BACTE - WEEK 1 (LABORATORY)

Universal Precautions

This is intended to protect hospital personnel from bloodborne infections

True

TOF: Blood and all body fluids, including secretions and excretions except sweat, regardless of whether visible blood is present, are considered infectious.

Hand washing

This must be done after touching blood, body fluids, secretions, excretions, and any items considered contaminated.

Gloves

It should be worn when handling blood, body fluids, secretions, excretions, and any items considered contaminated.

Mask, Eye protection, face shield

This must be worn anytime there is a potential for splashes or sprays of blood, body fluids, secretions, and excretions.

Laboratory coats

This must be worn to protect skin and clothing when contact with blood, body fluids, secretions, and excretions could occur.

Appropriate sharps disposal

This must be implemented with care to prevent injuries with sharps, needles, and scalpels. These devices must be placed in appropriate puncture-resistant containers after use.

Environmental control

This must include procedures for routine care, cleaning, and disinfection of environmental surfaces

Transmission-Based Precautions

These are added precautions that are used when the patient is known or suspected to be infected or colonized with an infectious agent that requires extra measures to prevent spread or transmission of the agent

Airborne, Contact, Droplets Precautions

What are the three categories of TRANSMISSION-BASED PRECAUTIONS?

Contact Precautions

These are used to stop the spread of infectious agents that may be transmitted through direct or indirect contact with the patient or with the patient’s environment

Droplets Precautions

These are used to stop the spread of infectious agents that can be transmitted by close respiratory contact or by exposure of mucous membranes to respiratory secretions.

Airborne Precautions

These precautions are used for infectious agents, such as M. tuberculosis, varicella virus, and rubeola virus, that can remain airborne and infectious over long distances.

Personal Protective Equipment (PPE)

It consists of gloves, laboratory coats, masks, respirators, face shields, and safety glasses.

PPE

It must be removed before leaving the work area and must be placed in an area designated for

Gloves

It should be removed whenever they become contaminated

Hands

It must be washed after the removal of gloves.

PPE

It must fit properly to be the most effective

Respirators

These are used for protection against airborne transmission of infectious agents must be fit tested to ensure the protection of the worker

1. Gown

2. Mask

3. Goggles

4. Gloves

What is the proper donning?

1. Gloves

2. Gown

3. Goggles

4. Mask

What is the proper doffing?

Biohazard Symbol

This symbol is used in labelling materials that could pose a health risk.

Charles Baldwin 1966

Who designed the BIOHAZARD SYMBOL?

Biohazard Symbol

It represents the TRIAD in Chain of Infection

Agent, Host, Environment

What is the triad in Chain of Infection?

Infection Control

When a microorganism invades the body, multiplies, and causes injury or disease. Communicable and nosocomial and healthcare-associated infection (HAIs)

Infectious (Causative) Agent

These are the pathogenic microbe such as virus, bacteria, fungus, protozoa, rickettsia

Reservoir

Source of infection agent or place where the microbe would grow, survive and multiply which could be in humans, animals, food, water, soil or equipment.

Exit Pathway

A way or manner where an infectious agent leave the reservoir host which could be through secretions and exudates, tissue specimens, blood, feces or urines.

Means of Transportation

It includes Airborne, Direct, Indirect, Droplets, Vector, and Vehicle

Entry Pathway

Refers to the way an infectious agent enters a host that is susceptible to infection which includes body orifices, mucous membranes, and breaks in skin.

Susceptible Host

Someone who is prone to infection due to age, health, or immune status.

Susceptible Host

They usually include the elderly, newborn, patients who are immune suppressed, unvaccinated, and those suffering from acute or chronic illness.

1. Effective handwashing techniques

2. Good nutrition

3. Use of PPE when needed

Give atleast 3 ways in BREAKING the chain of infection

1. Wear PPE

2. Use forceps for discarding the broken glass on a sharps container

3. Cover with absorbent paper towels

4. Flood area with 10% bleach solution

5. Let it sit for 10 minutes

6. Clean up the area with paper towels

7. Dispose in Biohazard bag

8. Repeat if necessary

Give the steps in cleaning blood spill.

1. processing of patient specimen

2. handling of the actively growing cultures of microorganisms

What are the two major souces of BIOLOGICAL HAZARD in the microbiology laboratory?

1. Parenteral inoculations

2. Spills and splashes into the skin, mucous membrane, and ingestions

3. Inhalation of aerosols

What are the three major routes of LAI’s in a clinical laboratory?

1. ✓ Laboratorians and students should know that the bacteria handled in the laboratory can make people sick

2. ✓ Students should have dedicated writing utensils and supplies at their work stations, and these should not leave the laboratory

3. ✓ Laboratorians and students must be aware of the organisms with which they are working and what the signs and symptoms are if they get infected with one of these organisms.

4. ✓ Laboratorians and students must be trained and proficient in biosafety practices and techniques.

5. ✓ Lab coats should always be worn over personal clothing (appropriate PPE should be worn). Individuals should not leave the laboratory with PPE on; PPE always should be disposed of properly

Enumerate the CDC Biosafety Recommendations.

No or Low Individual and Community Risk

Risk Group 1?

Moderate Individual Risk and Low Community Risk

Risk Group 2?

High Individual Risk and Low Community Risk

Risk Group 3?

High Individual and Community Risk

Risk Group 4

Risk Group 1

A microorganism that is unlikely to cause human or animal disease.

Risk Group 2

A pathogen that can cause human or animal disease but is unlikely to be a serious hazard to laboratory workers, the community, livestock, or the environment.

