Agolini G, Protano C, Puro V, Raitano A, Ferraro F, Vitali M
Dipartimento di Scienze Biomediche, Farmacologia, Università di Trieste, Italy.
Ann Ig. 2009 Nov-Dec;21(6):599-609.
In the last years, Clostridium difficile acquired great interest for public health because of constant increase of Clostridium difficile associated diarrhea (CDAD), especially in nosocomial field and as a consequences of its pathogenicity and virulence. Oro-faecal transmission and great environmental persistence of Clostridium difficile indicate hand hygiene of health care workers and environmental disinfection practices as key interventions for prevention and control of nosocomial CDAD. The current indications relative to the hand hygiene suggest the use of soap and water for hand washing and, to achieve a better compliance of health care workers to this treatment, the alternative use of sodium dichloroisocyanurate or alcohol-based solution or gel waterless. Regard to environmental disinfection, to avoid high concentrations of sodium hypochlorite (in the magnitude of 5.000-6.000 ppm), necessary to reduce microbic load of dirty environment, the most appropriate treatment should consist of 2 phases: preliminary cleaning with water and detergents or polyphenol, followed by treatment with solution containing 1.000 ppm available chlorine, obtained from sodium hypochlorite or sodium dichloroisocyanurate.
在过去几年中,艰难梭菌因其导致的艰难梭菌相关性腹泻(CDAD)持续增加而引起了公共卫生领域的高度关注,尤其是在医院环境中,并且鉴于其致病性和毒力。艰难梭菌的粪口传播以及在环境中的高持久性表明,医护人员的手部卫生和环境消毒措施是预防和控制医院内CDAD的关键干预措施。当前关于手部卫生的建议是使用肥皂和水洗手,为了提高医护人员对这种方法的依从性,也可选择使用二氯异氰尿酸钠或酒精基溶液或无水凝胶洗手液。关于环境消毒,为避免使用高浓度的次氯酸钠(5000 - 6000 ppm)来降低污染环境中的微生物负荷,最合适的处理应包括两个阶段:先用清水和洗涤剂或多酚进行初步清洁,然后用含有1000 ppm有效氯的溶液进行处理,该溶液可由次氯酸钠或二氯异氰尿酸钠制得。