., Choi, J.H., Park, S.M., Nam, H.S., Choi, J.H., Park, J.H., Epidemiological analysis of a food poisoning outbreak caused by multiple pathogens in a high school in Chungnam Korea. J. Environ. Health Sci., 45, 434-444 (2019). 
  6. Lee, H.A., Nam, H.S., Choi, J.H., Park, S.M., Park, J.J., Kim, H.M., Cheon, Y.H., Park, J.H., Analysis of food poisoning outbreaks occurred in Chungnam Korea. J. Environ. Health Sci., 46, 184-191 (2020). 
  7. Oh, T.Y., Baek, S.Y., Koo, M.S., Lee, J.K., Kim, S.M., Park, K.M., Hwang, D.K., Kim, H.J., Analysis of foodborne pathogens in food and environmental samples from foodservice establishments at schools in Gyeonggi province. J. Korean Soc. Food Sci. Nutr., 44, 1895-1904 (2015).  https://doi.org/10.3746/jkfn.2015.44.12.1895
  8. Granum, P.E., Lund, T., Bacillus cereus and its food poisoning toxins. FEMS Microbiol. Lett., 157, 223-228 (1997).  https://doi.org/10.1111/j.1574-6968.1997.tb12776.x
  9. Ihde, D.C., Armstrong, D., Clinical spectrum of infection due to Bacillus species. Am. J. Med., 55, 839-845 (1973).  https://doi.org/10.1016/0002-9343(73)90266-0
  10. Koo, M., Bacillus cereus - An ambusher of food safety. Bull. Food Technol., 22, 587-600 (2009). 
  11. Gilbert, R.J., Stringer, M.F., Pearce, T.C., The survival and growth of Bacillus cereus in boiled and fried rice in relation to outbreaks of poisoning. J. Hyg., 73, 433-444 (1974).  https://doi.org/10.1017/S0022172400042790
  12. Ministry of Food and Drug Safety (MFDS), Manual for detection of foodborne pathogens at outbreaks. MFDS, Cheongju, Korea (2019). 
  13. Korea Disease Control and Prevention Agency (KCDA), Guideline for water & foodborne diseases prevention and control. KCDA, Cheongju, Korea (2018). 
  14. Ministry of Food and Drug Safety (MFDS), Manual for detection of foodborne pathogens at outbreaks. MFDS, Cheongju, Korea (2018). 
  15. Korea Disease Control and Prevention Agency (KCDA), Guidelines for Laboratory Diagnosis of Waterborne and Food-borne Diseases. KCDA, Cheongju, Korea (2017). 
  16. Chon, J.W., Kim, J.H., Lee, S.J., Hyeon, J.Y., Song, K.Y., Park, C., Seo, K.H., Prevalence, phenotypic traits and molecular characterization of emetic toxin-producing Bacillus cereus strains isolated from human stools in Korea. J. Appl. Microbiol., 112, 1042-1049 (2012).  https://doi.org/10.1111/j.1365-2672.2012.05277.x
  17. Fricker, M., Messelhausser, U., Busch, U., Scherer, S., Ehling-Schulz, M., Diagnostic real-time PCR assays for the detection of emetic Bacillus cereus strains in foods and recent food-borne outbreaks. Appl. environ. microbiol., 73, 1892-1898 (2007).  https://doi.org/10.1128/AEM.02219-06
  18. Kim, M.J., Han, J.K., Park, J.S., Lee, J.S., Lee, S.H., Cho, J.I., Kim, K.S., Various enterotoxin and other virulence factor genes widespread among Bacillus cereus and Bacillus thuringiensis strains. J. Microbiol. Biotechnol., 25, 872-879 (2015).  https://doi.org/10.4014/jmb.1502.02003
  19. Kim, J.H., Lim, E.G., Jang, H.C., Park, J.Y., Lee, S.J., Park, M.S., Choi, G.B., Lee, B.K., A case of emetic toxin producing Bacillus cereus strains isolated from outbreak. Korean J. Clin. Microbiol., 12, 48-52 (2009).  https://doi.org/10.5145/KJCM.2009.12.1.48
  20. Kisek, T.C., Pogacnik, N., Torkar, K.G., Genetic diversity and the presence of circular plasmids in Bacillus cereus isolates of clinical and environmental origin. Arch. Microbiol., 203, 3209-3217 (2021).  https://doi.org/10.1007/s00203-021-02302-w
  21. Lee, H.A., Kim, J.Y., Nam, H.S., Choi, J.H., Lee, D.Y., Park, S.M., Lim, J.A., Cheon, Y.H, Choi, J.H., Park, J.H., Case report for a large-scale food poisoning outbreak that occurred in a group food service center in Chungnam, Korea. J. Environ. Health Sci., 46, 525-531 (2020). 
  22. Lund, T., Debuyser, M.L., Granum, P.E., A new cytotoxin from Bacillus cereus that may cause necrotic enteritis. Mol. Microbiol., 38, 254-261 (2000).  https://doi.org/10.1046/j.1365-2958.2000.02147.x
  23. Yang, I.C., Shih, D.Y., Huang, T.P., Huang, Y.P., Wang, J.Y., Pan, T.M., Establishment of a novel multiplex PCR assay and detection of toxigenic strains of the species in the Bacillus cereus group. J. Food Prot., 68, 2123-2130 (2005).  https://doi.org/10.4315/0362-028X-68.10.2123
  24. Guinebretiere, M.H., Broussolle, V., Nguyen-The, C., Enterotoxigenic profiles of food-poisoning and food-borne Bacillus cereus strains. J. Clin. Microbiol., 40, 3053-3056 (2002).  https://doi.org/10.1128/JCM.40.8.3053-3056.2002
  25. Kim, J.B., Kim, J.M., Kim, C.H., Seo, K.S., Park, Y.B., Choi, N.J., Oh, D.H., Emetic toxin producing Bacillus cereus Korean isolates contain genes encoding diarrheal-related enterotoxins. Int. J. Food Microbiol., 144, 182-186 (2010).  https://doi.org/10.1016/j.ijfoodmicro.2010.08.021
  26. Andersson, A., Ronner, U., Granum, P.E., What problems does the food industry have with the spore-forming pathogens Bacillus cereus and Clostridium perfringens?. Int. J. Food Microbiol., 28, 145-155 (1995). https://doi.org/10.1016/0168-1605(95)00053-4