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19-1 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Principles of Asepsis PowerPoint® presentation to accompany: Medical Assisting Third Edition.

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Presentation on theme: "19-1 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Principles of Asepsis PowerPoint® presentation to accompany: Medical Assisting Third Edition."— Presentation transcript:

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2 19-1 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Principles of Asepsis PowerPoint® presentation to accompany: Medical Assisting Third Edition Booth, Whicker, Wyman, Pugh, Thompson

3 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-2 Learning Outcomes 19.1Explain the historical background of infectious disease prevention. 19.2Identify the types of microorganisms that cause disease. 19.3List some infectious diseases, and identify their signs and symptoms. 19.4Discuss the importance of preventing antibiotic resistance in a health-care setting. 19.5Describe ways you can help prevent antibiotic resistance in health-care settings.

4 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-3 Learning Outcomes (cont.) 19.6Explain the disease process. 19.7Explain how the bodys defenses protect against infection. 19.8Describe the cycle of infection. 19.9Identify and describe the various methods of disease transmission Explain how you can help break the cycle of infection.

5 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-4 Introduction Antibiotic-resistant organisms Importance of patient education on the proper use of antibiotics You will learn about: Disease-causing microorganisms How the body fights disease Ways infections occur Our bodies are amazing structures that defend us against infections under normal circumstances

6 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-5 History of Infectious Disease Prevention Throughout history people have attempted to discover Causes of infection How to prevent infections How to treat infections

7 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-6 History of Infectious Disease Prevention (cont.) ScientistContribution Edward Jenner (1749–1823) Developed first effective vaccine Used cowpox to vaccinate against small pox Ignaz Semmelweis (1818–1865) and Oliver Wendell Holmes (1809–1894 ) Promoted handwashing as a means of reducing the spread of Puerperal fever to women in childbirth

8 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-7 ScientistContribution Louis Pasteur (1822–1895) Helped develop the germ theory of infectious disease stating that disease is caused by microorganisms Joseph Lister (1827–1912) Helped develop germ theory Introduced aseptic techniques through the use of antiseptics on wounds, surgical sites, and surgical instruments History of Infectious Disease Prevention (cont.)

9 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-8 ScientistContribution Robert Koch (1843–1910) Developed a set of proofs, known as Kochs Postulates, claiming that microbes cause disease Sir Alexander Fleming (1881–1955) Discovered penicillin History of Infectious Disease Prevention (cont.)

10 © 2009 The McGraw-Hill Companies, Inc. All rights reserved 19-9 Remarkable advances in the past century Threat of infection still present New infectious diseases AIDS Ebola Resistant diseases MRSA VRSA Multidrug-resistant TB History of Infectious Disease Prevention (cont.)

11 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge Why is the threat of infection still present even though great advances have been made in controlling infections over the past century? ANSWER: The threat of infection is still present because of new diseases and diseases that have become resistant to treatments.

12 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Microorganisms and Disease Microorganisms live all around us Pathogens Microorganisms capable of causing disease Evade host defenses People avoid infections most of the time Many microorganisms are beneficial or harmless Normal defenses resist infection Conditions are not favorable for pathogens to grow and be transmitted

13 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Microorganisms and Disease (cont.) ClassificationCharacteristicsExampleDisease Prions * Infectious particle made of protein No nucleic acid Reproduction unknown Pr PCJD BSE Mad cow disease * Experts disagree as to whether prions are directly responsible for disease or merely aid an unknown agent in causing disease.

14 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Classification CharacteristicsExampleDisease Viruses DNA or RNA surrounded by protein coat Reproduced in living cells Very small Varicella- zoster virus Chickenpox Bacteria Single-celled Reproduce quickly Mostly asexual reproduction Vibrio cholerae Cholera Microorganisms and Disease (cont.)

15 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Classification CharacteristicsExampleDisease Protozoans Single-celled Reproduction mostly asexual Entamoeba histolytica Amebic dysentery Fungi Multicellular Reproduction is sexual and asexual Candida albicans Candidiasis Helminths Multicellular parasitic Contain specialized organs Sexual reproduction Enterobius vermicularis Pinworms Microorganisms and Disease (cont.)

16 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge In many cases, we avoid contracting infections when exposed to microorganisms. What are the reasons for this? ANSWER: This is because: many microorganism are beneficial or harmless we have normal defenses to resist infection conditions are not favorable for the pathogen to grow and be transmitted. Correct!

