1. Introduction to Microbiology

2. Objectives Define terms related to asepsis. Discuss the relationship between the principles of asepsis and practice of sterile technique and surgical patient care. Discuss the history and development of disinfectant techniques. Identify characteristics of pathogens associated with surgical site infections.

3. History of Sterilization Even in ancient times, forms of disinfection were practiced. Understanding of how these practices worked to prevent disease, was not known. Many used the burning of sulfur to “cleanse” an area.

4. History of Sterilization Early bible passages suggest purification by fire. Aristotle, Hippocrates, and Galen used boiling of water, to sanitize drinking water and instruments used in surgery.

5. History of Sterilization In the middle ages, advances were made linking the spread of disease by direct contact, fomites, and airborne.

6. History of Sterilization 1775 – Spallanzani demonstrated that boiling for 1 hour killed microbes. 1832 – Henry demonstrated that dry heat could sterilize infected clothing. 1847 – Semmelweis advocated hand washing between patient contact to prevent spread of puerperal fever.

7. History of Sterilization 1862 – Pasteur developed early principles of sterile technique. –Father of bacteriology 1867 – Lister applied Pasteur’s principles of asepsis to surgery. –Father of antiseptic surgery 1876 – Tyndall discovered a heat resistant stage of bacteria the spore.

8. History of Sterilization 1880 – Chamberland developed the first pressure steam sterilizer. –Chamberland’s Autoclave 1885 – Schimmelbusch used steam sterilization for surgical dressings. 1888 – Esmarch recommended use of bacteriological testing to prove sterilization.

9. History of Sterilization 1888 – Kinyoun recommended use of a vacuum to increase steam penetration. 1915 – Gravity sterilizer introduced. 1933 – Development of the modern autoclave. 1963 – Glutaraldehyde was approved for sterilization of heat sensitive items.

10. Terminology Pathogen – Organism capable of causing disease. Fomite – Inanimate object that transmits disease. Vector – Living carrier that transmits disease. Resident flora – Normal microbes that live in the skin. Transient flora – Microbes that live on the skin surface that are easily removed.

11. Terminology Infection – Invasion of pathogens into the body that causes disease. –Nosocomial Infections

12. Terminology Antiseptic – Used on living tissue to inhibit growth of microbes. Disinfectant – Used on inanimate objects to kill most microbes.

13. Terminology Bacteriostatic – Substance that inhibits the growth of bacteria. Bacteriocidal – Substance that destroys bacteria. –Fungicide –Virucide –Sporicidal

14. Terminology Sterile – Rendered free of all microbes. –Sterilization –Sterile Field Sterile Technique – Methods used to prevent contamination of the sterile field. Contamination – Presence of pathogenic materials. –Cross-contamination

15. Terminology Decontamination – To reduce to a minimum the presence of pathogens. Terminal Disinfection – Render items safe to handle using high level disinfection. Terminal Sterilization – Render items safe to handle using sterilization.

16. Pathogens Microorganisms are a natural part of the world we live in. Some microbes are useful: –Decomposition of organic matter –Take inorganic matter and convert them to nutrients for plants and animals. Yogurt Cheese Antibiotics

17. Pathogens Certain microorganisms use a parasitic relationship with plants and animals causing harm. –Disease –SSI (Surgical Site Infections)

18. Bacteria Classified according to the environment that sustains its life. Aerobic – Must have Oxygen to survive. Anaerobic – Live without Oxygen. –Obligate Anaerobes –Faculatative Anaerobes Microaerophilic – Prefer low oxygen environments.

19. Bacteria May also be classified by a specialized lab test called a Gram’s Stain. Gram Positive stain blue Gram Negative stain pink

20. Bacteria Bacteria is also identified by shape. Cocci - Spherical Bacilli – Rod shaped Spirilla – Spiral shaped

21. Cocci Round spherical shaped bacteria. Found in chains or groups. Example: –Staphylococcus Aureus Methicillin Resistant Staphylococcus Aureus (MRSA) –Neisseria Gonorrhoeae –Streptococci Nectrotizing Fascitis

22. Bacilli Rod shaped bacteria. Have the ability to form heat and drought resistant spores. Examples: –Escherichea Coli –Pseudomonas Aeruginosa –Salmonella –Mycobacterium Tuberculosis

23. Spirilla Spiral shaped bacteria. Posses the ability to move itself. Examples: –Borreclia Burgdorferi (Lyme Disease) –Rickettsiae –Treponema Pallidum (Syphilis)

24. Yeasts Single Celled, type of parasite. Found on skins of fruits and vegetables. Grow well in warm temperatures. Examples: Candida Albicans Invade mucous membranes of the mouth, throat, and vagina.

25. Molds Multicellular, filamentous fungi. Responsible for most crop and food spoilage. Examples: –Aspergillus –Histoplasmosis

26. Virus Nonliving small particles that rely on a host cell for survival. Invades a cell host, combines with the DNA/RNA and replicates. Not affected by antibiotics. Transmission varies: –Blood –Body Fluids –Airborne

27. Virus Examples: –Hepatitis (A,B,C,D,E,F,G) –HIV (AIDS) –Influenza –Varicella (Chickenpox) –Rabies –HSV (Herpes Simplex Virus)

28. Prions Proeinaceous Infectious Particles Fatal disease referred to as spongiform encephalopathies. Example: –Creutzfeld-Jakob Disease (CJD) (Mad cow disease)

29. Parasites Organisms that nourish themselves at the expense of other living things, causing them damage. Examples: –Giardia Lamblia –Malaria –Helminths (worms)

30. Microbiology in the O.R. Most common transmitted pathogen in the O.R. is Staphylococcus aureus. Source: –Skin or nares of the patient and surgical team. Other contaminations occur with the type of procedure being performed. –Gastrointestinal tract –Respiratory tract

31. What are some ways to limit these contaminations from happening?

32. Review History Terminology Bacteria Yeasts Molds Viruses Parasites

33. Introduction to Microbiology QUESTIONS