Universal Precaution

Nosocomial Infections

- Infections acquired in the course of

medical care

- Infections contracted in an acute care

hospital, patients in extended care

facilities, outpatient clinics, & behavioral

health institutions

Nosocomial infections

Infections contracted at birth by infants of infected mothers

Health-Care associated infections/ Hospital-Acquired Infections (HAIs)

Nosocomial infections aka

Iatrogenic Infection

A nosocomial infection that results from a

particular treatment or therapeutic

procedure

Exogenous Infection

Infections or disease originates outside

the body

When a commensal organism enter

places it should not be

When a pathogen comes from other

source.

Endogenous Infection

Infection or disease originates within the

body

Disease can occur when microbes

included in normal bacteria flora enter a

sterile area of the body such as the brain

or muscle.

1. Environment

2. Therapeutic Regimen

3. Equipment

4. Contamination during medical procedures

Factors that encourage nosocomial infections:

1. Age

2. Heredity

3. Nutritional status

4. Stress

5. Inadequate rest & exercise

6. Personal habits

7. Health history

8. Inadequate Defenses

Factors that increase the patients potential for nosocomial infections:

Bloodstream & urinary tract

common sites of nosocomial infections

Microorganisms

- Living organisms that are too small to be seen

with the naked eye

- do not fit into the plant or animal kingdom

The Protista Kingdom

3rd kingdom formulated by Haeckel

Haeckel

The Protista kingdom is the 3rd kingdom formulated by ...

Bacteria, fungi, Protozoa, helminths, viruses & prions

The Protista kingdom includes ...

Protistos

greek word meaning the very first

Protists

are simple eukaryotic organisms that

are neither plants nor animals or fungi.

Prokaryotes

have plasma membranes,

cytoplasm, ribosomes, a cell wall, DNA, and

lack membrane-bound organelles.

Eukaryotes

are organisms whose cells

have a nucleus enclosed within a nuclear

envelope.

Normal Mircobial Flora

- Microorganisms that live on or inside the body

without causing infections or diseases

- Aid in skin preservation and digestion &

protect us from harmful organisms that can

cause infections or diseases

Pathogens

Microorganisms that cause infections and

diseases

Bacteria

- Colorless, minute, one-celled organisms with

a typical nucleus

Bacteria

Contains both DNA & RNA

-cocci

Spherical

-bacilli

Rod-shaped

-spirilla/spirochetes

Spiral

Pleomorphic

No definitive shape

Fungi

Cells that require an aerobic environment to live and reproduce

Fungi

Candida albicans is an example of ...

Yeast and molds

Fungi exists in 2 forms

Yeast

Single-celled, reproduce by forming buds

Molds

Multicellular, reproduce by spore formation

Parasites

An organism that lives on or in a host

organism at the expense of the host organ

Protozoa and helminths

A large number of parasites produce disease,

and they are classified as ... and ...

Protozoa

o Complex single-celled microorganisms that

generally exist as free-living organisms

o Often parasitic & are able to move from place

to place

o May be classified as motile (moving) or

nonmotile

o

"Amebiasis, giardiasis, malaria"

Helminths

o Parasitic worms (flatworms, roundworms)

o Worm-like parasites that survive by feeding

on a living host to gain nourishment and

protection

o Can live in the human intestinal tract for long

periods if not treated

Viruses

o Must be viewed with an electron microscope

o Smallest microorganisms known to produce

disease in humans

o Cannot survive independently

Viruses

Genetic material can be either dna or rna but

never both

Prion

Does not contain DNA or RNA

Prions

o Smallest & least understood of all microbes |

1983

o Present in brain but may mutate and become

an infectious disease

Capable of automatically transforming healthy

proteins in nerve cells into more ...

Creutzfeldt-Jakob disease

(CJD)

Most common form of prion disease that

affects humans is ...

urinary tract infection

E. Coli which normally inhabits the human

intestinal tract, does not cause disease

there, however if it gains entrance to the

urinary bladder, it can cause a ...

1. An infectious agent & a reservoir of available

organisms

2. An environment in which the pathogenic

microbes can live & multiply

3. A portal of exit from the reservoir

4. A means of transmission

5. A portal of entry into a new host

Elements needed to transmit infection:

Pathogenicity

Refers to the causative organism's ability

to cause disease

Virulence

Refers to the causative organism's ability

to grow & multiply with speed

Invasiveness

organism's ability to enter tissues

Specificity

Characterizes the organism's attraction to

a particular host

Indirect contact

o Transfer of pathogenic microbes by

touching objects (fomites) that have been

contaminated by an infected person.

o These objects include dressings,

instruments, clothing, dishes, or anything

containing live infectious organisms.

