ASEPSIS AND INFECTION CONTROL

Terminologies:

 Infection – An invasion of the body tissue by microorganisms and their proliferation

there.

 Asepsis – The absence of disease-producing microorganisms

- Being free from infection

 Medical Asepsis – Practices designed to reduce the number and transfer of pathogens
- Clean technique

 Surgical Asepsis – Practices that render and keep objects and areas free from
microorganisms

 Sepsis – The presence of infection.

 Septicemia – Transport of an infection or the products of infection throughout the body

or by blood

 Carrier – A person or an animal, who is without signs of illness but who harbors
pathogens within his body that can be transferred to another.

 Contact – A person or an animal known or believed to have been exposed to a disease

 Reservoir - The natural habitat for the growth and multiplication of microorganisms

 Transient flora or bacteria – The microorganisms picked up by the skin as a result of

normal activities that can be removed readily.

 Resident flora or bacteria – The microorganisms that normally live on a person’s skin

 Sterilization – The process by which all microorganisms including their spores are
destroyed

 Disinfectant – A substance, usually intended for use on inanimate objects, that destroys
pathogens but generally not the spores

 Antiseptic- A substance, usually intended for use on persons that inhibit the growth of
pathogens but not necessarily destroy them.
- Example is the substance used for surgical wounds

 Bactericidal - A chemical that kills microorganisms.

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  Bacteriostatic – An agent that prevents bacterial multiplication but does not kill all forms
of organisms

 Contamination - The process by which something is rendered unclean or unsterile

 Disinfection – The process by which pathogens but not their spores are destroyed, from
inanimate objects

 Communicable disease – Results if the infectious agent can be transmitted to an

individual by direct or indirect contact through a vector or vehicle, or as an airborne
infection

 Infectious disease – Results from the invasion and multiplication of microorganisms in a

host

 Pathogens – A disease-producing microorganism

 Pathogenicity – The ability to produce a disease

 Virulence – The vigor with which the organism can grow and multiply

 Specificity - The organism’s attraction to a specific host, which may include humans

 Opportunistic pathogens – Causes diseases only in susceptible individual

 Nosocomial infection – Hospital-acquired infections

 Isolation – The separation of persons with communicable diseases from other persons so
that either direct/indirect transmission to susceptible persons is prevented

 Isolation techniques - Practices designed to prevent the transfer of specific

microorganisms

 Etiology – The study of causes.

STAGES of INFECTIOUS PROCESS

 Incubation Period. Extends from the entry of microorganisms into the body to the
onset of signs and symptoms.

 Prodromal Period. Extends from the onset of non-specific signs and symptoms to the
appearance of specific signs and symptoms
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  Illness Period. Specific signs and symptoms develop and become evident.

 Convalescent Period. Signs and symptoms start to abate until the client returns to
normal state of health.

THE CHAIN OF INFECTION

(1) Etiologic/Infectious Agent

(microorganisms):
Bacteria, fungi, virus, parasites

(2) Reservoir
(6) Susceptible Host (source)
Immunosuppressed Human beings, animals,
children/elderly, chronically ill, inanimate objects, plants,
general environment such as
those with trauma or surgery
air, water and coil

(5) Portal of Entry (3) Portal of Exit

Mucous membrane, non-intact skin, Sputum, emesis, stool, blood
GI tract, GU tract, Respiratory tract

(4) Modes of Transmission

Contact, vehicle, airborne, vector-

borne
1. Etiologic Agent (microorganisms)

These may be bacteria, virus, fungi, or parasites. The ability of the infectious agent to
cause a disease depends on its pathogenicity, virulence, invasiveness and specificity.

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 pathogenicity = ability of an organism to cause disease (ie, harm the host).

 virulence = refers to the degree of pathology caused by the organism.
 invasiveness = tending to invade healthy tissue invasive cancer cells.
 specificity = measures the proportion of actual negatives that are correctly identified as
such (e.g., the percentage of healthy people who are correctly identified as not having the
condition).

 Sensitivity: the ability of a test to correctly identify patients with a disease.

