1 Lung Bacteria Group and.
2 Adult Cystic Fibrosis Centre, The Prince Charles Hospital, Brisbane, Australia.
Am J Respir Crit Care Med. 2018 Feb 1;197(3):348-355. doi: 10.1164/rccm.201707-1457OC.
People with cystic fibrosis (CF) generate Pseudomonas aeruginosa in droplet nuclei during coughing. The use of surgical masks has been recommended in healthcare settings to minimize pathogen transmission between patients with CF.
To determine if face masks and cough etiquette reduce viable P. aeruginosa aerosolized during coughing.
Twenty-five adults with CF and chronic P. aeruginosa infection were recruited. Participants performed six talking and coughing maneuvers, with or without face masks (surgical and N95) and hand covering the mouth when coughing (cough etiquette) in an aerosol-sampling device. An Andersen Cascade Impactor was used to sample the aerosol at 2 meters from each participant. Quantitative sputum and aerosol bacterial cultures were performed, and participants rated the mask comfort levels during the cough maneuvers.
During uncovered coughing (reference maneuver), 19 of 25 (76%) participants produced aerosols containing P. aeruginosa, with a positive correlation found between sputum P. aeruginosa concentration (measured as cfu/ml) and aerosol P. aeruginosa colony-forming units. There was a reduction in aerosol P. aeruginosa load during coughing with a surgical mask, coughing with an N95 mask, and cough etiquette compared with uncovered coughing (P < 0.001). A similar reduction in total colony-forming units was observed for both masks during coughing; yet, participants rated the surgical masks as more comfortable (P = 0.013). Cough etiquette provided approximately half the reduction of viable aerosols of the mask interventions during voluntary coughing. Talking was a low viable aerosol-producing activity.
Face masks reduce cough-generated P. aeruginosa aerosols, with the surgical mask providing enhanced comfort. Cough etiquette was less effective at reducing viable aerosols.
囊性纤维化（CF）患者在咳嗽时会产生含有铜绿假单胞菌的飞沫核。为了最大程度地减少 CF 患者之间病原体的传播，医疗机构推荐使用外科口罩。
确定口罩和咳嗽礼仪是否能减少咳嗽时产生的有活力的铜绿假单胞菌气溶胶。
招募了 25 名患有 CF 和慢性铜绿假单胞菌感染的成年人。参与者在气溶胶采样装置中进行了 6 次说话和咳嗽动作，包括不戴口罩（外科口罩和 N95 口罩）和戴口罩（咳嗽时用手捂住嘴）以及不戴口罩（咳嗽时用手捂住嘴）时咳嗽。使用 Andersen 级联撞击器从每个参与者 2 米处采集气溶胶。对定量痰和气溶胶细菌培养进行了分析，并在咳嗽动作期间评估了参与者对口罩舒适度的评价。
在未覆盖的咳嗽（参考动作）中，25 名参与者中有 19 名（76%）产生了含有铜绿假单胞菌的气溶胶，痰中铜绿假单胞菌浓度（以 cfu/ml 测量）与气溶胶中铜绿假单胞菌形成单位数呈正相关。与未覆盖的咳嗽相比，戴外科口罩咳嗽、戴 N95 口罩咳嗽和咳嗽礼仪都减少了气溶胶中铜绿假单胞菌的负荷（P<0.001）。在咳嗽时，两种口罩都观察到总菌落形成单位的类似减少；然而，参与者认为外科口罩更舒适（P=0.013）。与口罩干预措施相比，咳嗽礼仪在自愿咳嗽时仅能减少一半的有活力气溶胶。说话是一种产生低活力气溶胶的活动。
口罩减少了咳嗽产生的铜绿假单胞菌气溶胶，外科口罩提供了更高的舒适度。咳嗽礼仪在减少有活力的气溶胶方面效果较差。