17 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases Knowing signs and symptoms of common infectious diseases can help protect against exposure

18 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Chickenpox (Varicella) Contagious viral infection Incubation period of 7 to 21 days Itchy rash fluid-filled blisters Slight fever, headache, general malaise Spread by direct, indirect, droplet, or airborne transmission Isolate until all blisters have scabbed over 1996 – live vaccine approved

19 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Common cold Viral infections of upper respiratory tract No isolation needed Commonsense precautions to prevent spread Use tissues when coughing or sneezing Wash hands frequently Use disposable dishware, if possible Incubation – 2 to 3 days

20 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Croup Most often caused by a virus Characterized by a harsh, barking cough, difficulty breathing, hoarseness, and low- grade fever Most common in infants and young children Symptoms lessened by humidification of air, rest, and clear fluids Commonsense precautions to prevent spread

21 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Diphtheria Bacterial infection of nose, throat, and larynx Symptoms: pain, fever, respiratory obstruction Incubation – 2 to 5 days Isolation required Antibiotic therapy (fatal if untreated) Immunization available

22 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Epstein-Barr Virus Common human virus 95% of adults have had virus 35 – 50% of teens develop mononucleosis Symptoms – fever, sore throat, swollen lymph nodes Virus remains dormant for life Occasionally reactivates as tumors

23 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Haemophilus Influenzae Type B Bacterial infections in infants and young children Spread – direct, indirect, and droplet transmission Incubation – 3 days Upper respiratory symptoms, fever, drowsiness, body aches, diminished appetite Monitor closely – bacterial meningitis

24 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Hepatitis Viral infection of liver Spread through blood or fecal-oral route HIV/AIDS Human immunodeficiency virus Acquired immune deficiency syndrome

25 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Influenza (Flu) Symptoms – fever, chills, headaches, body aches, upper respiratory congestion Isolation and commonsense precautions Vaccines Live, attenuated virus – nasal spray Inactivated virus – IM injection Annual vaccination People at risk for complications People older than 50 years old People in close contact with persons at risk for complications

26 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Measles (Rubeola) Infectious viral disease Spread by droplets or direct transmission Initial symptom of fever develops 8 to 13 days after exposure, followed by a characteristic itchy rash 14 days after exposure Isolation for 7 days after rash appears Keep children under 3 years old away from anyone with the disease Reportable to state or county health dept.

27 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Meningitis Inflammation and infection of protective coverings of brain and spinal cord and the fluids around them Viral – milder form Clears in 1 to 2 weeks without treatment Aseptic meningitis

28 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Meningitis Bacterial – serious, life-threatening, requiring immediate treatment Vaccination available for people in high-risk groups Symptoms – red, blotchy rash, confusion, delirium, light sensitivity, headache, fever and chills, nausea and vomiting, sleepiness, stiff neck May spread through exchange of respiratory and throat secretions Reportable to state or county health dept.

29 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Mumps Viral infection Primarily affects salivary glands Incubation – 2 to 3 weeks Pain related to inflammation of parotid gland and fever Isolate until glandular swelling stops Reportable to state or county health dept.

30 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Pertussis (Whooping Cough) Highly contagious bacterial infection of respiratory tract Symptoms – fever, sneezing, runny nose, quick short coughs, characteristic whoop during inhaled breath following coughing fit Isolate for 3 weeks following onset of spasmodic coughs Reportable to state or county health dept.

31 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Roseola Rose-colored rash possibly caused by human herpes virus Infants and young children Incubation 5 to 15 days Symptoms – sudden, high fever; sore throat; swollen lymph nodes; rash Rubella (German Measles) Highly contagious viral disease Direct or droplet transmission Incubation 16 to 18 days Symptoms – fever and itchy rash Vaccination available Reportable

32 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Streptococcal pharyngitis (strep throat) Bacterial infection of throat Sore throat, swelling of pharyngeal mucosa, fever, headache, nausea, abdominal pain Treat with antibiotics Scarlet fever Bacteria becomes systemic Characteristic strawberry rash Incubation 7 to 10 days Isolate 7 days

33 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Streptococcal pharyngitis (cont.) Rheumatic fever Occurs after apparent recovery from strep throat Autoimmune disorder – antibodies to streptococci cross-react with heart tissues Symptoms – carditis, ECG changes, joint pain and inflammation, fever Acute post-streptococcal glomerulonephritis Inflammation of glomerulus of the kidney resulting in inadequate filtering of the blood Symptoms – swelling of hands and feet, decreased urine output, hypertension, protein in urine

