Chapter 12 2 Anton Van Leeuwenhoek - Dutch businessman developed first microscope described and drew three bacteria Louis Pasteur - French physician and chemist the Father of Immunology developed the germ theory of cause and effect developed vaccines against rabies and anthrax 3 Joseph Lister Scottish surgeon Known as the father of aseptic technique Used Carbolic acid solution in OR (contamination) Edward Jenner - English physician Smallpox vaccine 4 Alexander Fleming - Scottish physician discovered Penicillin Robert Koch - German bacteriologist isolated bacteria on agar plate discovered TB bacteria 5 Jonas Salk - US microbiologist polio vaccine Albert Sabin - US virologist developed oral polio vaccine, trivalent (3 viruses) TOPV Walter Reed - US physician identified yellow fever virus (mosquito) vaccine for yellow fever 1951, Dr. Tyler 6 MEDICAL/SURGICAL ASEPSIS & INFECTION CONTROL 7 In environment Not seen by naked eye Micro-organisms are considered either plant or animal Able to carry out living processes 8 Metabolism (sum of chemical and physical changes) Growth Reproduction Irritability Motion Protection (skin, covering) 9 Reservoir/host Water Nourishment Warmth Darkness 10 Do not produce disease Yeast cells help to make bread rise Fermentation helps make beer and wine Cheeses owe their flavor to molds Molds are used in the production of antibiotics Micro-organisms help in making soil fertile by the decomposition of animals and vegetable wastes Natural flora in the GI tract aid in the digestive process 11 Produce disease and are harmful to plants, animals and humans Aerobic organisms require O 2 for growth Anaerobic organisms can grow in the absence of O 2 12 There are 6 links in the chain of infection The microorganism (infectious agent) Reservoir (the place where the organism normally resides) A portal of exit from the reservoir A method (mode) of transmission A portal of entry into a susceptible host A susceptible host The nurse must understand this chain to reduce the risk of transmission at portals of exit/entry 13 Direct transmission Droplet spread Indirect transmission Fomites Airborne transmission TB 14 One cell animals Most highly developed of all single-celled organisms Have some form of locomotion Can ingest solid food Most are non-pathogenic (with the exception of some... malaria, amebic dysentery, toxoplasmosis (meat), crytosporidiosis (H 2 O), trypanosomiasis (African sleeping sickness caused by bite of fly) 15 Four divisions Amoebae - flow around and surround food Flagellates - whip-like tail Ciliates - cilia (hair like projections) Sporozoa -parasites; no locomotion 16 Multi-cellular animal forms Include round and flat worms Most mature worms can be seen with the naked eye Immature forms (ova and larvae) are microscopic Most common infestation in US is pinworm found in pediatric population; hookworm found in small intestine causes anemia in host 17 Single-cell organisms lacking a nucleus, reproduce about every 20 minutes; asexual reproduction called binary fission Classified according to their need for O 2, shape and Gram- staining properties Classification according to morphology: cocci are round bacilli are rod-shaped spirochetes are spiral or corkscrew-shaped 18 Classified according to their need for O 2, shape and Gram-staining properties Classification according to morphology: cocci are round bacilli are rod-shaped spirochetes are spiral or corkscrew-shaped 19 Further classification is accomplished by growth some grow in chains - streptococci some grow in pairs - diplococci some grow in clusters - staphylococci 20 A type of Bacteria Small round or rod-shaped organisms that are transmitted by the bite of a vector (lice, ticks, fleas, mites) Multiply in host cell Rocky Mountain Spotted Fever and typhus are caused by rickettsias 21 Extremely small, seen with the aid of an electron microscope Composed of particles of nucleic acids (DNA or RNA) and having a coat of protein; in some cases they have a membranous envelope 22 Viruses need a living cell within which to grow and replicate Viruses are identified by fluorescent techniques, electron microscopy and tissue culture 23 Tiny, primitive organisms of the plant kingdom, containing no chlorophyll In humans fungal infection are called Mycoses Yeast and molds are members of this group 24 They feed on living plants and animals, decaying organic material; thrive in warm, moist environments Reproduce by spore formation Common fungal infections in humans vaginal candidiasis athletes foot (tinea pedis) 25 Several types of organisms are difficult to classify and fall outside the usual classification Mycoplasmas are small organisms without a cell wall; cause infections of the respiratory tract and/or the genital tract (M. pneumoniae) Chlamydia affects the GU and reproductive tract; becoming increasingly more common in the US and is considered an STD In some parts of the world it causes trachoma, an eye disease causing blindness 26 New term HAI- Healthcare associated infections I There are currently four health agency-prevalent resistant organisms: Aminoglycoside-resistant - Pseudomonas Methicillin-resistant - Staphylococcus aureus Penicillin-resistant - Neisseria gonorrhoeae Vancomycin-resistant Enterococcus 27 Clients MUST be educated about the proper and improper use of antibiotics take entire prescription as ordered taking only a few pills will not kill the bacteria, will cause them to mutate and become resistant to medication, thereby harder to kill! 28 Disease state resulting from invasion and growth of microorganisms in the body; S&S include Fever Rash Pain Sores on mucus membrane Tenderness Redness/swelling Fatigue Discharge/drainage Loss of appetite Nausea/Vomiting Diarrhea 29 Source Reservoir Exit Transmission Portal of entry Susceptibility of host 30 Asepsis is freedom from infection or infectious material Medical asepsis 1)Inhibits growth and spread of pathogenic microorganisms 2)Clean technique Surgical asepsis 1)Destroys all microorganisms and their spores 31 Disinfection is the process by which pathogenic microorganisms are destroyed (by chemicals) Sterilization is the process by which all microorganisms are destroyed (by autoclave) 32 HANDWASHING (before and after everything!) HANDWASHING Provide individual toothbrushes, drinking glasses, towels and washcloths, etc. Cover yours and patients mouth and nose when coughing or sneezing Bath and shampoo hair regularly Observe sanitation practices, including disposal of garbage 33 Wash dishes, cooking, eating utensils with soap and hot water (dishwasher!) Cleanse and disinfect/sterilize large, non disposable equipment Hold equipment/linen away from uniform Avoid shaking items Clean from cleanest area to dirtiest 34 Pour contaminated liquids directly into sinks (dirty utility room), toilets; avoid splashing Avoid sitting on patients bed Items taken into patients room are considered contaminated 35 Are methods to prevent the spread of pathogens from one area to another; also called isolation techniques Prevents the spread of communicable/contagious disease Certain precautions are used to protect the patient, who is vulnerable to infection (reverse isolation) 36 Other precautions are used to protect the caregiver (gowns, masks, gloves) Isolation techniques can have negative psychosocial effects on the patient 37 Universal precautions-now called Standard Precautions Contact isolation Airborne Isolation Droplet Precautions Neutropenic Precautions Immunosuppressed patients To protect patient from others Host 1)An organism in which another, usually parasitic, organism is nourished and harbored 2)Susceptibility 3)Immunizations Infectious process- follows progressive course Incubation period Prodromal stage Illness Convalescence Localized- infection in one area Control and minimize infection with proper care; wound infections Systemic- whole body infected Potentially fatal Inflammatory Response Cellular response to injury or infection Protective vascular reaction Neutralizes and eliminates pathogens or necrotic tissues and establishes a means of repairing body cells and tissues Inflammatory process (cont) Signs of inflammation Edema, redness, heat, pain or tenderness, and loss of function Systemic signs: fever, leukocytosis, malaise, anorexia, nausea, vomiting, and lymph node enlargement May be triggered by physical agents, chemical agents, or microorganisms