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Principles of Infection Control: Understanding Disease Transmission and Prevention

This chapter provides a basic knowledge of how diseases are transmitted and emphasizes the prevention of disease transmission. It covers various microorganisms, including bacteria, protozoa, fungi, rickettsiae, and viruses, and their classifications. The chapter also discusses the use of antibiotics, antifungal medications, and vaccines for protection against certain diseases.

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Principles of Infection Control: Understanding Disease Transmission and Prevention

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  1. Chapter 13 Infection Control

  2. 13:1 Principles of Infection Control • Understanding is essential to all health care workers • Provide a basic knowledge of how disease is transmitted • Main emphasis on prevention of disease transmission

  3. Microorganisms or Microbes • Small living organisms • Not visible to the naked eye • Microscope must be used to see them • Found everywhere in the environment • Found on and in the human body • Many are part of normal flora of body • May be beneficial (continues)

  4. Microorganisms or Microbes(continued) • Called nonpathogens when not harmful to the body • Some cause infections and disease • Called pathogens (germs) when able to harm the body (continues)

  5. Microorganisms or Microbes(continued) • Most prefer warm environments • Most prefer darkness • Need source of food and moisture • Need for oxygen varies • Human body is ideal supplier of all the requirements

  6. Microbe Classifications • Bacteria • Protozoa • Fungi • Rickettsiae • Viruses

  7. Bacteria • Simple, one-celled organisms • Multiply rapidly • Classified by shape and arrangement (continues)

  8. Bacteria(continued) • Cocci are round or spherical in shape • Diplococci—in pairs • Streptococci—in chains • Staphylococci—clusters or groups • Examples of diseases (continues)

  9. Bacteria(continued) • Bacilli are rod shaped • Occur singly, in pairs, or in chains • May have flagella • Ability to form spores • Examples of diseases (continues)

  10. Bacteria(continued) • Spirilla are spiral or corkscrew shaped • Includes comma-shaped vibrio and corkscrew spirochete • Diseases include syphilis and cholera

  11. Antibiotics • Antibiotics are used to kill bacteria • Some strains of bacteria have become antibiotic-resistant • When antibiotic-resistant, the antibiotic is no longer effective against the bacteria

  12. Protozoa • One-celled, animal-like organism • Found in decayed materials and contaminated water • May have flagella for movement • Some are pathogenic • Examples of diseases

  13. Fungi • Simple, plant-like organisms • Live on dead organic matter • Yeast and molds • Can be pathogenic • Examples of diseases • Antibiotics do not kill • Antifungal medications

  14. Rickettsiae • Parasitic microorganisms • Cannot live outside the cells of another living organism • Transmitted to humans by the bites of insects (e.g., fleas, lice, ticks, mites) • Examples of diseases • Antibiotics are effective against many of them

  15. Viruses • Smallest microorganisms • Must use electron microscope to see • Must be inside another living cell to reproduce • Spread by blood and body secretions • Very difficult to kill • Cause many diseases (continues)

  16. Viruses(continued) • Viruses infecting animals can mutate to infect humans • Examples include: • Severe acute respiratory syndrome (SARS) • West Nile Virus (WNV) • Monkeypox • Ebola and Marburg • H5N1

  17. Virus—Hepatitis B • Also called serum hepatitis • Caused by HBV • Transmitted by blood serum and body secretions • Affects the liver • Vaccine available for protection • Vaccine is expensive (continues)

  18. Virus—Hepatitis B(continued) • Vaccine given in a series of three injections • By law, employers must provide vaccine at no cost to employees with occupational exposure to blood or other body secretions • If employee refuses, written statement must be signed documenting refusal

  19. Hepatitis C • Caused by HVC • Transmitted by blood and blood-containing body fluids • Many infected individuals are asymptomatic • Others have mild symptoms • Can cause severe liver damage (continues)

  20. Hepatitis C (continued) • Currently, no vaccine ready for use • Vaccine is in development stage • Extremely difficult to destroy HVC • Can survive and remain active for several days in dried blood • Health care workers must follow precautions to protect against virus

  21. Acquired Immune Deficiency Syndrome (AIDS) • Caused by the Human Immunodeficiency Virus (HIV) • Suppresses the immune system • Individual becomes susceptible to cancers and infections that would not affect a healthy person • No cure presently and no vaccine • Take precautions for prevention

  22. Helminths • Multicellular parasites otherwise known as worms or flukes • Are transmitted: • By eating contaminated food • Being bitten by infected insects • When worms enter the skin

  23. How Pathogens Cause Infection and Disease • Some produce poisons called toxins • Some cause an allergic reaction • Others attach and destroy the living cells they invade

  24. Classifications of Diseases and Infections • Endogenous • Exogenous • Nosocomial • Opportunistic

  25. Endogenous • Originates within the body • Examples: metabolic disorders, congenital abnormalities, tumors, and infections caused by microorganisms within the body

