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Approaches to the detection of Clostridioides difficile in the healthcare environment
Journal of Hospital Infection ( IF 3.9 ) Pub Date : 2019-08-24 , DOI: 10.1016/j.jhin.2019.08.017
R.J. Grainger , N.T. Stevens , H. Humphreys

Clostridioides difficile, a spore-forming bacillus, is a major cause of healthcare-associated infection, and can survive for prolonged periods in the inanimate environment. Environmental sampling to detect C. difficile is not routine but may be undertaken as part of outbreak management and during research projects. We conducted a literature search between 1980 and 2018 to review methods for the detection of this pathogen in the environment. There are many acceptable sampling methods used for environmental screening including contact plates, cotton swabs, flocked swabs and sponges. Most recent studies suggest that sponges are the most effective method of sampling and have the added benefit of being capable of sampling larger and curved areas. Culture methods are the most common laboratory method of detecting C. difficile from environmental samples. However, the results are variable depending on the type of agar used and the turnaround time can be long. Molecular methods such as real-time polymerase chain reaction (RT-PCR), although more commonly used to detect C. difficile from faecal specimens, has been used with varying degrees of success in environmental sampling. Further studies are needed to determine if molecular techniques could offer a more reliable, faster method of environmental sampling, giving infection prevention and control teams more reassurance that patients are being placed in adequately decontaminated hospital environments.



中文翻译:

在医疗环境中检测艰难梭菌的方法

艰难梭状芽孢杆菌是一种形成芽孢的芽孢杆菌,是医疗保健相关感染的主要原因,可以在无生命的环境中长期存活。环境采样以检测艰难梭菌这不是日常工作,但可以作为爆发管理的一部分以及在研究项目期间进行。我们在1980年至2018年之间进行了文献检索,以审查在环境中检测这种病原体的方法。有许多可接受的用于环境筛选的采样方法,包括接触板,棉签,植绒棉签和海绵。最近的研究表明,海绵是最有效的采样方法,并且具有能够采样较大和弯曲区域的额外好处。培养方法是检测艰难梭菌的最常用实验室方法从环境样本中提取。但是,结果取决于所用琼脂的类型而变化,周转时间可能很长。实时聚合酶链反应(RT-PCR)等分子方法虽然更常用于从粪便标本中检测艰难梭菌,但在环境采样中已获得了不同程度的成功。需要进行进一步的研究以确定分子技术是否可以提供一种更可靠,更快速的环境采样方法,从而使感染预防和控制团队更加放心将患者置于经过充分消毒的医院环境中。

更新日期:2019-08-25
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