2DefinitionInfection Control: Efforts designed to protect both the patient and care provider.Infectious Disease: Any illness resulting from invasion of a host by disease producing organisms such as bacteria, viruses, fungi, or parasites.
3Microorganisms Also known as: microbes Small living plant/animal not visible to naked eyeFound everywhere in the environment, including in/on human bodyMany microbes exist on or within us and do not cause disease or infection (are called non-pathogens)
4MicroorganismsMicrobes that cause infection/disease are called pathogensSome microbes can be beneficial (Normal Flora)in one body system & become pathogenic in another(ex. E-coli- normal in large intestine, causes UTI in urinary)
5Classifications of Microbes 5 types:BacteriaProtozoaFungiRickettsiaeViruses
61. BacteriaSimple one-celled organism that can produce disease in a host, can multiply outside of cells on surfaces or objects.Classified by shape and arrangementBacterium protected by a hard shell is called a spore3 main types: cocci, bacilli, spirilla
7Bacteria-Cocci Round/spherical in shape 3 types: Diplococci-occur in pairs or 2 circles, causes gonorrhea, meningitis, & pneumoniaStreptococci-occur in chains, causes strep throatStaphylococci-occur in clusters/groups, causes boils, wound infections & toxic shock, UTI’S
10Bacteria-Bacilli Rod shaped Occur singly, in pairs, or in chains Many have flagella(threadlike projections like tails that allow them to move)Ability to form spores or thick walled capsules(extremely difficult to kill while in spore form)Can cause TB, tetanus, whooping cough, botulism
11Bacillus AnthracisAnthrax with white blood cells
12Bacteria-Spirilla Spiral or corkscrew in shape Include corkscrew spirocheteCan cause syphilis and cholera
132. Protozoa One celled animals Found in decaying materials & contaminated waterSome are pathogenic & cause malaria, amebic dysentery, Pneumocystis Carini Pneumonia (PCP), Trichomonas
153. Fungi Simple plantlike organisms Live on dead organic matter Yeasts & molds are common forms of pathogenic fungiCan cause ringworm, athlete’s feet, & histoplasmosis (systemic respiratory infection)
164. Rickettsiae Parasitic microbe: Cannot live outside the cells of another living organismCommonly found on fleas, ticks, & mitesTransmitted to humans by bites of these insectsCan cause typhus fever & Rocky Mountain spotted fever
185. Viruses Smallest microbe-only visible with electron microscope Cannot reproduce unless they are inside another living cellSpread mainly from human to human by blood & body secretionsVery difficult to kill-resist most disinfectants, not affected by antibioticsCan cause common cold, flu, pneumonia, measles, chickenpox, herpes, warts, hepatitis B, HIV
20Factors Required for growth of Microbes Warm environmentDarkness-most are killed quickly in sunlightSource of food & moistureNeed for oxygen varies- aerobic(need O2 to live) anaerobic(don’t need O2)Human body is ideal supplier of all of these requirements
21Pathogenic Microbes cause Infection/Disease Some produce poisons (toxins) which harm the bodySome cause an allergic reaction resulting in watery eyes, runny nose & sneezingOthers attack & destroy the living cell they invade ( ex. Malaria invades RBC & causes it to rupture, HIV invades T-cells)
22Chain of InfectionFactors that must exist for disease to occur. Includes:1. Causative agent2. Reservoir3. Portal of exit4. Means of transmission5. Portal of entry6. Susceptible host
23Causative Agent / Pathogen Chain of InfectionCausative Agent / PathogenHostReservoirPortal of EntryPortal of ExitTransmission
24Chain of Infection Causative agent- pathogen such as bacteria or virus Reservoir place- where causative agent lives. Common reservoirs include human body, animals, environment, and fomites ( objects contaminated with infectious material that contains the pathogens, i.e. pencil, desk, hand rail, etc.)
25Chain of InfectionA Human being or animal that is a reservoir for microorganisms but is not ill with infection/disease is a carrier or host. (Example: HIV)
26Chain of InfectionPortal of exit- way for causative agent to escape from the reservoir. Pathogens can leave the body through urine, feces, saliva, blood, tears, mucous discharge, sexual secretions & draining wounds
27Chain of InfectionMeans of transmission- pathogen must be transmitted to another reservoir or host where it can live.Five main routes of transmission:Contact- direct/indirectDroplet- propelled short distances through air (flu)Airborne- remain suspended in air for long periods of time ( TB, measles, chicken pox)
28Chain of Infection Vectorborne – Insect bite (fleas/ticks) Five main routes of transmission:Vectorborne – Insect bite (fleas/ticks)Common Vehicle – pathogen transmitted through items such as surgical instruments, stethoscopes, blood pressure equipment, etc.
29Routes of transmission: CONTACT Contact: According to the CDC, this is the most frequent method of disease transmission in a hospital environment. Direct- direct contact transmission from one person to another through physical contact. Indirect- transmission from one person to another through an object such as contaminated hands or medical instruments (needle stick, dressings, patient care items).
30CONTACT PRECAUTIONSPatients under contact precautions should be placed in a private room or in a room with another patient who has the same infection. If this is not possible, patient placement will depend on the type of infection and an infection control expert should be consulted.
31CONTACT PRECAUTIONS Gloves should be worn Change gloves after handling potentially infective materialDispose of gloves before leaving room.NEVER wear gloves in hallways or outside patient’s room
32CONTACT PRECAUTIONSA non-sterile gown should be worn when entering the patient's room if clothing may be contaminated.Remove before leaving patients roomAvoid touching contaminated areas with uniform/hands
33CONTACT PRECAUTIONSPatient movement should be limited, but if it is necessary, care should be taken not to contaminate other patients and surfaces.Whenever possible, patient care equipment should be dedicated to a single patient or group of patients with the same infection. If this is not possible, the equipment must be carefully disinfected after each use.
