1. Infection Control & Standard Precautions
Chapter 16

2. Page 323
Flora
Flora = Microorganisms that live in a specific environment
Resident flora = normal flora that are always present
Transient flora = Occur in periods of limited duration
Vigorous handwashing with soap & water or the use of an alcohol-based hand sanitizer is an effective means of removing most flora.

3. Pathogenicity & Virulence
Page 323
Pathogenicity & Virulence
Pathogens = disease-producing microorganisms
Pathogenicity = the ability of a microorganism to produce disease
Virulence = the frequency with which a pathogen causes disease
There are six types of pathogenic microorganisms:
Bacteria, Viruses, Fungi, Protozoa, Rickettsia, Helminths

4. Table 16-1 Page 323 Bacteria Viruses Fungi Staphylococcus Common Cold
Ringworm (Tineal)
Streptococcus
Herpes Simplex
Athlete's Foot
E. coli
Mononucleosis
Candidiasis
Klebsiella
HIV
Thrush-candida albicans
Pseudomonas
Measles
Vaginitis
Shigella
Mumps
Coccidioidomycosis
Salmonella
Rubella
Influenza (flu)

5. Table 16-1 Page 323 Rickettsia Protozoa Helminths
Rocky Mountain Spotted Fever
Malaria
Roundworms
Lyme Disease
Giardasis
Flatworms
Typhus
Pinworms
Tapeworms

6. Page 323
Bacteria
Bacteria = Small, one-celled microorganisms that lack a true nucleus or mechanism to provide metabolism; Need an environment that will provide food for survival; Multiply by simple cell division
Some bacteria produce spores (resistant to heat, drying & disinfectants then germinate & form new cells when they find a favorable environment)
Cause a wide range of illnesses
Including diarrhea, pneumonia, sinusitis, UTI, & gonorrhea

7. Pages 323 – 324
Viruses
Viruses = organisms that can live only inside cells
They Cannot get nourishment or reproduce outside the cell
Damage or kill the cell they inhabit
Contain a core of DNA or RNA surrounded by a protein coating
Some have another coating called an envelope, which protects them from an attack by the immune system
The same viral infection may cause different symptoms in different individuals. Some viruses will immediately trigger a disease response, while others may remain latent for many years.

8. Page 324
Fungi
Fungi = Microscopic plantlike organisms that may cause disease.
Diseases they produce are referred to as mycoses
Obtain food from living organisms (organic matter)
Seen more frequently in individuals that are immunologically impaired
Fungi can cause infections of the hair, skin, nails, & mucous membranes

9. Page 324
Protozoa
Protozoa = Single-celled parasitic organisms with the ability to move
Obtain food from dead or decaying organic matter
Spread by ingestion of contaminated food or water or through insect bites
Malaria, gastroenteritis & viginal infections

10. Page 324
Rickettsia
Rickettsia = Intercellular parasites that need to be in living cells to reproduce
Spread through bites of fleas, ticks, mites, & lice

11. Page 325
Helminths
Helminths (Parasitic worms) = any one of the roundworms, flatworms, pinworms or tapeworms
Acquired by eating uncooked or inadequately cooked meat, or contaminated food or water
Pinworms cause itching but do not cause serious illness
Tapeworms may cause intestinal disease in humans

12. Chain of Infection Page 235
It is an interactive process that involves an agent, a host, and the environment.
Infectious agent
Reservoir or source
Portal of exit from reservoir or source
Mode of transmission
Portal of entry to host
Susceptible host
Break the chain & stop the infection

13. Agent Pages 325 – 326 Agent = Entity that is causing disease
Biological – living organisms that invade the host, such as bacteria, viruses, fungi, protozoa, & rickettsia
Chemical – substances that can interact with the body, such as pesticides, food additives, medication, & industrial chemicals.
Physical – factors in the environment, such as heat, light, noise, & radiation

14. Page 326
Reservoir
Reservoir = Place where the agent can survive; It promotes growth of pathogens must contain the proper nutrients, maintain temperature, moisture, pH, proper amount of light
Most common reservoir is fomites (objects that have been contaminated with an infectious agent)
Humans & animals can have symptoms of the infectious agents or they can be strictly carriers of the agent.
Carriers = have the infectious agent but are symptom free. The agent can be spread to others in both instances.

15. Reservoir (Cont’d) Pages 326 – 327
Portal of Exit = the route by which an infectious agent leaves the reservoir to be transferred to a host.
Mode of Transmission = the process that bridges the gap between the portal of exit from the reservoir & the portal of entry to the “new” host
Contact – through direct contact
Droplet – through large respiratory droplets – usually (less than 3 feet)
Airborne – through droplets that are suspended in the air (greater than 3 feet)
Vehicle – through fomite transfer
Vector-borne – mosquitoes, fleas, ticks, lice, etc.
The agent leaves the reservoir through body secretions such as sputum, semen, vaginal secretions, urine, feces, blood, & draining wounds, & by coughing & sneezing.

