在醫療環境中,哪項措施最能預防困難梭狀芽孢桿菌(C. difficile)的傳播?
Which of the following actions best prevents the transmission of Clostridioides difficile in a healthcare setting?
- AApply sterile gloves before entering the room進入房間前戴無菌手套
- BWash hands with soap and water after patient contact✓ 正解接觸病人後用肥皂和水洗手
- CWear a N95 respirator mask佩戴 N95 呼吸防護口罩
- DUse alcohol-based hand sanitizer after patient contact接觸病人後使用含酒精的乾洗手液
核心概念在於接觸隔離(contact precautions)與微生物特性。困難梭狀芽孢桿菌(C. difficile)會產生芽孢(spores),這些芽孢對酒精類消毒劑(alcohol-based sanitizers)具有高度抗藥性。因此,醫療照護人員在接觸受感染病人後,必須使用肥皂與流動水進行機械性洗手,才能有效將芽孢從皮膚表面移除,防止交叉感染。這是感染控制中的黃金準則,應優先於其他防護措施。
Clostridioides difficile spores are resistant to alcohol-based hand sanitizers, making mechanical removal with soap and water essential to prevent transmission. Contact precautions are required, but hand hygiene with soap and water remains the primary method for decontaminating hands after patient contact.
在美國,醫療機構對於 C. difficile 的感染控制極為嚴格,通常要求病室門口明確標示接觸隔離,且嚴格執行「肥皂與水洗手」(Soap and Water Hand Hygiene)。台灣臨床雖亦知此原則,但美國醫院的品質監測(如 Joint Commission)對此 compliance 的稽核頻率更高。