MODULE 3: INFECTION CONTROL
C. Block the portal of entry
Chain of Infection
 A chain is only as strong as the weakest link.
 In order for us to break the chain of infection,
we must first learn what the components of the
chain are.
Breaking the Chain of Infection
 Laboratory work has high risk of exposure to
infectious organisms.
 Maintaining a safe working environment is
essential.
 We need to protect ourselves, our clients, and our
family from contamination.
 In the microbiology section, contamination of
specimen should also be prevented to have quality
test results.
A. Kill the pathogen (Elimination)
 Eliminating the pathogen is a sure way to prevent
disease from happening.
a. Elimination could be done by physically removing
the pathogen (handwashing)
 hands are the most common medium in how
pathogens enter the body
 best way to eliminate the pathogen is by
washing of hands
b. If the microbes were able to enter, eliminating it is
by means of our defence mechanism
 1st line of defence: intact skin, reflexes
(coughing, sneezing), mucous membranes
 2nd line of defence: neutrophils, phagocytes,
RES (reticuloendothelial system)
 3rd line of defence: antibodies from (a)
immunization or (b) previous exposure
 Antibiotic – used to kill or limit the number for
microbes so as not to cause disease
B. Prevent contact with the microbe
 Done by preventing things from coming in contact
with the infected source
 Personal Protective Equipment (PPE) – one way of
preventing contact serving as a barrier between the
person and the microbe
 Microbes by themselves do not cause disease
 It has to enter its host as we have learned in the
epidemiologic triangle
 Blocking the portal of entry will surely prevent
infection
 Examples: using masks (white side out),
covering of wounds and using latex barriers
during sexual intercourse
D. Prevent its escape
 The exit of microbes from the host is as important
as its entry since infection would always have a
source
 Sneezing, coughing or even extracting blood with
used needles are some ways in how microbes could
escape from its host to potentially infect others
E. Prevent transmission
 Transmission of pathogens could either be direct or
indirect.
a. Preventing direct transmission has already been
discussed under “Kill the Pathogen”
b. Indirect transmission involves carriers
(asymptomatic patients) and vectors
 prevention of indirect transmission includes
killing or controlling animal carriers and insect
vectors, proper preparation of food and
treatment of water facilities
F. Make the Host Resistant
 Even if microbes were able to enter, attach itself to
membranes, multiply and produce toxic substances
in the host, if the host resistant, then the disease
won’t occur (importance of keeping yourself
healthy)
 Resistance could be maximized by having proper
nutrition, enough rest, exercise, immunizations and
by avoiding toxic chemicals such as smoking and too
much alcohol
Disinfectants and Antiseptics
Two major categories in eliminating microbes in the
lab:
1. Physical Sterilization (involves physics)
 Physical control involves:
a. use of temperature
b. use of pressure
c. use of mechanical equipment
d. use of autoclave – most efficient physical
control, wherein no microbe is left to
survive when used
2. Chemical Sterilization – involves use of compounds
a. Disinfectants – are chemicals that are used on
inanimate objects (fomites)
b. Antiseptics – are used on mucous membranes
 gonorrhoeae = blindness of the child;
called as ophthalmia neonatorum)
 AgNO3 replace with tetracycline and
Chemical Agents erythromycin
A. Disruption of Cell Membrane (by denaturing
protein)
1. Alcohols 3. H2O2 (hydrogen peroxide)
 antiseptic  antiseptic
 denatures protein  for cleansing wounds and contact lenses
 disorganizes the lipid structure in the  oxidizes microbes (bubbles produced)
membranes
 egg white (albumin) when exposed to 4. Formaldehyde (concentrated form)
alcohol, the liquid nature turns into  disinfectant
solid  formalin – 37% in water (used in preserving
 Example: 70% isopropyl alcohol cadavers)
 denatures protein
2. Detergents/soaps  bactericide and fungicide
 antiseptic
 surfactants interact with the lipid in the cell 5. Glutaraldehyde
membrane and with the surrounding water  antiseptic
 increases the surface tension (adsorbs  10X more effective than formaldehyde and
microorganisms) less toxic
 Example: Quaternary ammonium (Quats or  used for sterilizing respiratory therapy
Zephiran) equipment (like ambu bags)

3. Phenols 6. Ethylene oxide

 original disinfectant of Lister  counter-part of autoclave
 the carbolic acid that he used is a  for sterilization of heat-sensitive equipment
phenol  most effective cold sterilization technique
 denatures protein
 Example: carbolic acid/ cresol (Lysol) 7. Acids and Alkalis
 denatures protein
 weak acids are used as food preservatives
B. Modification of Protein (bacteriostatic – maintains certain level of
1. Halogens microorganism)
a. Chlorine  Example: benzoic, propionic, citric acids
 disinfectant and antiseptic
 Example: hypochlorite in restaurants
and swimming pools C. Modification of Nucleic Acids (dyes/stains)
 whitening agent, antibacterial agent in 1. Crystal Violet (Gentian Violet)
toothpaste  skin antiseptic (used in mumps)
 binding of (+) charged dye molecule to the
b. Iodine (–) charged PO4 groups of nucleic acid
 most effective skin antiseptic
 Example: Tincture of Iodine – 2% 2. Malachite green
solution of KI in ethanol  Example: in L-J Medium for MTB
 also known as “Iodophors”  kills other bacteria except MTB
(commercially available as betadine)

c. Bromine
 in the past, it is used in the
manufacture of bread (cancerous)

2. Heavy Metals
 found in the latter portion of periodic table
 inhibits enzymatic activities
 Example: Hg – merthiolate, Ag – AgNO3,
Silver sulfadiazine
 in early days, merthiolate is used for
wounds but very irritating/painful
 in place of merthiolate, wounds are
cleansed with hydrogen peroxide

 Crede’s prophylaxis (AgNO3) – washing

a newborn’s eyes with a 2% silver
nitrate solution to protect against
gonorrhoeae (mother is infected with