MICROPARA Lesson 3: Normal Flora of Human Body and Infection Control

Normal microbiota

Refers to the microorganisms that reside on the surface and deep layers of the skin, in the saliva and oral mucosa, conjunctiva and in gastrointestinal tracts of every human being.

Normal microbiota

These microorganisms are not harmful to a healthy human in fact they are beneficial and helps maintain our health (symbiotic relationship).

Symbiotic relationship

Relationship between healthy human and normal microbiota.

Normal microbiota

They are composed of bacteria, fungi, and archaea and are introduced at birth.

bacteria, fungi, and archaea

Normal microbiota are composed of ___ and are introduced at birth.

Indigenous & Transient

Types of Microbiota

Types of Microbiota: Indigenous

These microbiota are always present in body parts.

Types of Microbiota: Transient

These microbiota are present for a short time, but are eventually cleared.

Normal Microbiota of Skin, Transient

Because of its constant exposure and contact with the environment, the __ particularly harbors __ microorganisms.

Normal Microbiota of Skin

a. Examples: S. epidermidis, S. aureus, S. mitis.

Normal Microbiota of Mouth and Upper Respiratory Tract

Prominent composed of corynebacteria, staphylococci, and streptococci.

Normal Microbiota of Intestinal Tract

At birth the intestine is sterile, but soon microorganisms are introduced with food.

Normal Microbiota of Intestinal Tract Breastfeeding

Bifidobacteria

Normal Microbiota of Intestinal Tract Bottle Fed

Lactobacilli

Normal Microbiota of Intestinal Tract Adult

Depends on what we eat.

Normal Microbiota of Anterior urethras of both sexes

Contain small numbers of the same types of organisms found in the skin and perineum.

skin and perineum

Normal Microbiota of Anterior urethras of both sexes contain small numbers of the same types of organisms found in the ___.

aerobic lactobacilli, pH remain acidic, infection

Normal Microbiota of Vagina After Birth and persists as long as the ___ (2) (if the pH rises, it can cause ___)

mixed of flora of cocci and bacilli

pH becomes neural (until before puberty) a ___ is present

aerobic and anaerobic lactobacilli

Normal Microbiota of Vagina Puberty

Normal Microbiota of Vagina After Menopause

lactobacilli (acidic in nature) diminishes.

short urethra

UTI/Infection is common to girls (esp. older) due to ___.

Normal Microbiota of Conjunctiva

Predominates by diptheroids, S. epidermidis, and nonhemolytic streptococci a.

Conjunctiva flora

Is normally held in check by the flow of tears, which contain antibacterial lysozyme.

antibacterial lysozyme

Conjunctiva flora is normally held in check by the flow of tears, which contain ___

Normal Microbiota Will Not Cause Diseases If

normal count.

Normal Microbiota Will Not Cause Diseases If

stay in location.

Normal Microbiota Will Not Cause Diseases If

di na iiba enviro if nabago dadami infection.

Normal Microbiota Will Not Cause Diseases If

if u r not immuno compromised.

Infection Control: Ignaz Philipp Semmelweis

A Hungarian doctor who tries to prevent a young women from dying and thought of washing his hands in between patients - fewer of his patients died.

Infection Control: Joseph Lister

Idea of killing germs by using chemicals and began using antiseptic to clean surgical instruments, sprayed the air and required apron.

Infection Control: Florence Nightingale

Idea of cleanliness and its importance in preventing disease; first to recognize the value of cleanliness and recommended it as part of good nursing practice.

Asepsis: Aseptic Technique

Technique designed to reduce the risk of bacterial, fungal, or viral contamination in instruments that is commonly practice in healthcare setting.

Asepsis: Aseptic Technique

Involves general cleanliness, frequent and thorough handwashing, isolation of infected patients, disinfection, and sterilization.

Asepsis: Aseptic Technique

Depends on the site, circumstances and environment.