16. Reservoir (Cont’d) Page 327
Portal of Entry = route by which an infectious agent enters the host.
Skin – through a break in the skin or mucous membrane
Respiratory tract – by inhaling contaminated droplets
Genitourinary – through contamination with infected vaginal secretions, semen, or catheter
GI – by ingesting contaminated food or water
Circulatory – through the bite of insects or rodents
Transplacental – through the placental & umbilical cord.

17. Host Page 328 Host = Organism that can be affected by an agent
Susceptible host = a person who lacks resistance to an agent & is vulnerable to a disease.
Compromised host = a person whose normal defense mechanisms are impaired & who is therefore more susceptible to infection.
Characteristics that influence susceptibility to & severity of infections are age, concurrent disease, weakened immune system, stress, immunization/vaccination status, lifestyle, occupation, nutritional status, heredity.

19. Breaking the Chain of Infection
Page 328
Breaking the Chain of Infection
Health care professionals (HCP) must focus on breaking the chain of infection
Proper infection control – Specific strategies are on the next slides

20. Between Agent & Reservoir
Page 328
Between Agent & Reservoir
Cleansing = the removal of soil or organic matter from equipment used in providing care to someone. Cleanse prior to sterilization & disinfection.
Disinfection = the elimination of pathogens, except spores, from inanimate objects.
Sterilization = the total elimination of all microorganisms, including spores.
Boiling is still the most common & best method of sterilization at home.

21. Between Reservoir & Portal of Exit
Pages 328 – 329
Between Reservoir & Portal of Exit
Proper hygiene – bathing & handwashing
Clean supplies – changing dressings & cleaning wounds regularly
Clean linens
Clean equipment – disinfect after each use & use wear gloves & masks when cleaning equipment to avoid being splashed with contaminated waste products or secretions.

22. Between Portal of Exit & Mode of Transmission
Page 329
Between Portal of Exit & Mode of Transmission
Maintain clean dressings on all injuries & wounds
People should cover their mouth when coughing or sneezing
Gloves must be worn at all times
Take care when disposing of all contaminated articles.

23. Between Mode of Transmission & Portal of Entry
Page 329
Between Mode of Transmission & Portal of Entry
HCP must always wash hands between patients
Barrier protection must be maintained
Gloves, masks, gown, goggles

24. Between Host & Agent Page 329 Eliminate infection before it begins
Proper nutrition, exercise, UTD immunizations

25. Stages of the Infectious Process
Page 329
Stages of the Infectious Process
There are two types of infectious responses Localized (cold sores) & systemic infections (AIDS)
Incubation – the time between entry of an infectious agent & the onset of symptoms.
Prodromal – time from the onset of nonspecific symptoms until specific symptoms begin
Illness – the time when patient manifests specific signs & symptoms of an infectious process
Convalescence – the period of time from the beginning of disappearance of acute symptoms until the patient returns to the previous state of health
Depending on the disease on can be contagious during only certain stages or during all of the stages.

26. Changes Occurring in Infectious Disease
Page 330 SB
Changes Occurring in Infectious Disease
Factors that have led to a reduction in infectious diseases
Improved sanitation & hygiene
Vaccine development & distribution
Development of drugs, especially antibiotics
Better communication & collaboration by scientists
Development of Public Health organizations
Factors that have led to an increase of microbes & their global spread
Emerging threats
Recent scientific & medical progress

27. Nosocomial Infections or HAI
Pages 329 – 331
Nosocomial Infections or HAI
Acquired in a hospital or other health care facility & was not present or incubating at the time of the patient’s admission.
Most common categories:
Urinary tract
Surgical wounds
Pneumonia
Septicemia

28. Pages 331 – 332
Bioterrism
Use of microbes to cause illness & spread fear
Inhalational anthrax
Smallpox
Pneumonic plague
Tularemia
Botulism
For up to date helpful information
cdc.gov/niosh/topics/emres/terrorresp.html

29. Standard Precautions Pages 333 – 335
Hand washing – single most effective way to prevent infection.
Gloves
Mask, eye protection, & face shield
Gown
Client care equipment
Linens
Occupational health & blood-borne pathogens
Client placement
Never recap needles!

30. Isolation Pages 335 – 337 Airborne precautions Contact precautions
Droplet precautions
Reverse isolation