Chapter 14: Infection Control

Anaerobic

Organisms that live and reproduce in the absence of oxygen: a- without

Sterilization

A process that destroys all microorganisms, including spores and viruses: achived by heat or chemical

Fungi

A plant-like organisms that live on dead organic matter
Yeast and molds
Can be pathogenic
Antibiotics do not kill
Antifungal medications

Asepsis

Absence of pathogens

Pathogen

Germ- or disease producing microorganism

Nosocomial

Infection contracted in a hospital; or health care facility: Most common is Staph
Many are antibiotic-resistant
Can cause serious and even life-threatening infections

Microorganism

Small living organisms
Not visible to the naked eye
Microscope must be used to see them
Found everywhere in the environment
Found on and in the human body
Many are part of normal flora of body
May be beneficial
Called nonpathogens when not harmful to the

Aerobic

Organisms that require oxygen to live

Exogenous

Disease originates outside the body
Examples: radiation, chemical agents, trauma, electric shock, and temperature extremes

Bacteria

One-celled plantlike organisms that multiply rapidly
Classified by shape and arrangement

Disinfection

Process that destroys or kills pathogens

Chain of Infection

Present for disease to occur and spread from one individual to another:
Causative agent
Reservoir
Portal of exit
Mode of transmission
Portal of entry
Susceptible host

Endogenous

Infection or disease originating within the body
Examples: metabolic disorders, congenital abnormalities, tumors, and infections caused by microorganisms within the body

Viruses

Smallest microorganism
Must use electron microscope to see
Must be inside another living cell to reproduce
Spread by blood and body secretions
Very difficult to kill
Cause many diseases
infected animals can mutate to infect humans
Examples include:
Severe

Antisepsis

The process of inhibiting the growth and multiplication of pathogenic organisms

Protozoa

One celled animals often found in decayed materials and contaminated water
May have flagella for movement
Some are pathogenic

Microbe Classifications

Bacteria, Protozoa, Fungi, Rickettsiae, Viruses

Round or spherical in shape (Bacteria)

Cocci
Diplococci�in pairs
Streptococci�in chains
Staphylococci�clusters or groups

Rod shaped (Bacteria)

Bacilli
Occur singly, in pairs, or in chains
May have flagella
Ability to form spores

Spiral or corkscrew shaped (Bacteria)

Spirilla
Includes comma-shaped vibrio and corkscrew spirochete
Diseases include syphilis and cholera

Antibiotics

Antibiotics are used to kill bacteria
Some strains of bacteria have become antibiotic-resistant
When antibiotic-resistant, the antibiotic is no longer effective against the bacteria

Rickettsiae

Parasitic microorganisms
Cannot live outside the cells of another living organism
Transmitted to humans by the bites of insects (e.g., fleas, lice, ticks, mites)
Examples of diseases
Antibiotics are effective against many of them

Hepatitis B

Virus�Also called serum hepatitis
Caused by HBV
Transmitted by blood serum and body secretions
Affects the liver
Vaccine available for protection
Vaccine is expensive
Vaccine given in a series of three injections
By law, employers must provide vaccine a

Hepatitis C

Caused by HVC
Transmitted by blood and blood-containing body fluids
Many infected individuals are asymptomatic
Others have mild symptoms
Can cause severe liver damage
Currently, no vaccine ready for use
Vaccine is in development stage
Extremely difficult

Acquired Immune Deficiency Syndrome (AIDS)

Caused by the Human Immunodeficiency Virus (HIV)
Suppresses the immune system
Individual becomes susceptible to cancers and infections that would not affect a healthy person
No cure presently and no vaccine
Take precautions for prevention

Helminths

Multicellular parasites otherwise known as worms or flukes
Are transmitted:
By eating contaminated food
Being bitten by infected insects
When worms enter the skin

Classifications of Diseases and Infections

Endogenous, Exogenous, Nosocomial, Opportunistic

Opportunistic

Infections that occur when the body's defenses are down: Usually do not occur in normal immune system
Examples: Kaposi's sarcoma (rare type of cancer) and Pneumocystis carinii pneumonia in individuals with AIDS

Common Body Defenses

Mucous membranes
Cilia
Coughing and sneezing
HCL in the stomach
Tears
Fever
Inflammation response
Immune response

Ending the Chain of Infection

Eliminate any step in the chain and infection is stopped
Follow practices to interrupt or break the chain
Remember, pathogens are everywhere
Prevention is a continuous process

Aseptic Techniques

Contaminated: any object or area that may contain pathogens
Major aim: maintaining cleanliness and eliminating or preventing every aspect of contamination

Asepsis

absence of disease-producing microorganisms

Common Aseptic Techniques

Thorough handwashing
Good personal hygiene
Disposable gloves
Cleaning instruments and equipment
Proper cleaning of environment

Levels of Aseptic Control

Antisepsis�used on the skin
Disinfection�used mainly on objects
Sterilization�use of steam under pressure, gas, radiation, and chemicals on objects

Bioterrorism

The use of microorganisms or biologic agents for warfare
Infecting humans, animals, or plants
Have been used over time by different nations not only in war but also on innocent people

Biologic Agents

Microorganisms with characteristics suitable for bioterrorism:
Inexpensive, available, easily produced, spreads quickly
Maintains its survival
Brings death or disability
Travels from person to person
Difficult to prevent/treat
High priorities include: Sma

Smallpox

A contagious and infectious disease, result of the Variola virus

Anthrax

An infectious disease caused by Bacillus anthracis

Plague

An infectious disease from the bacteria Yersinia pestis

Botulism

A paralytic illness resulting from a nerve toxin from the bacteria Clostridium botulinum

Tularemia

An infectious disease from the bacteria Fracisella tularensis

Filoviruses

infectious diseases causing severe hemorrhagic fever known as Ebola virus and Marburg virus

Preparing for Bioterrorism

Bioterrorism attack would result in a public health emergency
Would have impact on health care facilities
Social disorder would ensue
Comprehensive plan
The Act 2002 passed by Congress and signed into law Involves local, regional, state, and national gove

When to Wash Hands

On arrival at facility
Immediately before leaving facility
Before and after every patient contact
After contact with patient's skin
Before moving from a contaminated site to a clean site
Anytime the hands become contaminated during a procedure
Before appl

Principles of Handwashing

Use soap as a cleansing agent
Use warm water
Use friction
Clean all surfaces
Point fingertips down
Use dry paper towels to turn faucet on and off
Clean nails

Bloodborne Pathogen Standards

Established in 1991 by OSHA
Must be followed by all health care workers
Civil penalties if not implemented and followed

Regulation Requirements

Written exposure control plan
Identify all employees with occupational exposure
Hepatitis B vaccines free of charge
Provide personal protective equipment
Provide adequate handwashing facilities and supplies
Ensure worksite is maintained in a clean, sanita

Needle Stick Safety Act

Passed by Congress in 2000
Centers for Disease Control and Prevention (CDC) estimated 600,000 to 800,000 needle sticks per year
OSHA revised Bloodborne Pathogen Standard to requirements of this act

Employer Requirements

Identify and use effective and safer medical devices
Incorporate changes in annual update of exposure control plan
Solicit input from nonmanagerial employees who are responsible for direct patient care
Maintain a sharps injury log
Ensure that every emplo

Standard Precautions

Rules developed by the CDC
Every body fluid must be considered potential source of infection
All patients must be considered potential source of infection

When to Use Standard Precautions

Any situation where you might come in contact with:
Blood or any fluid that contains blood
Body fluids, secretions, and excretions
Mucous membranes
Nonintact skin
Tissue or cell specimens