Asepsis: Medical Asepsis

Clean technique with a goal of excluding pathogens.

Asepsis: Medical Asepsis

a. All necessary precautionary necessary to prevent direct transfer of pathogens measures.

Asepsis: Medical Asepsis

b. Include frequent and thorough handwashing; personal grooming, clean mask, gloves and gowns.

Asepsis: Surgical Asepsis

Practices that includes rendering and keeping objects and areas sterile (free of microbes).

Asepsis: Surgical Asepsis

a. Practiced in operating room, in labor, and delivery areas, and during invasive procedures.

Asepsis: Surgical Asepsis

b. E.g. surgical scrubbing of hands and fingernails.

Modes of Transmission: Contact Transmission Direct

Pathogens are transferred from one infected person to another person without a contaminated intermediate object of person.

Modes of Transmission: Contact Transmission Indirect

Happens when pathogens are transferred via contaminated intermediate object or person.

Modes of Transmission: Droplet Transmission

Respiratory droplets carrying pathogens transmit infection when they travel from the respiratory tract of an infectious individual (e.g Sneezing, coughing) to susceptible mucosal surfaces of a recipient.

Modes of Transmission: Droplet Transmission, 5um

Droplet larger than ___ in size.

Modes of Transmission: Airborne Transmission

Dissemination of either airborne droplet nuclei or small particles containing pathogens.

Modes of Transmission: Airborne Transmission

a. Droplet less than or equal to 5um in size.

Modes of Transmission: Fomites

Involves inanimate objects that are contaminated with an infectious agents (e.g. doorknob, telephones, handrails).

Modes of Transmission: Fomites

Usually stays until disinfected.

Modes of Transmission: Transfusion

Blood borne infections that occur from the "introduction of a pathogen via blood transfusion.

Modes of Transmission: Trans-cutaneous

Vector borne; happens when living organisms carries a disease pathogen and passes it to another living organisms via vector.

Vector borne

Happens when living organisms carries a disease pathogen and passes it to another living organisms via vector.

Modes of Transmission: Enteric

Fecal-oral route; infectious agents transmitted through infected feces of an individual to the mouth of another individual.

Fecal-oral route

Infectious agents transmitted through infected feces of an individual to the mouth of another individual.

Modes of Transmission: Vertical

Maternal-fetal; pathogen was passes from the mother to child either in utero, or during birth.

Maternal-fetal

Pathogen was passes from the mother to child either in utero, or during birth.

Standard Precautions for Infection Control: 1. Handwashing

Touching body fluids, after removal of gloves, and in between patients.

Standard Precautions for Infection Control: 2. Gloves

Before touching body fluids, mucous membranes and nonintact skin.

Standard Precautions for Infection Control: 3. Mask and Eye protection or face shield

In procedures that may cause splashes or sprays of body fluids.

Standard Precautions for Infection Control: 4. Gown

In procedures that may cause splashes or sprays of body fluids.

Standard Precautions for Infection Control: 5. Patient care equipment

Handled soiled equipment SO as to prevent personal contamination and transfer to other patients.

Personal Protective Equipment (PPE): Gloves

Protects both patients and healthcare personnel from exposure to infectious materials that may be carried on hands.

Personal Protective Equipment (PPE): Isolation gowns

Protects the healthcare worker's arms and exposed body areas and prevent contamination of clothing with blood, body fluids and other potentially infectious materials.

Personal Protective Equipment (PPE): Masks

Protect healthcare workers from contact with infectious materials from patients.

Spaulding System for Classification of Instruments and Items for Patient Care: Critical Items

High risk of infection if they contaminated with any microbes; e.g. objects used in O.R.

Spaulding System for Classification of Instruments and Items for Patient Care: Semi-critical Items

Contact mucous membranes or nonintact skin and require high-level disinfection: e.g. respiratory therapy, anesthesia equipment, some endoscope.

