现症病人艰难梭菌空气传播潜能（翻译有奖）

潮水

The Potential for Airborne Dispersal of Clostridium difficile from Symptomatic Patients
Clinical Infectious Diseases 2010;50:1450–1457
Background.The high transmissibility and widespread environmental contamination by Clostridium difficile suggests the possibility of airborne dissemination of spores. We measured airborne and environmental C. difficile adjacent to patients with symptomatic C. difficile infection (CDI).

Methods.We conducted air sampling adjacent to 63 patients with CDI for 180 h in total and for 101 h in control settings. Environmental samples were obtained from surfaces adjacent to the patient and from communal areas of the ward. C. difficile isolates were characterized by ribotyping and multilocus variable-number tandem-repeat analysis to determine relatedness.

Results.Of the first 50 patients examined (each for 1 h), only 12% had positive air samples, most frequently those with active symptoms of CDI (10%, vs 2% for those with no symptoms). We intensively sampled the air around 10 patients with CDI symptoms, each for 10 h over 2 days, as well as a total of 346 surface sites. C. difficile was isolated from the air in the majority of these cases (7 of 10 patients tested) and from the surfaces around 9 of the patients; 60% of patients had both air and surface environments that were positive for C. difficile. Molecular characterization confirmed an epidemiological link between airborne dispersal, environmental contamination, and CDI cases.

Conclusions.Aerosolization of C. difficile occurs commonly but sporadically in patients with symptomatic CDI. This may explain the widespread dissemination of epidemic strains. Our results emphasize the importance of single-room isolation as soon as possible after the onset of diarrhea to limit the dissemination of C. difficile.

潮水

艰难梭菌能通过空气传播？

出发

从症状的患者具有潜在的机载的艰难梭菌扩散
临床传染病杂志2010; 50:1050-1457.
背景：高艰难梭菌的传播和广泛的环境的污染建议的空气传播的孢子的可能性。我们测定空气和环境的艰难梭菌毗邻艰难梭菌感染症状（CDI）的患者。

方法：我们进行空气取样180个邻近的H与课程发展处63例，在控制设置为101小时。环境标本从表面附近的病人，从病房的公用地方。艰难梭菌菌株的特点是核糖分型和多位点可变数目串联，重复分析，以确定相关性。

结果：第一次检查50例（为每1小时），只有12％有正面的空气样本，最常见的症状有积极的课程发展处（10％者，相较于那些没有症状的2％）。我们集中采样与课程发展处约10症状，病人每2天超过10 h的空气，以及表面的346个地点。艰难梭菌是从空气中分离出的7测试的病人中10例（多数）和来自全世界的9名患者的表面，60％的患者有空中和地面的环境，这些都是艰难梭菌阳性。分子鉴定证实一间飞散，污染环境流行病学联系，与课程发展处的案件。
结论：C的艰难，但雾化一般出现在有症状的病人偶尔课程发展处。这可能解释了流行株的广泛传播。我们的研究结果强调后腹泻发病的单间隔离的重要性，尽快限制艰难梭菌的传播。

木易杨

交作业：艰难梭菌显性感染患者通过空气扩散的潜能
临床感染性疾病杂志2010; 50:1450-1457
背景：艰难梭菌的高传播性和广泛的环境污染暗示了其芽孢通过空气传播的可能性。我们测定了有症状的艰难梭菌感染患者邻近环境和空气中的艰难梭菌。
方法：我们对63名CDI患者毗邻环境进行空气采样总计180小时，而对照环境采样共计101小时。环境标本从病人附近的表面和病房的公共区域获得。艰难梭菌分离株通过核糖分型和多位点可变数量重复序列分析，以确定相关性。
结果：首批50个检测的病人中（每个1h）中，只有12％获得了阳性的空气样本，绝大多数是那些有症状的CDI感染者（10％，相较于那些没有症状的2％）。我们我们进一步对10个有症状的病人周围进行空气采样，2天内每人10 h，以及表面采样共计346个地点。大部分病例从空气（7/10）和物体表面（9/10）中分离出艰难梭菌；60％的患者空气和环境表面都是艰难梭菌阳性。表征分子流行病学证实，环境污染、空气播散和CDI病例之间存在联系.
结论：艰难梭菌的气溶胶化通常发生在偶尔有症状的CDI感染患者中。这可能解释了流行株的广泛传播。我们的研究结果强调腹泻发病后尽快单间隔离在限制艰难梭菌的传播方面的重要性。