1. INFECTION CONTROL Unit #8

2. Definition
Infection 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.

3. Microorganisms Also known as: microbes
Small living plant/animal not visible to naked eye
Found everywhere in the environment, including in/on human body
Many microbes exist on or within us and do not cause disease or infection (are called non-pathogens)

4. Microorganisms
Microbes that cause infection/disease are called pathogens
Some 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)

5. Classifications of Microbes
5 types:
Bacteria
Protozoa
Fungi
Rickettsiae
Viruses

6. 1. Bacteria
Simple one-celled organism that can produce disease in a host, can multiply outside of cells on surfaces or objects.
Classified by shape and arrangement
Bacterium protected by a hard shell is called a spore
3 main types: cocci, bacilli, spirilla

7. Bacteria-Cocci Round/spherical in shape 3 types:
Diplococci-occur in pairs or 2 circles, causes gonorrhea, meningitis, & pneumonia
Streptococci-occur in chains, causes strep throat
Staphylococci-occur in clusters/groups, causes boils, wound infections & toxic shock, UTI’S

8. Streptococci
Strep bacteria

9. Staphylococci
Staphylococcus aureus (wound)

10. Bacteria-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

11. Bacillus Anthracis
Anthrax with white blood cells

12. Bacteria-Spirilla Spiral or corkscrew in shape
Include corkscrew spirochete
Can cause syphilis and cholera

13. 2. Protozoa One celled animals
Found in decaying materials & contaminated water
Some are pathogenic & cause malaria, amebic dysentery, Pneumocystis Carini Pneumonia (PCP), Trichomonas

14. Protozoa
Plasmodium: Malaria

15. 3. Fungi Simple plantlike organisms Live on dead organic matter
Yeasts & molds are common forms of pathogenic fungi
Can cause ringworm, athlete’s feet, & histoplasmosis (systemic respiratory infection)

16. 4. Rickettsiae Parasitic microbe:
Cannot live outside the cells of another living organism
Commonly found on fleas, ticks, & mites
Transmitted to humans by bites of these insects
Can cause typhus fever & Rocky Mountain spotted fever

17. Rickettsiae
Rocky Mountain Spotted Fever

18. 5. Viruses Smallest microbe-only visible with electron microscope
Cannot reproduce unless they are inside another living cell
Spread mainly from human to human by blood & body secretions
Very difficult to kill-resist most disinfectants, not affected by antibiotics
Can cause common cold, flu, pneumonia, measles, chickenpox, herpes, warts, hepatitis B, HIV

19. Virus
Hepatitis B virus

20. Factors Required for growth of Microbes
Warm environment
Darkness-most are killed quickly in sunlight
Source of food & moisture
Need for oxygen varies- aerobic(need O2 to live) anaerobic(don’t need O2)
Human body is ideal supplier of all of these requirements

21. Pathogenic Microbes cause Infection/Disease
Some produce poisons (toxins) which harm the body
Some cause an allergic reaction resulting in watery eyes, runny nose & sneezing
Others attack & destroy the living cell they invade ( ex. Malaria invades RBC & causes it to rupture, HIV invades T-cells)

22. Chain of Infection
Factors that must exist for disease to occur. Includes:
1. Causative agent
2. Reservoir
3. Portal of exit
4. Means of transmission
5. Portal of entry
6. Susceptible host

23. Causative Agent / Pathogen
Chain of Infection
Causative Agent / Pathogen
Host
Reservoir
Portal of Entry
Portal of Exit
Transmission

24. Chain 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.)

25. Chain of Infection
A Human being or animal that is a reservoir for microorganisms but is not ill with infection/disease is a carrier or host. (Example: HIV)

26. Chain of Infection
Portal 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

27. Chain of Infection
Means of transmission- pathogen must be transmitted to another reservoir or host where it can live.
Five main routes of transmission:
Contact- direct/indirect
Droplet- propelled short distances through air (flu)
Airborne- remain suspended in air for long periods of time ( TB, measles, chicken pox)