34 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Tetanus Acute infectious bacterial disease following a contaminated puncture wound Incubation – 3 to 21 days Late symptoms – lockjaw, paralysis No isolation needed, but reportable

35 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Tuberculosis Infectious bacterial disease affecting mainly lungs Symptoms – night sweats, productive cough, fever, chills, fatigue, unexplained weight loss, diminished appetite, bloody sputum Incidence – higher in urban centers Transmission Mycobacterium tuberculosis Droplet

36 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Tuberculosis (cont.) Increasing resistance to TB Early diagnosis, prompt treatment Compliance with treatment regimen Preventing TB Vaccination – BCG (not used in the U.S.) Causes false-positive with TB skin test

37 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Infectious Diseases (cont.) Tuberculosis (cont.) Treating TB Mantoux TB test Positive test = Induration – skin turns red and becomes raised and hard Positive result from immunization or exposure to TB bacteria Treatment based on area affected and type of TB involved Patients must complete entire course of treatment – 12 to 18 months on medication Isolation

38 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge ANSWER: The spread of many infectious diseases can be limited or prevented by using common sense precautions: Using tissues when coughing or sneezing Washing hands frequently Using disposable dishware How can the spread of many infectious diseases can be limited or prevented? Excellent!

39 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Drug-Resistant Microorganisms MRSA – methicillin/oxacillin-resistant S. aureus VRE – vancomycin-resistant enterococci VISA – vancomycin-intermediate S. aureus VRSA – vancomycin-resistant S. aureus ESBLS – extended-spectrum beta-lactamases PRSP – penicillin-resistant Streptococcus pneumoniae

40 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Drug-Resistant Microorganisms (cont.) MRSA and VRE Most common in non-hospital health-care facilities Community-associated MRSA Increasing in incidence PRSP Common in patients seeking care in physicians offices and clinics (pediatrics)

41 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Drug-Resistant Microorganisms (cont.) Risk factors for development of infections by drug-resistant organisms Advanced age Invasive procedures Prior use of antibiotics Repeated contact with health-care system Severity of illness Underlying diseases of conditions

42 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Drug-Resistant Microorganisms (cont.) Preventing antibiotic resistance Four strategies to reduce incidence of antibiotic- resistant microorganisms Prevent infection Diagnose and treat infection appropriately Use antibiotics carefully Prevent transmission of infections

43 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What strategies reduce the incidence of antibiotic- resistant microorganisms? ANSWER: Strategies to reduce the incidence of antibiotic- resistant microorganisms include: Prevent infections Diagnose and treat infections appropriately Use antibiotics carefully Prevent transmission Good Job!

44 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Disease Process Begins with microorganisms finding host Grows with specific requirements Proper temperature pH Moisture level Virulence – microorganisms disease- producing power Damage is caused by: Depleting nutrients Reproducing themselves Making body cells the target of bodys own defenses Producing toxins

45 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Disease Process (cont.) Once exposed to a pathogen, the body goes through 4 stages of illness: Incubation – begins at first exposure; ends when first symptom appears Prodromal – begins at first onset of symptoms; generally short Invasion – numbers of organisms are greatest; symptoms are most pronounced Convalescent – patient regains normal health status

46 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge ANSWER: The four stages of illness are: Incubation – begins at first exposure; ends when first symptom appears Prodromal – begins at first onset of symptoms; generally short Invasion – numbers of organisms are greatest; symptoms are most pronounced Convalescent – patient regains normal health status What are the four stages of illness?

47 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses Immunity – condition of being resistant to pathogens and the disease they cause First lines of defense Skin Sweat glands Mucous membranes Cilia Lacrimal glands Saliva Hydrochloric acid Lysozyme

48 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses (cont.) Resident normal flora – microorganisms found in the body Provide a barrier against pathogens Normally live in balance Become pathogenic when hosts defenses are compromised Opportunistic infections Infections occurring when a hosts resistance is low

49 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses (cont.) Immune system includes nonspecific defenses Mechanisms to protect against pathogens in general Includes Nonspecific defenses Humoral defenses Cell-mediated defenses

