— 安全與感染控制 · MEDIUM · MCQ —
哪項護理行為最能預防困難梭狀芽孢桿菌（C. difficile）的傳播？
Which of the following actions by the nurse best prevents the spread of Clostridioides difficile?
- AUsing soap and water for hand hygiene✓ 正解使用肥皂和水進行手部衛生
- BWearing a gown only when changing linens僅在更換床單時穿著隔離衣
- CCleaning equipment with alcohol wipes使用酒精濕巾清潔設備
- DUsing alcohol-based hand sanitizer after every contact每次接觸後使用酒精性手部消毒液
— Explanation · 中文詳解 —
困難梭狀芽孢桿菌（C. difficile）具有芽孢（Spore）結構，對酒精具有高度抵抗力，一般的酒精性乾洗手液無法殺滅或移除芽孢。預防傳播的黃金準則為接觸隔離（Contact Precautions），並務必使用肥皂與流動水進行手部衛生，透過物理性的機械摩擦（Mechanical friction）將芽孢從皮膚表面洗除。
Clostridioides difficile spores are resistant to alcohol-based sanitizers and require mechanical removal. Therefore, washing hands with soap and water is the most effective method to prevent transmission. Contact precautions, including wearing gowns upon room entry and using bleach-based cleaners, are also essential.
✦ 台美臨床差異
美國 CDC 嚴格規範針對 C. diff 病人必須使用肥皂洗手，且病室清潔必須使用經 EPA 核准之殺芽孢消毒劑，台灣臨床亦遵循此原則，但在病室環境清潔劑選擇上需確保符合殺芽孢規格。