Spaulding System for Classification of Instruments and Items for Patient Care: Non-critical Items

Those that come in contact with intact skin, but not mucous membranes.

Spaulding System for Classification of Instruments and Items for Patient Care: Non-critical

Contact with intact skin.

Spaulding System for Classification of Instruments and Items for Patient Care: ILD

(microbes but not spores).

Spaulding System for Classification of Instruments and Items for Patient Care: LLD

(bacteria & enveloped viruses, variable on nonenv. viruses & fungi & no action on spores and TB bacilli).

Spaulding System for Classification of Instruments and Items for Patient Care: Semicritical

Contact with mucosa/ body fluids.

Spaulding System for Classification of Instruments and Items for Patient Care: HLD

(Spores +/-).

Spaulding System for Classification of Instruments and Items for Patient Care: Critical

Enters sterile site.

Spaulding System for Classification of Instruments and Items for Patient Care: Sterilization

(all microbes & spores).

Infection Control: Environmental control

Hospital must have, and employees must comply with adequate procedures for the routine environmental surfaces cleaning, and disinfection and towels, body blood, secretions, or excretions must be handled, transported, and laundered in a safe manner.

Infection Control: Disposal of sharps

Broken glass, or sharps; never recap a needle.

Infection Control: Transmission based precaution

Used for patients who are know or suspected to be infected or colonized with highly transmissible epidemiologically important or pathogen beyond standard precautions are required to interrupt transmission within hospitals.

Infection Control: Patient Placement

Single patient rooms is always indicated for patients placed on airborne precautions and preferable for those who require contact or droplet precautions.

Infection Control: Patient Placement

Cohort patients with same organisms.

Infection Control: Management of Visitors

Visitors as sources of healthcare associated infections.

Infection Control: Management of Visitors

Practice cough etiquette.

Infection Control: Management of Visitors

Have an isolation logbook.

Infection Control: Management of Visitors

Use barrier precautions by visitors.

Infection Control: Management of Visitors

Educate patients and family members.

Infection Control: Management of Visitors

Follows signs for isolation precautions.

Three Types of Transmission Based Precaution: Contact Precaution

Germs that can be spread through direct or indirect contact.

Three Types of Transmission Based Precaution: Contact Precaution

a. Limit patient movement.

Three Types of Transmission Based Precaution: Contact Precaution

b. Private/single room or cohort room.

Three Types of Transmission Based Precaution: Contact Precaution

c. Wear disposable gown & gloves when entering the patient’s room; removed and disposed when leaving.

Three Types of Transmission Based Precaution: Contact Precaution

d. Wash hands immediately after leaving in the patient’s room.

Three Types of Transmission Based Precaution: Contact Precaution

e. Clean patient’s room daily using hospital disinfectant, with attention to frequently touched surfaces.

Three Types of Transmission Based Precaution: Contact Precaution

f. Use dedicated equipment as possible.

Three Types of Transmission Based Precaution: Droplet Precaution

Infections spread by large respiratory droplet produced during activities like coughing, sneezing or talking; droplets do not usually travel very far (usually less than 3 feet).

Three Types of Transmission Based Precaution: Droplet Precaution

a. Private/single room or cohort room.

Three Types of Transmission Based Precaution: Droplet Precaution

b. Use mask when entering the room and definitely if within 3 feet from the patient.

Three Types of Transmission Based Precaution: Droplet Precaution

c. Limit movement and transport of the patient.

Three Types of Transmission Based Precaution: Droplet Precaution

d. Keep at least 3 feet between infected patients and visitors.

Three Types of Transmission Based Precaution: Airborne

Infections spread by small particles and that can remain suspended in the air for long time and travel farther than droplet.

Three Types of Transmission Based Precaution: Airborne

a. Place the patient in an airborne infection isolation room (AIIR).

Three Types of Transmission Based Precaution: Airborne

b. Positive Pressure should be monitored with visible indicator (recommended).