Kaatz G W, Gitlin S D, Schaberg D R, Wilson K H, Kauffman C A, Seo S M, Fekety R
Department of Internal Medicine, University of Michigan, Ann Arbor.
Am J Epidemiol. 1988 Jun;127(6):1289-94. doi: 10.1093/oxfordjournals.aje.a114921.
An outbreak of antibiotic-associated colitis that occurred on a ward of a Michigan hospital during February-April, 1984, was studied by bacteriophage-bacteriocin typing. Stools from the seven involved patients yielded Clostridium difficile isolates of types B1537 or Cld7;B1537. C. difficile was recovered from 31.4% of environmental cultures obtained on the ward, and the majority of isolates were types B1537 or Cld7;B1537. When the ward was disinfected with unbuffered hypochlorite (500 parts per million (ppm) available chlorine), surface contamination decreased to 21% of initial levels and the outbreak subsequently ended. Phosphate buffered hypochlorite (1,600 ppm available chlorine, pH 7.6) was even more effective; its use resulted in a 98% reduction in surface contamination. These findings suggest that environmental contamination with C. difficile is important in the epidemiology of antibiotic-associated colitis, and that hypochlorite is effective in eliminating C. difficile from the hospital environment.
1984年2月至4月期间，密歇根州一家医院的一个病房发生了一起与抗生素相关的结肠炎疫情，通过噬菌体-细菌素分型法进行了研究。7名相关患者的粪便中分离出了B1537型或Cld7;B1537型艰难梭菌。从病房环境样本中31.4%的样本中分离出了艰难梭菌，大多数分离株为B1537型或Cld7;B1537型。当病房用无缓冲次氯酸盐（有效氯500ppm）进行消毒时，表面污染降至初始水平的21%，疫情随后结束。磷酸盐缓冲次氯酸盐（有效氯1600ppm，pH值7.6）效果更佳；使用后表面污染减少了98%。这些发现表明，艰难梭菌的环境污染在抗生素相关性结肠炎的流行病学中很重要，并且次氯酸盐在消除医院环境中的艰难梭菌方面是有效的。