  26. Exogenous • Originates outside the body • Examples: radiation, chemical agents, trauma, electric shock, and temperature extremes

  27. Nosocomial • Acquired in a health care facility • Usually present in facilities and carried by health care workers to the patient • Many are antibiotic-resistant • Can cause serious and even life-threatening infections (continues)

  28. Nosocomial(continued) • Examples are staphylococcus, pseudomonas, and enterococci • Infection-control programs are used in facilities to prevent and deal with nosocomial infections

  29. Opportunistic • Infections that occur when the body’s defenses are down • Usually do not occur in normal immune system • Examples: Kaposi’s sarcoma (rare type of cancer) and Pneumocystiscarinii pneumonia in individuals with AIDS

  30. Chain of Infection • Present for disease to occur and spread from one individual to another • Causative agent • Reservoir • Portal of exit • Mode of transmission • Portal of entry • Susceptible host

  31. Common Body Defenses • Mucous membranes • Cilia • Coughing and sneezing • HCL in the stomach • Tears • Fever • Inflammation response • Immune response

  32. Ending the Chain of Infection • Eliminate any step in the chain and infection is stopped • Follow practices to interrupt or break the chain • Remember, pathogens are everywhere • Prevention is a continuous process

  33. Aseptic Techniques • Asepsis: absence of disease-producing microorganisms • Contaminated: any object or area that may contain pathogens • Major aim: maintaining cleanliness and eliminating or preventing every aspect of contamination

  34. Common Aseptic Techniques • Thorough handwashing • Good personal hygiene • Disposable gloves • Cleaning instruments and equipment • Proper cleaning of environment

  35. Levels of Aseptic Control • Antisepsis—used on the skin • Disinfection—used mainly on objects • Sterilization—use of steam under pressure, gas, radiation, and chemicals on objects

  36. Summary • Important for health care workers to know and use proper aseptic techniques at all times • Prevents spread and transmission of disease

  37. 13:2 Bioterrorism • Bioterrorism: use of microorganisms or biologic agents for warfare • Infecting humans, animals, or plants • Have been used over time by different nations not only in war but also on innocent people

  38. Biologic Agents • Microorganisms with characteristics suitable for bioterrorism: • Inexpensive, available, easily produced, spreads quickly • Maintains its survival • Brings death or disability • Travels from person to person • Difficult to prevent/treat (continues)

  39. Biologic Agents(continued) • High priority agents include: • Smallpox: contagious and infectious disease, result of the Variola virus • Anthrax: infectious disease caused by Bacillus anthracis • Plague: infectious disease from the bacteria Yersinia pestis (continues)

  40. Biologic Agents(continued) • Botulism: paralytic illness resulting from a nerve toxin from the bacteria Clostridium botulinum • Tularemia: infectious disease from the bacteria Fracisella tularensis • Filoviruses: infectious diseases causing severe hemorrhagic fever known as Ebolavirus and Marburgvirus

  41. Preparing for Bioterrorism • Bioterrorism attack would result in a public health emergency • Would have impact on health care facilities • Social disorder would ensue • Comprehensive plan (continues)

  42. Preparing for Bioterrorism(continued) • Bioterrorism Act 2002 passed by Congress and signed into law • Involves local, regional, state, and national government and includes: • Early detection by communities • Public to be notified • Infection control and education • Funding available (continues)

  43. Preparing for Bioterrorism(continued) • Guidelines and restrictions • Nationwide immunizations • Protection of food/water supplies • Trained personnel available • Emergency management controls • Investigation of potential threats • Preparation of health care facilities • Efficiency of communication

  44. Summary • All health care workers need to be aware of bioterrorism • Attack could occur at any time • Being prepared and properly trained will result in saving many lives

  45. 13:3 Washing Hands • Major aspect of standard precautions • Most important aseptic technique • Hands are perfect media for the spread of pathogens

  46. Purpose of Handwashing • Prevent and control spread of pathogens • Protect the health care worker from disease and illness

  47. Recommendations for Handwashing • Regular handwashing with plain soap and water • Antiseptic handwashing with antimicrobial soap and water • Antiseptic hand rub with alcohol-based cleaner (waterless)

  48. When to Wash Hands • On arrival at facility • Immediately before leaving facility • Before and after every patient contact • After contact with patient’s skin • Before moving from a contaminated site to a clean site (continues)

  49. When to Wash Hands(continued) • Anytime the hands become contaminated during a procedure • Before applying gloves • Immediately after removing gloves • When gloves are torn or punctured • Before and after handling specimens • After contact with any soiled or contaminated item (continues)

  50. When to Wash Hands(continued) • After picking up any item off the floor • After personal use of the bathroom • Following a cough, sneeze, or using a tissue • Before and after any contact with mouth or mucous membranes

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