Infection Control and Disease Infection Control and Disease PreventionPrevention

Infection ControlInfection Control Microorganism – a small living organism Microorganism – a small living organism

that is not visible to the naked eye; that is not visible to the naked eye; found everywhere in the environmentfound everywhere in the environment

Normal flora - plant life adapted for Normal flora - plant life adapted for living in a specific environment; living in a specific environment; important for maintaining certain body important for maintaining certain body processes; processes; non-non-pathogenic pathogenic

Pathogen - disease or infection causing Pathogen - disease or infection causing microorganism microorganism

Types of MicroorganismsTypes of Microorganisms

BacteriaBacteria• Simple, one-celled organisms that Simple, one-celled organisms that

multiply rapidlymultiply rapidly• Examples of disease caused by bacteria Examples of disease caused by bacteria

include gonorrhea, meningitis, strep include gonorrhea, meningitis, strep throat, botulismthroat, botulism

• Antibiotics are used to kill bacteriaAntibiotics are used to kill bacteria

Types of MicroorganismsTypes of Microorganisms

ProtozoaProtozoa• One-celled animal-like organisms One-celled animal-like organisms

often found in decayed materials and often found in decayed materials and contaminated watercontaminated water

• Cause diseases such as malaria, Cause diseases such as malaria, amebic dysentery, trichomonasamebic dysentery, trichomonas

Types of MicroorganismsTypes of Microorganisms FungiFungi• Simple, plant-like organisms that live Simple, plant-like organisms that live

on dead organic matteron dead organic matter• Yeasts and molds are two common Yeasts and molds are two common

forms that can be pathogenicforms that can be pathogenic• Cause diseases such as ring worm, Cause diseases such as ring worm,

athlete’s foot, yeast vaginitis, and athlete’s foot, yeast vaginitis, and thrushthrush

• Treated with antifungals Treated with antifungals

Types of MicroorganismsTypes of Microorganisms

Virus Virus • Smallest microorganism, visible only with an Smallest microorganism, visible only with an

electron microscope electron microscope • Cannot reproduce unless inside another Cannot reproduce unless inside another

living cellliving cell• More difficult to kill because resistant to More difficult to kill because resistant to

many disinfectants and are not affected by many disinfectants and are not affected by antibiotics.antibiotics.

• Cause diseases such as common cold, Cause diseases such as common cold, herpes, chicken pox, AIDS, Hepatitis herpes, chicken pox, AIDS, Hepatitis

TermsTerms Nosocomial infection - acquired by an Nosocomial infection - acquired by an

individual in a health care facilityindividual in a health care facility

Opportunistic infection - those that occur Opportunistic infection - those that occur when the body’s defenses are weak when the body’s defenses are weak (Pneumocystis carinii)(Pneumocystis carinii)

Disinfection – to cleanse (wounds, rooms, Disinfection – to cleanse (wounds, rooms, clothing, etc..) of infection clothing, etc..) of infection

Sterilization - Sterilization - The act or procedure of sterilizing

Chain of Infection Chain of Infection

Causative agent (or pathogen) - virus, Causative agent (or pathogen) - virus, bacteria, etc.bacteria, etc.

Reservoir - A place where the Reservoir - A place where the pathogen can live (human body, the pathogen can live (human body, the environment, fomites)environment, fomites)

Portal of exit - A way for the pathogen Portal of exit - A way for the pathogen to escape the reservoir in which it has to escape the reservoir in which it has been growing (body secretions)been growing (body secretions)

Chain of Infection Cont.Chain of Infection Cont. Mode of transmission - the way in which the Mode of transmission - the way in which the

pathogen is transmitted to another reservoir pathogen is transmitted to another reservoir or host where it can live (direct person-to-or host where it can live (direct person-to-person contact or direct contact with body person contact or direct contact with body secretions)secretions)

Portal of entry - the manner in which the Portal of entry - the manner in which the pathogen enters a new reservoir or host pathogen enters a new reservoir or host (break in the skin, respiratory or digestive (break in the skin, respiratory or digestive tract, circulatory system)tract, circulatory system)

Susceptible host - a person likely to get an Susceptible host - a person likely to get an infection or diseaseinfection or disease

How do we break the chain of How do we break the chain of infection????????infection????????

Standard PrecautionsStandard Precautions

Equipment and methods that prevent Equipment and methods that prevent the transmission of microorganisms the transmission of microorganisms from one person to another. from one person to another.

Prior to the diagnosis of AIDS, personal Prior to the diagnosis of AIDS, personal protective equipment was used only in protective equipment was used only in identified infectious processes.identified infectious processes.

Became universal with further study of Became universal with further study of AIDS as a disease.AIDS as a disease.

Standard PrecautionsStandard Precautions

Applies to Applies to all all patients at patients at allall times because times because not all diseases are readily observable.not all diseases are readily observable.

Gloves should be worn ANYTIME there is Gloves should be worn ANYTIME there is ANY possibility of coming into contact with ANY possibility of coming into contact with a patients’ body fluids.a patients’ body fluids.