Droplet contact

Involves contact with infectious secretions

that come from the conjunctiva, nose, or

mouth of a host or disease carrier as the

person coughs, sneezes, or talks.

3-5 feet

Droplets can travel from approximately ...

Vehicles

o May also transport infection.

o Route of transmission includes food,

water, drugs, or blood contaminated with

infectious microorganisms.

Airborne route

o Residue from evaporated droplets of

diseased microorganisms suspended in

air for long periods of time

o Residue is infectious if inhaled by a

susceptible host

Vectors

o Insect or animal carriers of disease

o They deposit the diseased microbes by

stinging or biting the human host

Direct contact

o When a person or an animal with a disease or

his blood and bodily fluids are touched

o Touching with hands

o Kissing

o Sexual intercourse

Placenta

Can be a portal of entry for pathogens in pregnant women

ingestion, by inhalation,

by injection, across mucous membranes, placenta

Entry of pathogenic microorganisms into a

new host can be by ...(5)

1. Persons with chronic diseases such as

diabetes mellitus or cancer

2. Immune-suppressed persons

People with great risk of acquiring infections:

Immune system

- reacts to specific invaders that are able to

bypass the nonspecific body defenses by

forming antigens.

- Made up of special organs, cells and

chemicals that fight infection

Antigens

Foreign body or unrecognizable organic

substances that invade the body & induce it to

produce antibodies

Antibodies

A protein substance produced by a particular

white blood cell, the lymphocyte or more

specifically the B cell.

B cell

Antibodies are A protein substance produced by a particular white blood cell, the lymphocyte or more

specifically the ...

The Joint Commission

Sets requirements

for hospital safety, infection control practices,

& patient care standards (QAQC) that must

be met if the institution or agency is to receive

an accreditation.

Occupational Safety and Health Administration (OSHA)

A federal agency that

protects workers & students from work-related

injuries & illnesses, inspects work sites, and

makes & enforces regulations concerning

workplace safety

Center for Disease Control and Prevention (CDC)

Performs research & compiles statistical data

concerning infectious diseases, develops

immunization guidelines & administers OSHA

& OSHA's research institute, the NIOSH

(National Institute of Occupational Safety &

Health).

National Institute of Occupational Safety and Health (NIOSH)

OSHAs research institute

World Health Organization (WHO)

Works under

UN to reduce famine & disease throughout

the world. Compiles information concerning

infectious diseases from all countries &

compiles this information into reports for

every country.

2005 - CDC

... published revised guidelines for

infection control for all persons working in health

care settings in ...

Standard Precaution - Tier 1

Used at all times when any health care

worker is caring for a patient

Prevent spread of infection are used daily for

all persons cared for in all heath care settings

Transmission-based Precaution - Tier 2

Designed to place barrier to the spread of

highly infectious disease between persons

with (suspected) communicable diseases and

the persons caring for them

Category-specific guidelines

body fluids, secretions, and excretions

The new guidelines are attentive to the

importance of ..., ..., and ... in the transmission of nosocomial infections

Isolation precautions

... are meant to separate

the patient who has contagious illness from

other hospitalized patients & from the health

care workers.

Airborne Isolation

Tier 2: Method of transmission occurs when

microbes are spread on evaporated droplets

that remain suspended in air or are carried on

dust particles in the air and may be inhaled by

persons in that room or air space.

1. SARS

2. Smallpox

3. Tuberculosis

4. Varicella "Chicken pox"

5. Rubeola

Diseases spread by airborne route:

Droplet Isolation

Tier 2: Transmission occurs when droplets

contaminated with pathogenic

microorganisms are placed in the air from a

person infected with a droplet-borne

infections.

1. Influenza

2. Rubella

3. Mumps

4. Pertussis (whooping cough)

5. Pneumonias

6. Diphtheria

7. Pharyngitis

8. Scarlet fever

9. Meningococcal meningitis

Diseases spread by droplet transmission:

Colonization

Presence of microorganisms on

the skin or body surface of an individual who has

no symptoms of the disease

1. Drug-resistant wound infections

2. Gastroenteritis

3. Hepatitis A

4. Herpes Simplex

5. Herpes Zoster

6. Impetigo

7. Scabies

8. Respiratory/ Skin disease

9. Cellulites

10.Conjunctivitis

Diseases spread by contact routes:

DIRECT CONTACT

Occurs when a susceptible person

actually touches an infected or colonized

person's body surface in an area where

infectious microbes are present.

INDIRECT CONTACT

Occurs when a susceptible person

touches or comes into contact with an

object that has been contaminated with

infectious microorganisms.

1. Airborne Isolation

2. Droplet Isolation

3. Contact Isolation

Types of Isolation: