Risk factors for yersiniosis: a case-control study
HAN Junli1, LIU Yang2, GAO Dawei2, SUN Jie2, XU Pengpeng2, GONG Tianqi2, HU Jieying2, CAO Yanhong3, LÜ Yong1,2
1. School of Public Health, Anhui Medical University, Hefei, Anhui 230032, China; 2. Lu'an Center for Disease Control and Prevention, Lu'an, Anhui 237010, China; 3. West District, The First Affiliated Hospital of University of Science and Technology of China, Hefei, Anhui 230031, China
Abstract:Objective To investigate the risk factors for yersiniosis, so as to provide insights into prevention of yersiniosis. Methods The patients with yersiniosis admitted to the clinics in the surveillance site of Chengbei Township of Jin'an District and Chengnan Township of Yu'an District in Lu'an City from 2013 to 2021 were included as the case group, and the healthy family members matched to cases were selected as the family control group, while normal residents with a 1︰2 match in the same village, gender, and age difference within 5 years were included in the community control group. Participants' demographics, hand-washing and eating habits, living environment hygiene, poultry and livestock feeding were collected using questionnaire surveys, and factors affecting yersiniosis were identified using a multivariable conditional logistic regression model. Results There were 43 cases in the case group, with a median (interquartile range) age of 45 (34) years, 91 cases in the family control group, with a median (interquartile range) age of 36 (36) years and 86 cases in the community control group, with a median (interquartile range) age of 46 (34) years. Multivariable conditional logistic regression analysis showed that compared with the family control group, the habit of drinking unboiled water (OR=6.721, 95%CI: 1.765-25.588), and direct consumption of food stored in the refrigerator (OR=7.089, 95%CI: 1.873-26.829) were risk factors for yersiniosis in the case group; and compared with the community control group, not washing hands after contacting with poultry and livestock (OR=50.592, 95%CI: 2.758-927.997), habit of eating raw vegetables and fruits (OR=5.340, 95%CI: 1.022-27.887), direct consumption of food stored in the refrigerator (OR=19.973, 95%CI: 2.118-188.336), and unclean refrigerator (OR=12.692, 95%CI: 1.992-80.869) were risk factors for yersiniosis in the case group. Compared with the family and community control groups, not washing hands after contacting with poultry and livestock (OR=4.075, 95%CI: 1.427-11.637), habit of drinking unboiled water (OR=4.153, 95%CI: 1.331-12.957), habit of eating raw vegetables and fruits (OR=4.744, 95%CI: 1.609-13.993), and direct consumption of food stored in the refrigerator (OR=5.051, 95%CI: 1.773-14.395) were risk factors for yersiniosis in the control group. Conclusion Unhealthy habits such as eating raw vegetables and fruits, drinking unboiled water, direct consumption of food stored in the refrigerator, unclean refrigerator, and not washing hands after contacting poultry and livestock may increase the risk of yersiniosis.
[1] LUCIA R,HUGO S,SHEVAUN P,et al.Yersiniosis in New Zealand[J/OL].Pathogens,2021,10(2)[2022-12-22].https://doi.org/10.3390/pathogens10020191. [2] NIKOLA R,PETRA M,IVETA B,et al.Detection,characterization,and antimicrobial susceptibility of Yersinia enterocolitica in different types of wastewater in the Czech Republic[J].J Appl Microbiol,2022,133:2255-2266. [3] 李旭,梁俊容,肖玉春,等.小肠结肠炎耶尔森菌在中国家畜家禽间分布的研究[J].中国媒介生物学及控制杂志,2015,26(2):145-147. [4] 中华预防医学会.耶尔森菌病诊断:T/CPMA 005—2019[J].中华流行病学杂志,2019,40(9):1035-1043. [5] LAURENT G,PHILIPPE F,ALEXANDRE L,et al.Risk factors for sporadic Yersinia enterocolitica infections:a systematic review and meta-analysis[J/OL].Microb Risk Anal,2021,17[2022-12-22].https://doi.org/10.1016/j.mran.2020.100135. [6] BOQVIST S,PETTERSSON H,SVENSSON A,et al.Sources of sporadic Yersinia enterocolitica infection in children in Sweden,2004:a case-control study[J].Epidemiol Infect,2009,137(6):897-905. [7] ROSNER B M,STARK K,HHLE M,et al.Risk factors for sporadic Yersinia enterocolitica infections,Germany 2009-2010[J].Epidemiol Infect,2012,140(10):1738-1747. [8] 景怀琦,王鑫.小肠结肠炎耶尔森菌假结核耶尔森菌实验室分离与鉴定手册[M].3版.北京:中国疾病预防控制中心传染病预防控制所,2010:11. [9] CHEYNE B M,VAN DYKE M I,ANDERSON W B,et al. The detection of Yersinia enterocolitica in surface water by quantitative PCR amplification of the ail and yadA genes[J].J Water Health,2010,8(3):487-499. [10] ESPENHAIN L,RIESS M,MÜLLER L,et al.Cross-border outbreak of Yersinia enterocolitica O3 associated with imported fresh spinach,Sweden and Denmark,March2019[J/OL].Euro Surveill,2019,24[2022-12-22].https://doi.org/10.2807/1560-7917.ES.2019.24.24.1900368. [11] LEON-VELARDE C G,JUN J W,SKURNIK M.Yersinia phages and food safety[J/OL].Viruses,2019,11(12)[2022-12-22].https://doi.org/10.3390/v11121105. [12] 高大维,张凤,陈智超,等.六安地区小肠结肠炎耶尔森菌分型分布和特征分析[J].中国人兽共患病学报,2019,35(10):939-943. [13] 陈智超,张凤,高大维,等.安徽省六安市家禽家畜粪便中小肠结肠炎耶尔森菌的病原学研究[J].中国热带医学,2019,19(10):943-946. [14] YE Y W,LING N,HAN Y J,et al.Detection and prevalence of pathogenic Yersinia enterocolitica in refrigerated and frozen dairy products by duplex PCR and dot hybridization targeting the virF and ail genes[J].J Dairy Sci,2014,97(11):6785-6791. [15] 傅祎欣,洪锦春,叶海梅,等.2019—2020年福建省生肉中小肠结肠炎耶尔森菌污染状况及耐药分析[J].中国预防医学杂志,2021,22(3):193-196. [16] 王丽丽,张寻,段然,等.北京市市售生禽肉及社区居民冰箱耶尔森菌污染状况及分子特征研究[J].中国人兽共患病学报,2020,36(9):752-757. [17] 杨卫,丁业荣,常宏伟,等.冷冻冷藏食品小肠结肠炎耶尔森菌病原学检测[J].中国公共卫生,2017,33(2):338-341.