護理師正在照護一位腦膜炎雙球菌腦膜炎病人。哪種隔離防護是合適的?
A nurse is caring for a client with Meningococcal Meningitis. Which isolation precaution is appropriate?
- AContact precautions接觸防護
- BDroplet precautions✓ 正解飛沫防護
- CAirborne precautions空氣傳播防護
- DProtective isolation保護性隔離
核心概念在於識別特定傳染病的傳播途徑以採取適當的隔離措施。腦膜炎雙球菌(Neisseria meningitidis)引起的腦膜炎主要透過大顆粒的呼吸道飛沫(Droplets)傳播,這些飛沫通常在空氣中移動距離不超過 3 到 6 英尺。因此,醫療人員在進入病房時必須配戴外科口罩。正確執行飛沫防護(Droplet precautions)能有效阻斷病原體與易感人群的接觸。在臨床實務中,病人一旦開始接受有效的抗生素治療(如 Ceftriaxone)滿 24 小時後,傳染性會大幅降低,屆時可考慮解除隔離,但在這之前,嚴格遵守飛沫隔離是維護病人及工作人員安全的關鍵。
The core concept is matching transmission route to the correct isolation precaution. Meningococcal meningitis caused by Neisseria meningitidis is transmitted primarily by large respiratory droplets that usually travel no more than 3-6 feet. Healthcare staff must wear a surgical mask when entering the room. Droplet precautions effectively interrupt transmission between the pathogen and susceptible hosts. Clinically, after 24 hours of effective antibiotic therapy (e.g., ceftriaxone), infectivity drops markedly and isolation can be reconsidered; until then, strict droplet precautions protect both patients and staff.
台美在腦膜炎雙球菌的隔離原則上基本一致。但在美國 NCLEX 考試中,非常強調「抗生素治療滿 24 小時」這個時間點作為解除隔離的關鍵指標。台灣臨床則有時會依據醫師判斷或兩次採檢陰性,實務操作上美國更標準化遵循 CDC 的 24 小時指引。