28. Chain 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.

29. Routes 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).

30. CONTACT PRECAUTIONS
Patients 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.

31. CONTACT PRECAUTIONS Gloves should be worn
Change gloves after handling potentially infective material
Dispose of gloves before leaving room.
NEVER wear gloves in hallways or outside patient’s room

32. CONTACT PRECAUTIONS
A non-sterile gown should be worn when entering the patient's room if clothing may be contaminated.
Remove before leaving patients room
Avoid touching contaminated areas with uniform/hands

33. CONTACT PRECAUTIONS
Patient 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.

34. Routes 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.

37. Routes 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.

38. DROPLET PRECAUTIONS Placed in a private room
Or room with patient who has the same infection.
Three foot separation between the infected patient and other people
It is not necessary to keep the door closed.
Health care personnel should wear a mask and goggles
The patient should wear a mask if moved

39. Routes of transmission: AIRBORNE
Airborne transmission - when tiny particles containing pathogens remain suspended in the air for long periods of time.
Examples: Measles and chickenpox

40. One 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.

41. AIRBORNE 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 closed
Air circulation system must prevent spread of unfiltered air to other areas
Negative Air Pressure System
Patient movement around the facility should be minimized.

42. AIRBORNE PRECAUTIONS
If 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,

43. Vector-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.

44. Common 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.

45. Chain of Infection
5. Portal of entry- way to enter a new reservoir or host
Different portals of entry:
Breaks in the skin or mucous membrane
Respiratory tract
Digestive tract
Genitourinary tract
Circulatory system

46. Chain of Infection
6. Susceptible host- individual who can contract the disease
Most susceptible- elderly, newborns, persons with weak immune systems, persons with cancer
Humans become host when large numbers of pathogens invade the body and body defenses are weak

47. Breaking the Chain of Infection
If any part of the chain can be eliminated, the spread of disease/infection will be stopped
Follow practices to interrupt or break this chain (wash your hands)

48. Aseptic techniques
Asepsis- absence of disease producing microbes or pathogens
Common aseptic techniques: handwashing & good personal hygiene, using disposable gloves when contacting contaminated objects, proper cleaning of instruments & equipment
Handwashing: the single most effective way to prevent the spread of pathogens

49. Levels of aseptic control
Antisepsis - prevent/inhibit the growth of pathogenic organisms.
Usually not effective against spores & viruses
Can be used on the skin
Example; Alcohol & betadine

50. Levels of aseptic control
2. Disinfection - process that destroys or kills pathogenic organisms
Used mainly on objects not people
Not always effective against spores & viruses
Can irritate and damage the skin,
Example; Bleach solutions

51. Levels of aseptic control
3. Sterilization - process that destroys all microorganisms both pathogenic and nonpathogenic.
Kills spores & viruses
Steam under pressure, gas, radiation, and chemicals can be used to sterilize objects
Autoclave is the most common piece of equipment used for sterilization

52. Infection control methods
CDC (Center for Disease Control) has identified 2 levels for infection control.
Standard Precautions
Transmission-Based Precautions
Goal: Keep pathogens within a specific area

53. Infection 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 pathogens
Body-Substance Isolation (BSI)- reduces the risk of transmitting pathogens from moist body substances

54. Standard Precautions Wash hands:
Before/after examining patients
After 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.

55. Standard Precautions Do not recap needles. EVER!
Clean and disinfect frequently touched surfaces including beds, bed rails, patient examination tables and bedside tables
Launder soiled linens and avoid direct contact with soiled items
Use oral rather than injectable medications whenever possible 

56. Universal 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.

57. Infection control methods
Standard precautions include:
Protective work practices - handwashing, handling sharps, good hygiene
Use of personal protective equipment (PPE) - gloves, gowns, face shields, masks
Protective housekeeping (disinfectants)
Protection: Hepatitis B vaccination
Exposure reporting

58. Infection control methods
Transmission-Based Precautions are used in addition to standard precautions.
Categories include airborne, droplet, contact
Place patient in private room
Keep their door closed
Wear masks & gloves to enter the room,
Move patient only for essential purposes
Have patient wear mask outside of the room

59. So Go Out, SAVE LIVES and FIGHT DISEASE!! The END!