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Abstract：
This study was designed to investigate the prevalence and associated risk factors of Shigella flexneri isolated from drinking water and retail raw food samples in Peshawar, Pakistan. A total of 1,020 different samples were collected from various areas of Peshawar between January 2016 and May 2017, followed by identification of S. flexneri through biochemical, serological, and 16S rRNA gene sequencing. Potential risk factors associated with the development and spreading of S. flexneri infection were also investigated. Overall, 45 (4.41%) samples were positive for Shigella species. Among these samples, the predominant species was S. flexneri (n = 44) followed by S. boydii (n = 1). Interestingly, S. sonnei and S. dysenteriae isolates were not found in any sample. The isolation rate of S. flexneri in drinking water samples, market raw milk, and fruits/vegetables from Peshawar were 6.47%, 3.5%, and 2.9%, respectively. The phylogenetic reconstruction showed genetic diversity among three clades, as clades I and II have isolates of S. flexneri that were circulating within the drinking water, milk, fruits/vegetables, while clade III isolates were recovered from milk samples. Most of S. flexneri were detected in June to September. Potential risk factors of S. flexneri were water sources contaminated by toilet wastes (p = 0.04), surface water drainage (p = 0.0002), hospital wastes (p = 0.01), unhygienic handling (p < 0.05), and transportation of raw food (p = 0.04). In conclusion, S. flexneri isolates of closely related lineage originating from non-clinical samples might be associated with an increased human risk to shigellosis in Pakistan, as significant numbers of S. flexneri were observed in the drinking water and retail raw food samples. PRACTICAL APPLICATION: This study demonstrated the presence of S. flexneri in drinking water and retail raw food samples which seem to possess a serious threat to public health. Potential sources of food and water contamination should properly be monitored by public health authorities to reduce cases of shigellosis.
摘要：
这项研究旨在调查白沙瓦饮用水和零售生食样本中分离的福氏志贺氏菌的患病率和相关危险因素。巴基斯坦。在2016年1月至2017年5月之间，从白沙瓦的各个地区共收集了1,020个不同的样本，然后通过生化鉴定了弗氏链球菌，血清学,和16SrRNA基因测序。还研究了与福氏链球菌感染的发展和传播相关的潜在危险因素。总的来说,45份(4.41%)样本为志贺氏菌属物种阳性。在这些样本中，优势种是福氏链球菌(n=44)，其次是博伊氏链球菌(n=1)。有趣的是,在任何样本中都没有发现桑内和痢疾分离株。饮用水样品中福氏杆菌的分离率，市场原料奶,来自白沙瓦的水果/蔬菜占6.47%，3.5%,和2.9%，分别。系统发育重建显示三个进化枝之间的遗传多样性，因为进化枝I和II有在饮用水中循环的福氏杆菌分离株，牛奶，水果/蔬菜,而进化枝III分离株是从牛奶样品中回收的。大部分福尔内尼在6月至9月被发现。福氏链球菌的潜在危险因素是被厕所废物污染的水源(p=0.04)，地表水排水(p=0.0002)，医院废物(p=0.01)，不卫生处理(p<0.05)，和生食运输(p=0.04)。总之,来自非临床样本的密切相关谱系的福氏链球菌分离株可能与巴基斯坦志贺氏菌病的人类风险增加有关，因为在饮用水和零售生食样本中观察到显著数量的福氏杆菌。实际应用：这项研究表明，饮用水和零售生食样品中存在福氏链球菌，这似乎对公众健康构成了严重威胁。公共卫生当局应适当监测食物和水污染的潜在来源，以减少志贺氏菌病的病例。