50 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses: Nonspecific Inflammation Signs Redness Localized heat Swelling Pain Purpose Summon immunologic agents to site Begin tissue repair Destroy invading microorganisms Steps 1.Initial constriction, then dilation of blood vessels, causing redness and heat 2.Fluid leakage from local vessels swelling 3.Scar tissue formation Chronic inflammation damages tissues and causes permanent loss of function

51 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses: Nonspecific (cont.) Phagocytosis White blood cells (phagocytes) engulf and digest pathogens Three types Neutrophils – found in pus Monocytes – formed in bone marrow and become Macrophages when they migrate to specific tissues Found in lymph nodes, liver, spleen, lungs, bone marrow, and connective tissue Deliver antigens (foreign substances) to lymphocytes

52 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses: Humoral Immunity Lymphocytes – B cells and T cells T cells activate B cells to produce antibodies to neutralize an antigen Memory B cells respond quickly to produce antibodies in later invasions Specific antibodies are produced in response to specific antigens Antibodies attract phagocytes, which destroy antigens

53 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Types of immunity Active – body produces own antibodies Natural active Artificial active Passive – antibodies that are produced outside body enter the body Natural passive Artificial passive Complement Proteins activated by antibodies Helps white blood cells destroy pathogens The Bodys Defenses: Humoral Immunity (cont.)

54 © 2009 The McGraw-Hill Companies, Inc. All rights reserved The Bodys Defenses: Cell-Mediated Immunity T cells attack invading pathogen directly Helper T cells Activate Killer T cells Bind with antigen and kill it Suppressor T cells Slow down or stop attack after antigen is destroyed Memory T cells Respond quickly to another attack by same antigen

55 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge What is the difference between active and passive immunity? ANSWER: Active immunity is long-term immunity in which the body produces its own antibodies. Passive immunity results when antibodies produced outside the body enter the body. Both can be natural or artificial. Impressive!

56 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection A reservoir host – animal, insect, or human body capable of sustaining pathogen growth Carrier – unaware of presence of pathogen Subclinical case – unnoticeable infection Endogenous infection – normally harmless microorganisms become pathogenic Exogenous infection – pathogen introduced into the body Click for Cycle of Infection

57 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection (cont.) Means of exit – how the pathogen leaves the host Nose, mouth, eyes, or ears Feces or urine Semen, vaginal fluid, or other reproductive discharge Blood or blood products Click for Cycle of Infection

58 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection (cont.) Means of transportation – how a pathogen spreads to a host Airborne Blood-borne During pregnancy or birth Foodborne Vector-borne Living organism that carries microorganisms to another person Touching Direct Indirect through fomites Inanimate reservoir of pathogens Drinking glass, door knob, etc. Click for Cycle of Infection

59 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Means of entrance Enter through any cavity lined with mucous membrane Mouth, nose, vagina, rectum Ears, eyes, intestinal tract, urinary tract, reproductive tract, breaks in the skin Cycle of Infection (cont.) Click for Cycle of Infection

60 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection (cont.) Pathogen factors Number and concentration Virulence Point of entry Susceptible host Individual with little or no immunity to infection by a pathogen Host factors influencing susceptibility Age Genetic predisposition Nutritional status Other disease processes Stress levels Hygiene habits General health Click for Cycle of Infection

61 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection (cont.) Back

62 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Cycle of Infection (cont.) Environmental factors Dense populations Animals Unpasteurized milk Insects Economic and political factors Availability of transportation Population growth rates Sexual behavior

63 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Apply Your Knowledge ANSWER: Fomites are inanimate objects such as clothing, water, and food that serve as a means of transportation for microorganisms. What are fomites? Nice Job!

64 © 2009 The McGraw-Hill Companies, Inc. All rights reserved Breaking the Cycle Asepsis – condition in which pathogens are absent or controlled Maintain strict housekeeping standards Adhere to government guidelines to protect against disease Educate patients in hygiene, health promotion, and disease prevention

65 © 2009 The McGraw-Hill Companies, Inc. All rights reserved In Summary Medical Assistant Must learn how pathogens cause disease, how disease is transmitted, and how to prevent the spread of infection. As knowledge about causes of infection have increased, principles and practices of asepsis have developed. Use this knowledge to educate patients about remaining healthy and decreasing the risk of contracting disease.

66 © 2009 The McGraw-Hill Companies, Inc. All rights reserved End of Chapter In today's world, new infections and diseases can spread across the country and even across the world in a matter of days, or even hours, making early detection critical. ~ John Linder U.S. Representative, Georgia


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