Risk Group 2

Laboratory exposures may cause serious infection, but effective treatment and preventive measures are available, and the risk of spread of infection is limited.

Risk Group 3

A pathogen that usually causes serious human or animal disease but does not ordinarily spread from one infected individual to another. Effective treatment and preventive measures are available.

Risk Group 4

A pathogen that usually causes serious human or animal disease and that can be readily transmitted from one individual to another, directly or indirectly. Effective treatment and preventive measures are not usually available.

Biosafety Level 1

Level not known to consistently cause disease in healthy adult humans, and of minimal potential hazard to laboratory personnel and the environment.

Biosafety Level 2

Level of moderate potential hazards to personnel and the environment. ➢ Includes bacteria and viruses that cause mild disease to humans or are difficult to contact via aerosol in a lab setting.

Biosafety Level 3

Level wherein microbes can either be indigenous or exotic, and they can cause serious or potentially lethal disease through respiratory transmission.

BSL 4

What level : EBOLA VIRUS

Biosafety Level 4

Level where it is dangerous and exotic, posing a high risk of aerosol-transmitted infections. Infections caused by these microbes are frequently fatal and without treatment or vaccines.

BSL 4

What level : SMALL POX

BSL 3

What level : MYCOBACTERIUM TUBERCULOSIS

BSL 3

What level : Yersinia pestis (plague), SARS, Rabies virus, West Nile Virus, Hantaviruses

BSL 2

What level : Hepatitis A virus, Streptococcus pyogenes, Borrelia burgdorferi Salmonella species.

BSL 1

What level : Saccharomyces cerevisiae, E. coli K-12, and non-infectious bacteria

BSL 1

Level where these agents pose a minimal threat to laboratory personnel and the environment

BSL 1

In this level, laboratory work can be conducted on open benchtops.

BSL 2

In this level, infectious agents that require BSL-2 containment and practices are agents that pose a moderate potential hazard for the employees and the environment.

BSL 2

In this level, laboratorians should receive immunizations or tests for agents handled or for agents that could potentially be in the laboratory environment.

Hepatitis B Vaccine and Tuberculosis skin test

What are the examples of immunization required to work in a biosafety level 2 laboratory?

BSL 2

A biosafety manual must be developed and updated in this level

BSC Class II

What is the recommended biosafety cabinet BSC in BSL 2?

BSL 2

In this level, the use of needles and syringes is restricted within the laboratory to only times when there is no alternative equipment that can be used.

BSL 3

In this level, infectious agents that are either indigenous or exotic. These agents have the potential for aerosol transmission, and diseases with these agents may have serious lethal consequences.

BSL 3

In this level, laboratory personnel must have specific training in handling these pathogenic and potentially lethal organisms.

BSL 3

In this level, laboratory should be separated from the other parts of the building and be accessed through two self-closing doors. An anteroom may be used for access.

BSL 3

In this level, laboratory requires a ducted air ventilation system that must provide for sustained directional airflow. This directional airflow pulls air from “clean” areas toward “potentially contaminated” areas.

BSL 4

In this level, agents that are dangerous and exotic. These agents have a risk of causing life-threatening infections, can be transmitted by aerosols, or have an unknown risk of transmission.

BSL 4

This level of facility either located in a separate building or is in an isolated zone within a building. This facility is isolated from all other areas, and access is strictly controlled.

1. Cabinet Laboratory

2. Suit Laboratory

What are the two types of BSL 4 Laboratories?

Cabinet Laboratory

In this type of laboratory, all work is performed within a class III BSC.

Suit Laboratory

In this type of laboratory, personnel wear a positive pressure protective suit to perform all work.

BSL 4

This level of laboratory has a dedicated nonrecirculating ventilation system, which is filtered through a HEPA filter before being exhausted.

1. Class I

2. Class II

3. Class III

What are the three types of Biological Safety Cabinets?

False

Chemical fume hoods can be used as BSC and BSC cannot be used as chemical fume hoods

Class I

It uses an exhaust fan to move air inward through the open front. The air is circulated within the safety hood, passing through a high-efficiency particulate air (HEPA) filter before reaching the environment outside the hood.

Class I

This kind of cabinets allow room (unsterilized) air to pass into the cabinet and around the area and material within, sterilizing only the air to be exhausted.

Class I

This cabinet have negative pressure and may be ventilated to the outside or exhausted to the work area are usually operated with an open front.

Class II

This cabinet is the most common in microbiology laboratories.

Class II

This cabinet’s air is pulled inward and downward by a blower and passed up through the airflow plenum where it passes through a HEPA filter before reaching the work surface.

Vertical Laminal Flow BSC

The air flows in “sheets”, which serve as barriers to particles from outside the cabinet and direct the flow of contaminated air into the filters. Such cabinets are called ________

1. Class II A

2. Class II B

What are the different types of Class II cabinets?

Class II A

This cabinet is self-contained, and 70% of the air is recirculated into the work area.

Class II B

This cabinet is selected if radioisotopes, toxic chemicals or carcinogens will be used.

Class II B

The exhaust air in this class II cabinet is discharged outside the building

Class III

This cabinet is a self-contained ventilated system for highly infectious microorganisms or materials and provides the highest level of personal protection.

Class III

This cabinet has the closed front containing attached gloves for manipulation on the work surface.

Class III

This cabinet are completely enclosed and have negative pressure and also afford the most protection to the worker.

Autoclave and Incinerator

Infectious waste may be decontaminated by use of _____ and _______