一位 72 歲女性接受長期抗生素治療後出現嚴重惡臭腹瀉，糞便檢測 C. difficile 陽性。一位護理學生照護後脫除 PPE 出房，僅用酒精乾洗手液後便去下一個病房。學生犯了什麼關鍵錯誤？
A 72-year-old female develops severe foul-smelling diarrhea after prolonged antibiotics; stool is positive for Clostridium difficile. After caring for the client, a nursing student removes PPE, exits the room, and uses only alcohol-based hand sanitizer before going to the next room. What critical error did the student make?
- AC. diff is airborne; the client should be in a negative pressure room.難辨梭狀芽孢桿菌為空氣傳染；病人應安置於負壓病房。
- BThe student executed perfect infection control; alcohol kills all bacteria on contact.該學生執行了完美的感染控制；酒精能瞬間殺死所有細菌。
- CC. diff bacteria adapt to alcohol and reproduce faster on hands.難辨梭狀芽孢桿菌會適應酒精並在手上更快繁殖。
- DC. difficile produces alcohol-resistant spores; hands must be washed with soap and water—alcohol gel is ineffective.✓ 正解難辨梭狀芽孢桿菌會產生耐酒精的孢子；必須用肥皂和水洗手——酒精搓揉劑無效。
Clostridium difficile 是接觸傳染病原體，產生對酒精乾洗手液具高抗性的孢子（spores）。 選項 D 正確：照護 C. diff 病人後必須以肥皂與水機械式洗手，物理性沖去孢子；酒精洗手液對孢子無效。需執行接觸隔離（contact precautions）。 選項 B 錯誤：酒精無法殺滅孢子。 選項 C 錯誤：細菌不會「適應酒精」。 選項 A 錯誤：C. diff 為接觸傳染，非空氣傳染。
Clostridium difficile is a contact pathogen producing alcohol-resistant spores. C correct: After caring for C. diff clients, hands must be washed with soap and water to mechanically remove spores—alcohol gel does not kill spores. Contact precautions are required. A incorrect: Alcohol does not kill spores. B incorrect: Bacteria don't 'adapt to alcohol.' D incorrect: C. diff is contact-transmitted, not airborne.
「C.diff (困難腸梭菌) = 只能用 Soap & Water (肥皂與水) 洗手，絕對禁用酒精！」。這是感染控制界的世界奇蹟共識題。台美護理師誰敢在清理完 C.diff 大便後只抹酒精，這輩子絕對會被阿長罵死。