• It is NEVER wrong to put on gloves!!!!!It is NEVER wrong to put on gloves!!!!!

Standard PrecautionsStandard Precautions

The HCP should choose what barriers The HCP should choose what barriers to wear when caring for a patient to wear when caring for a patient based on:based on:– the activity performed (vital signs)the activity performed (vital signs)– the patients illness, andthe patients illness, and– the amount of exposure to blood and the amount of exposure to blood and

body fluids body fluids Ex: gown and goggles if patient is coughing, Ex: gown and goggles if patient is coughing,

bleeding, or has drainage from wounds or bleeding, or has drainage from wounds or body orifices.body orifices.

Standard PrecautionsStandard Precautions All sharps (needles, razors, etc.)

should be disposed of immediately in biohazardous puncture proof sharps containers located in each room.– Red, plastic container

All unknown spills or waste should be treated as potentially hazardous.

Types of IsolationTypes of Isolation

Airborne PrecautionsAirborne Precautions - - used for used for patients known (or suspected) to be patients known (or suspected) to be infected with pathogens transmitted by infected with pathogens transmitted by small particles small particles of evaporated droplets of evaporated droplets that contain microorganisms.that contain microorganisms.

Diseases: rubella, tuberculosis, and Diseases: rubella, tuberculosis, and shingles. shingles.

Types of Isolation Cont.Types of Isolation Cont. Droplet PrecautionsDroplet Precautions - must be followed - must be followed

for a patient known (or suspected) to be for a patient known (or suspected) to be infected with pathogens transmitted by infected with pathogens transmitted by large particle large particle droplets expelled during droplets expelled during coughing, sneezing, talking, or laughing. coughing, sneezing, talking, or laughing.

Diseases: flu, Neisseria meningitis, Diseases: flu, Neisseria meningitis, pertussis, some types of pneumonia, pertussis, some types of pneumonia, and diphtheria. and diphtheria.

Types of Isolation Cont.Types of Isolation Cont. Contact PrecautionsContact Precautions - must be followed for - must be followed for

any patients known or suspected to be any patients known or suspected to be infected with microorganisms that can be infected with microorganisms that can be transmitted by either direct or indirect transmitted by either direct or indirect contact. contact.

Diseases: GI, respiratory, or skin infection Diseases: GI, respiratory, or skin infection caused by a multi-drug resistant organism caused by a multi-drug resistant organism (MRSA), incontinent patients infected with E. (MRSA), incontinent patients infected with E. coli, patients with lice or scabies, and patients coli, patients with lice or scabies, and patients with a staph infection. with a staph infection.

Isolation precautions include the Isolation precautions include the use of gloves, gowns, and disposable use of gloves, gowns, and disposable equipment.equipment.

Types of Isolation Cont.Types of Isolation Cont. Protective or Reverse IsolationProtective or Reverse Isolation - refers to - refers to

methods used to protect certain patients from methods used to protect certain patients from organisms present in the environment. Protective organisms present in the environment. Protective isolation is used mainly for immunocompromised isolation is used mainly for immunocompromised patients, or those whose body defenses are not patients, or those whose body defenses are not capable of protecting them from infections. capable of protecting them from infections.

ExamplesExamples: organ transplant patients, burn patients, : organ transplant patients, burn patients, patients receiving chemotherapy, and patients patients receiving chemotherapy, and patients whose immune systems have failed (e.g. AIDS). whose immune systems have failed (e.g. AIDS).

PrecautionsPrecautions include frequent disinfecting of the include frequent disinfecting of the patient’s room and the use of gloves, gowns, and patient’s room and the use of gloves, gowns, and masks. masks.

Body’s Defense MechanismsBody’s Defense Mechanisms

Mucous membranesMucous membranes CiliaCilia Coughing and sneezingCoughing and sneezing Stomach acidStomach acid TearsTears White blood cellsWhite blood cells FeverFever InflammationInflammation

Inflammatory ResponseInflammatory Response TheThe Inflammatory Response Inflammatory Response is a is a

defensive action which takes into account defensive action which takes into account fluids, hormones, and cells. fluids, hormones, and cells.

Some symptoms relating to this response Some symptoms relating to this response are redness, heat, swelling, and pain.are redness, heat, swelling, and pain.

Other signs of infection include foul smell Other signs of infection include foul smell from drainage, fever, fatigue, rash, from drainage, fever, fatigue, rash, nausea, vomiting or loss of appetite. nausea, vomiting or loss of appetite.

Personal Protective Equipment

Gloves Masks Gowns

Standard Precautions Standard Precautions

Standard Standard precautionsprecautions

Transmission-Transmission-based based precautions precautions – Blood and body Blood and body

fluids fluids – Personal Personal

protective protective equipmentequipment

Medical Asepsis Medical Asepsis

Hand washingHand washing

Removing Contaminated Removing Contaminated GlovesGloves