34Routes of transmission: DROPLET Droplet transmission - Occurs when an infected patient expels droplets into the air and the droplets land in the nasal cavity, mouth, or conjunctiva. The droplets are generated from coughing, sneezing, talking, and by some medical procedures. When you sneeze, millions of tiny droplets are propelled from your mouth and nose.
37Routes of transmission: DROPLET The droplets fly through the air rather than remaining suspended in the air. Measles, mumps, rubella, and Severe Acute Respiratory Syndrome (SARS) can all be transmitted through droplet transmission. Almost all common diseases may be spread through droplet transmission.
38DROPLET PRECAUTIONS Placed in a private room Or room with patient who has the same infection.Three foot separation between the infected patient and other peopleIt is not necessary to keep the door closed.Health care personnel should wear a mask and gogglesThe patient should wear a mask if moved
39Routes of transmission: AIRBORNE Airborne transmission - when tiny particles containing pathogens remain suspended in the air for long periods of time.Examples: Measles and chickenpox
40One of the worst outbreaks of disease in human history was the influenza pandemic of Historians believe it began in America.At least 21 million people died, and possibly as many as 50 million. Many of them drowned to death when fluid from the infection filled their lungs.Some airborne pathogens can be spread in the wind, and affect huge areas.
41AIRBORNE PRECAUTIONS Placed in a private room or, if necessary, OR: In a shared room with another patient who has an active infection of the same type.Door should be kept closedAir circulation system must prevent spread of unfiltered air to other areasNegative Air Pressure SystemPatient movement around the facility should be minimized.
42AIRBORNE PRECAUTIONSIf the patient must be moved, he or she should wear an N95 mask.Everyone entering the room should wear a N95 respirator.Examples: pulmonary tuberculosis, chickenpox,
43Vector-borne transmission A vector - organism that carries pathogens from one host to another.Examples: fleas, ticks, and rats. Malaria, yellow fever, and bubonic plague are all diseases that can be spread through vectors.
44Common vehicle transmission This type of transmission occurs when pathogens are spread to several hosts through a single contaminated item such as food, water, or surgical instruments.Example E. coli spread through food.
45Chain of Infection5. Portal of entry- way to enter a new reservoir or hostDifferent portals of entry:Breaks in the skin or mucous membraneRespiratory tractDigestive tractGenitourinary tractCirculatory system
46Chain of Infection6. Susceptible host- individual who can contract the diseaseMost susceptible- elderly, newborns, persons with weak immune systems, persons with cancerHumans become host when large numbers of pathogens invade the body and body defenses are weak
47Breaking the Chain of Infection If any part of the chain can be eliminated, the spread of disease/infection will be stoppedFollow practices to interrupt or break this chain (wash your hands)
48Aseptic techniquesAsepsis- absence of disease producing microbes or pathogensCommon aseptic techniques: handwashing & good personal hygiene, using disposable gloves when contacting contaminated objects, proper cleaning of instruments & equipmentHandwashing: the single most effective way to prevent the spread of pathogens
49Levels of aseptic control Antisepsis - prevent/inhibit the growth of pathogenic organisms.Usually not effective against spores & virusesCan be used on the skinExample; Alcohol & betadine
50Levels of aseptic control 2. Disinfection - process that destroys or kills pathogenic organismsUsed mainly on objects not peopleNot always effective against spores & virusesCan irritate and damage the skin,Example; Bleach solutions
51Levels of aseptic control 3. Sterilization - process that destroys all microorganisms both pathogenic and nonpathogenic.Kills spores & virusesSteam under pressure, gas, radiation, and chemicals can be used to sterilize objectsAutoclave is the most common piece of equipment used for sterilization
52Infection control methods CDC (Center for Disease Control) has identified 2 levels for infection control.Standard PrecautionsTransmission-Based PrecautionsGoal: Keep pathogens within a specific area
53Infection control methods Standard precautions: treat all patients as though they may be infected.Standard precautions combine the major features of :Universal Precautions - reduces the risk of transmitting bloodborne pathogensBody-Substance Isolation (BSI)- reduces the risk of transmitting pathogens from moist body substances
54Standard Precautions Wash hands: Before/after examining patientsAfter contact with blood, body fluids & contaminated items.Wear gloves: if there could be contact with blood, body fluids, mucous membrane, or broken skin.Remove gloves: Before going to another patient, wash hands and put on new gloves.Wear a mask protective eyewear and gown: when splashes or sprays of body fluids are likely.
55Standard Precautions Do not recap needles. EVER! Clean and disinfect frequently touched surfaces including beds, bed rails, patient examination tables and bedside tablesLaunder soiled linens and avoid direct contact with soiled itemsUse oral rather than injectable medications whenever possible
56Universal Precautions Universal Precautions - introduced in as a response to the appearance of AIDS.Treat all materials as though they are infected with diseases such as HIV or HBV.Use gloves and gowns, masks and eye protection during medical procedures.
57Infection control methods Standard precautions include:Protective work practices - handwashing, handling sharps, good hygieneUse of personal protective equipment (PPE) - gloves, gowns, face shields, masksProtective housekeeping (disinfectants)Protection: Hepatitis B vaccinationExposure reporting
58Infection control methods Transmission-Based Precautions are used in addition to standard precautions.Categories include airborne, droplet, contactPlace patient in private roomKeep their door closedWear masks & gloves to enter the room,Move patient only for essential purposesHave patient wear mask outside of the room
59So Go Out, SAVE LIVES and FIGHT DISEASE!! The END!