2. Infection Control

3. Classes of Microorganisms 1. Bacteria-simple, one celled organisms that rapidly multiply. Many different shapes Cause diseases like meningitis, pneumonia, Streptococcus causes severe sore throat (strep throat) and rheumatic fever. Staphylococci cause infections such as boils, wound infections, and toxic shock.

4. MRSA-Methicillin Resistant Staph Aureus- hard to kill and Vancomycin is the only antibiotic to work. Antibiotics are used to kill bacteria.

5. 2. Protozoa-one-celled animal like organisms found in decayed materials and contaminated water. – Cause malaria, amebic dysentery, trichomonas, African sleeping sickness. 3. Fungi-simple, plant like organisms that live on dead matter. – Cause ringworm, athlete’s foot, yeast vaginitis and thrush. – Antibiotics do not kill fungi. Use anti-fungal medications.

6. 4. Rickettsiae-parasitic microorganisms- can not live outside the cells of another living organism. – Found in fleas, lice, ticks, and mites. – Transmitted to humans by the bites of these insects. – Cause typhus fever, Rocky Mountain spotted fever. – Antibiotics are used to treat these.

7. 5. Virus- smallest microorganism, visible only using an electron microscope. – Can’t reproduce unless they are inside another living cell. Spread human to human by blood or body fluids. Viruses are more difficult to kill because they are resistant to many disinfectants and antibiotics. – Cause: common cold, measles, mumps, chicken pox, influenza.

8. Three Viruses of Major Concern 1. Hepatitis B -caused by the hepatitis virus (HBV) and is transmitted from blood and body fluids. – Affects the liver and can lead to destruction and scarring of the liver cells. Vaccine available in three injections. – Expensive-available to all healthcare providers at no cost by the employer.

9. 2. Hepatitis C -caused by hepatitis C virus (HCV) and is transmitted by blood and blood containing body fluids. Asymptomatic-no symptoms Others have mild symptoms-flu-like Can cause serious liver damage. No preventative immunization (vaccine). Hepatitis B and C are difficult to destroy. – Remain active for several days in dried blood!

10. Acquired immune deficiency syndrome- caused by the human immunodeficiency virus (HIV) and suppresses (weakens) the immune system (protection against a disease). Can not fight off many cancers and infections that would not affect healthy people. No cure nor vaccine available.

11. Hospital Acquired Infections Acquired-”got it” in a hospital or long term care facility. Called nosocomial infections Transmitted (carried) by health care providers to pts./residents

12. Many of the pathogens transmitted are antibiotic resistant and can cause serious and even life-threatening infections in pts./residents. Examples: staphylococcus (MRSA), pseudomonas, and enterococci (Ecoli). Infection control programs- used in health care facilities to prevent and deal with nosocomial infections.

13. Terms to know I Causative agent- pathogen Reservoir-place to live Portal of exit -way for pathogen to escape from reservoir where it was living. Mode of transmission -way spread from one reservoir or host where it can live Portal of entry -way to enter a new reservoir or host

14. Chain of Infection

15. Terms con’t II Infection control – the set of methods used to control and prevent the spread of disease Infections - are caused by pathogens (germs) Communicable disease – disease spread from one person to another Infectious disease – disease caused by a pathogen (germ or bacteria)

16. Terms con’t III Fomite = inanimate objects that transmit disease – The bathroom door knob is a fomite. Pyogenic = pus producing Endogenous- originates inside body Exogenous- originates outside body Nosocomial – hospital or healthcare acquired Opportunisitic – weakened immune system

17. Types of contacts 1.Direct: person to person (physical or sexual) or direct contact with a body secretion containing the pathogen. -Contaminated hands are one of the most common sources containing the pathogen. 2.Indirect: indirect contact with body secretion or person Air (Dried Droplet Nuclei) Insect (Vector-borne) Fomite (Vehicle-borne) Feces (Fecal-to-oral

18. Body Defenses Mucous membrane-traps pathogens Cilia-tiny, hairlike structures that trap pathogens Coughing and sneezing Tears in the eyes Fever Inflammation-leukocytes-white blood cells, destroy pathogens Immune response-produces antibodies that combat pathogens

19. Asepsis Absence of disease producing microorganisms or pathogens – aseptic techniques: proper handwashing, good personal hygiene, use of disposal gloves.

20. Levels of Aseptic Control Antisepsis-prevent growth of pathogens but not effective against spores and viruses. – Used on skin – Betadine and alcohol Disinfection-process that destroys pathogens. Not effective for spores and viruses. – Chemical disinfectants-used on objects – bleach, Lysol

21. Sterilization-destroys ALL microorganisms, including spores and viruses. – Autoclave : Steam under pressure

22. Infection Control Precautions

23. Standard Precautions Prevent the transmission of common infectious agents Hand washing key Assume infectious agent could be present in the patient’s – Blood – Body fluids, secretions, excretions – Non-intact skin – Mucous membranes

24. PPE for Standard Precautions Wear: Gloves Gowns Eye Protection and / or Mask If: Touching –Respiratory secretions –Contaminated items or surfaces –Blood & body fluids Soiling clothes with patient body fluids, secretions, or excretions Procedures are likely to generate splashes / sprays of blood, body fluids, secretions, excretions

25. Precaution Levels All levels require hand hygiene Standard Transmission based precautions: Contact Droplet Airborne

26. Contact Precautions Taken in addition to Standard Precautions Limit patient movement Isolate patients Gown + gloves for patient / room contact – Remove immediately after contact Do not touch eyes, nose, mouth with hands Avoid contaminating environmental surfaces

27. Contact Precautions Wash hands immediately after patient contact Use dedicated equipment if possible – If not, clean and disinfect between uses Clean, then disinfect patient room daily – Bed rails – Bedside tables – Lavatory surfaces – Blood pressure cuff, equipment surfaces

28. Cleaning and Disinfection for Contact Precautions Detergents – Remove dirt, soiling – Mechanical force essential – Flush with clean water Disinfectants – Kill viruses, bacteria – Decontaminate surfaces – Type depends on infectious agent – Use after detergent

29. Droplet Precautions Prevent infection by large droplets from – Sneezing – Coughing – Talking Examples – Neisseria meningitidis – Pertussis – Seasonal influenza

30. Droplet Precautions Taken in addition to Standard Precautions Place patients in single rooms or cohort 3 feet apart Wear surgical mask within 3 feet or 1 meter of patient Wear face shield or goggles within 3 feet or 1 meter of patient Limit patient movement within facility – Patient wears mask when outside of room

31. Airborne Precautions Taken in addition to Standard Precautions Prevent spread of infection through inhalable airborne particles Examples – Tuberculosis – Measles – Varicella – Variola

32. Airborne Precautions N95 respirator (or equivalent) for personnel – Check seal with each use Patient in isolation Airborne isolation room, if available – Air exhaust to outside or re-circulated with HEPA filtration Patient to wear a surgical mask if outside of the isolation room

33. Negative Pressure Isolation Room

34. Types of Isolation Respiratory Isolation – protection from airborne droplets Skin and wound Isolation – protection from open wounds, skin drainage Enteric Isolation – solid body wastes Strict Isolation – complete protection