The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet
The potential spread of infection caused by aerosol contamination of surfaces after flushing a domestic toilet
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DOI：
10.1111/j.1365-2672.2005.02610.x
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发表时间：
2005-01-01
影响因子：
4
通讯作者：
Jones, MV
中科院分区：
文献类型：
--
作者：
Barker, J;Jones, MV
目的：测定在感染性腹泻期间，厕所被指示菌污染的厕所冲厕后，厕所内的气溶胶形成和粉尘水平，以模拟感染性腹泻期间病原体脱落的水平。方法和结果：使用含有粘质沙雷氏菌或MS2噬菌体的半固体琼脂载体污染家庭厕所的侧壁和碗水，以模拟急性腹泻后污垢的影响。使用活菌计数来比较瓷器表面附着的沙雷氏菌数量和冲厕所前后碗水中的沙雷氏菌数量。使用空气采样和沉降板来确定厕所隔间内是否存在细菌或携带病毒的气雾剂。播种后，瓷器表面无论是在边缘下还是在碗的侧面都有很高的污染。在一次冲洗后，表面附着的微生物减少了2.0-3.0个对数周期厘米(-2)。在第一次冲洗后，碗水中的微生物数量减少了2.0-3.0个对数循环ml(-1)，在第二次冲洗之后，进一步减少了约2.0个对数循环ml(-1)。空气中微生物在第一次冲刷后立即达到最高水平(沙雷氏菌的平均值为1370cfu m(-3)，MS2 PAGE的平均值为2420pfu m(-3))。顺序冲洗导致微生物进一步分布到空气中，尽管每次冲洗后微生物数量都有所下降。沙雷氏菌附着在马桶侧壁上，以及马桶水中的自由漂浮生物，是造成细菌气溶胶形成的原因。结论：虽然一次性冲水会降低马桶水中微生物的水平，但马桶表面和马桶水中的大量微生物会通过进一步的冲水传播到空气中。这项研究的意义和影响：许多人可能没有意识到冲厕时微生物在空气中传播的风险，以及随之而来的表面污染，可能会通过直接的面对面接触在家庭中传播感染。一些肠道病毒在冲厕所后会留在空气中，吸入和吞咽后可能会感染。
Aims: To determine the level of aerosol formation and fallout within a toilet cubicle after flushing a toilet contaminated with indicator organisms at levels required to mimic pathogen shedding during infectious diarrhoea.Methods and Results: A semisolid agar carrier containing either Serratia marcesens or MS2 bacteriophage was used to contaminate the sidewalls and bowl water of a domestic toilet to mimic the effects of soiling after an episode of acute diarrhoea. Viable counts were used to compare the numbers of Serratia adhering to the porcelain surfaces and those present in the bowl water before and after flushing the toilet. Air sampling and settle plates were used to determine the presence of bacteria or virus-laden aerosols within the toilet cubicle. After seeding there was a high level of contamination on the porcelain surfaces both under the rim and on the sides of the bowl. After a single flush there was a reduction of 2.0-3.0 log cycles cm(-2) for surface attached organisms. The number of micro-organisms in the bowl water was reduced by 2.0-3.0 log cycles ml(-1) after the first flush and following a second flush, a further reduction of c. 2.0 log cycles ml(-1) was achieved. Micro-organisms in the air were at the highest level immediately after the first flush (mean values, 1370 CFU m(-3) for Serratia and 2420 PFU m(-3) for MS2 page). Sequential flushing resulted in further distribution of micro-organisms into the air although the numbers declined after each flush. Serratia adhering to the sidewalls, as well as free-floating organisms in the toilet water, were responsible for the formation of bacterial aerosols.Conclusions: Although a single flush reduced the level of micro-organisms in the toilet bowl water when contaminated at concentrations reflecting pathogen shedding, large numbers of micro-organisms persisted on the toilet bowl surface and in the bowl water which were disseminated into the air by further flushes.Significance and Impact of the Study: Many individuals may be unaware of the risk of air-borne dissemination of microbes when flushing the toilet and the consequent surface contamination that may spread infection within the household, via direct surface-to-hand-to mouth contact. Some enteric viruses could persist in the air after toilet flushing and infection may be acquired after inhalation and swallowing.