 Specificity: the ability of a test to correctly identify people without the disease.

o Sensitivity (also called the true positive rate, the recall, or probability of detection
in some fields) measures the proportion of actual positives that are correctly
identified as such (e.g., the percentage of sick people who are correctly identified
as having the condition).
o Specificity (also called the true negative rate) measures the proportion of actual
negatives that are correctly identified as such (e.g., the percentage of healthy
people who are correctly identified as not having the condition).

2. Reservoir (source)
Humans (clients, visitors, health care personnel)
Animals (insects, rats)
Plants
General Environment (air, water, food, soil)
3. Portal of Exit from Reservoir
Respiratory Tract: droplets, sputum
Gastrointestinal Tract: vomitus, feces, saliva, drainage, tubes
Urinary Tract: urine, urethral catheters
Reproductive Tract: semen, vaginal discharge
Blood: open wound, needle puncture site

4. Mode of Transmission
a. CONTACT Transmission. This may be direct or indirect contact:
o Direct contact involves immediate and direct transfer from person to person (body
surface-to-body surface)
Examples: Healthcare personnel to clients during bathing, dressing changes, insertion of
tubes and catheters; direct transfer between two clients, with one acting as the
source and the others as the host.

o Indirect Contact occurs when a susceptible host is exposed to a contaminated object

such as dressing, needle, and surgical instrument.

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Contact transmission of infectious organisms on the hands of caregivers

is the most frequent mode of transmission in health care facilities.

b. DROPLET Transmission. This may be considered a type of contact transmission

 It occurs when mucous membrane of the nose, mouth, or conjunctiva are exposed to
secretions of an infected person who is coughing, sneezing, laughing, or talking, usually
within a distance of 3 feet

c. VEHICLE TRANSMISSION. This involves the transfer of microorganisms by way of

vehicles or contaminated items that transmit pathogens.

Examples: food, water, milk, blood, eating utensils, pillows, mattress.

d. AIRBORNE TRANSMISSION. This occurs when fine particles are suspended in the air for
a long time or when dust particles contain pathogens. Air current disperses microorganisms,
which can be inhaled or deposited on the skin of a susceptible host.
e. VECTOR-BORNE TRANSMISSION. Vectors can be biologic or mechanical.

 Biologic Vectors are animals, like rats, snails, mosquitoes

 Mechanical vectors are inanimate objects that are infected with infected body fluids like
contaminated needles and syringes.

5. Portal of entry

 This permits the organism to gain entrance into the host

Pathogens can enter susceptible hosts through body orifices such as the mouth, nose, ears,
eyes, vagina, rectum or urethra. Breaks in the skin or mucous membranes from wounds or
abrasions increase chance for organisms to enter hosts.

6. Susceptible Host

 A host is a person who is at risk for infection; whose own body defense mechanisms,
when exposed, are unable to withstand the invasion of pathogens.
 Examples: malnourished children, the elderly, the client with leukemia are immune-
compromised, and therefore, have propensity to develop numerous types of infection.

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For organisms to spread disease, they must grow, reproduce, and move
from one source to another.

FACTORS INFLUENCING THE HOST’S SUSCEPTIBILITY

 Intact skin and mucous membrane are the body’s first line of defense
 The normal pH levels of secretions and of genito-urinary tract help ward off microbial
invasion.
 The body’s WBC influence resistance to certain pathogens.
 The age, sex and race have been shown to influence susceptibility
 Immunization. (natural/acquired), acts to resist infection.
 Fatigue, climate, general health status, presence of pre-existing illness, previous/current
treatments and some kinds of medications may play a part in the susceptibility of a
potential host.

TYPES OF IMMUNIZATION
1. Active Immunization. Antibodies are produced by the body in response to infection.

a. NATURAL. Antibodies are formed in the presence of active infection in the body. It
is lifelong. Eg. recovery from mumps, chicken pox

b. ARTIFICIAL. Antigens. (vaccines or toxoids) are administered to stimulate

antibody production. Requires booster inoculation after many years. Eg. Tetanus toxoid , Oral
Polio Vaccine.

2. Passive Immunization. Antibodies are produced by another source, such as animal or

human.

a. NATURAL. Antibodies are transferred from the mother to her newborn through the
placenta or in the colostrum.

b. ARTIFICIAL. Immune serum (antibody) from an animal or another human in

injected to a person Eg. Tetanus immunoglobulin human (TIgH)