Principles of Medical Laboratory Science Practice 2 Module 1: Infection Prevention & Control

INFECTION CHAIN OF INFECTION

DEFINITION OF TERMS
• A model used to depict the transmission of infection.
Infection
Infectious Agent
• is a condition that results when a microorganism is able to
• Causative agent
invade the body, multiply, and cause injury or disease.
• The pathogenic microbe responsible for causing an
Microorganism infection.

• microscopic organism that can potentially benefit or harm Reservoir

living things
• Source of infectious agent
Pathogens • A place where the microbe can survive and grow or
multiple.
• microorganisms that are capable of causing or producing • Animal, human equipment, food, soil, water
infection/diseases. • Reservoir Host: an individual or animal infected with a
pathogen; has the ability to transmit the pathogen
Communicable Infection
• Fomite: inanimate object that has the ability to transmit
• Infections that can be easily spread from person-to- infection
person.
Factors that affect the transmissibility:
• Spread from one person to another through a variety of
ways: o Viability of the microorganism: ability of the microbe to survive
o Contact of blood and bodily fluids on the object
o Virulence of the microorganism: degree to which the microbe
o Breathing in an airborne virus
is capable of causing disease
o By being bitten by an insect/vector
o Amount of contamination
o Amount of time that has passed since the item was
Healthcare-associated Infections
contaminated

• Formerly known as nosocomial infections

Exit Pathway
• “Hospital-acquired infections”
• Applies to infections associated with healthcare delivery in • Pathway where the infectious agent leaves a reservoir host
any healthcare setting • Blood, excretion, secretions
• Are nosocomial infections that are not present or
incubating at the time of admission to a hospital? Means of Transmission

• Method that an infectious agent uses to travel from a

• Centers for Disease Control and Prevention
reservoir to a susceptible host
o An agency of the U.S. Department of Health and
• Airborne, contact, droplet, vector, vehicle
Human Services that is in-charged with the
• The same microbe can be transmitted by more than one
investigation and control of various diseases
route.
o Develops guidelines and recommends safety
precautions to protect healthcare workers and Entry Pathway
others from infection
• Pathway where the infectious agent is able to enter a
susceptible host
• Body orifices, mucous membranes, broken skin

Susceptible host

• Someone with a decreased ability to resist infection

• Elderly, newborn, acute/chronically ill, immune suppressed,
unvaccinated

Common factors that affect susceptibility:

o Age
o Health
o Immune status

Cis and Trans | BSMT 2B&C

 DIFFERENT MODES OF TRANSMISSION COMMON BLOOD-BORNE PATHOGENS IN THE HEALTHCARE
SETTINGS
Contact Transmission

BLOOD-BORNE PATHOGEN
• most common means of transmitting infection

Two Types: • any infectious microorganism present in blood and other

body fluids and tissues.
a. Direct Contact Transmission
o Involves physical transfer of an infectious agent to a
susceptible host through close or intimate contact
HEPATITIS B VIRUS
o Touching or kissing
b. Indirect Contact Transmission • A blood-borne pathogen which is the causative agent of
o Can occur when a susceptible host touches serum hepatitis, a systemic disease that primarily affects
contaminated objects the liver.
o Fomites • Lower concentrations of virus may appear in semen,
vaginal fluid, and saliva
• Modes of transmission: sexual, perinatal, and parenteral

Droplet Transmission routes

• Flu-symptom; fatigue, loss of appetite, mild fever; jaundice
• transfer of an infectious agent to the mucous membranes (25%); cirrhosis of the liver; liver cancer
of the mouth, nose, or conjunctiva of the eyes of a • HBV vaccination (series of 3-equal intramuscular
susceptible individual via infectious droplets (particles 5 injections)
um in diameter or larger) generated by coughing,
sneezing, or talking or through procedures such as
HOW SOMEONE CAN GET HEPATITIS B?
suctioning or throat swab collection

Blood Sex
direct blood to direct contact with
Airborne Transmission blood contact sexual fluids
• Mother to child during • Sexual transmission:
• dispersal of infectious agents that can remain infective for birth there is a risk during any
long periods of time in particles that are typically less than • Household contact type of sexual contact
5 um in diameter and can be inhaled • Sharing hygiene
equipment (razors,
toothbrushes, earrings)
• Tattoos, piercings,
Vector Transmission
barbers, scarification,
circumcision practices
• transfer of an infectious agent carried by an insect,
• Sharing needles
arthropod, or animal
Unsterile healthcare
Two Types:

a. Mechanical Transmission
o Facilitated by a mechanical vector, an animal that
HEPATITIS C VIRUS
carries a pathogen from one host to another without
being infected itself • A blood-borne pathogen from the genus Hepacivirus
b. Biologic Transmission • Modes of transmission: parenteral, perinatal, and sexual
o Occurs when the pathogen reproduces within a • Clinical manifestations: acute and chronic hepatitis
biological vector that transmits the pathogen from • Complications: cirrhosis and hepatocellular carcinoma
one host to another. • Treatment: interferon alpha with or without ribavirin
• Risk of injury and transmission: The total acute HCV
infections that have occurred annually ranging from
Vehicle Transmission
100,000 in 1991 to 41,200 in 2016; 2-4% have been healthcare

• transmission of an infectious agent through contaminated workers exposed to blood in the workplace

food, water, or drugs

Cis and Trans | BSMT 2B&C

 HUMAN IMMUNODEFICIENCY VIRUS (HIV) How do we break the chain of infection?

• Modes of transmission: vertical, parenteral and sexual 1. Implementing Infection Control Programs
transmission 2. Carrying out Infection Control Methods
• Individuals at risk: those having unprotected sex with
NOTE: The Joint Commission requires every healthcare
multiple partners, IV drug users and blood product
institution to have an infection-control program responsible for
recipients and children of infected mothers
protecting patients, employees, visitors, and anyone doing
• Those with STIs are at the greatest risk
business within healthcare institutions from infection
• Target cells: CD4+ cells, monocytes, and macrophages
• You can get HIV via
o Sex without a condom
o Passed from mother to baby IMPORTANT COMPONENTS OF INFECTION CONTROL PROGRAM

o Sharing injecting equipment

o Contaminated blood transfusion & organ
transplants

• Risk of injury and transmission: The estimated risk of HIV

infection from a sharps injury is about 0.3% (1 in 300). The
CDC has reported 57 documented cases and 140 possible
cases of HIV transmission to US health care workers 1. Employee Screening and Immunization
between 1981 and December 2006. Of the 57 documented • Constant screening of employees
cases, 48 were associated with percutaneous injury • Includes: health checkups, annual physical examinations,
(puncture/cut injury) mandatory vaccination
o Most of the cases involved nurses and lab
technicians 2. Evaluation and Treatment
• It should contain methods or means to evaluate and treat
employees especially if they are exposed to infection
Two most common modes of transmission in the healthcare
settings:
3. Surveillance
a. Percutaneous injury • Continuous monitoring
o An injury caused by sharps object • Check the patients and employees at risk
o Human needle stick injury • Collect and evaluate data on infection contracted by the
patient and employees
b. Mucocutaneous exposure • This would help update and create new policies if needed
o The skin becomes non-impact depending on the collected information from the
o Breaks in the skin and then the mucous membrane surveillance
become exposed to blood tissues and other • Surveillance will keep you on track if your methods are still
potentially infectious bodily fluids effective in helping stop the spread of infection

BREAKING THE CHAIN OF INFECTION HIERARCHY OF CONTROL METHODS

• Safety rules and precautions when working in the

laboratory and in-patient areas

How do we halt the transmission?

o Stop the infection at the source

o Prevent contact of some substances from exit
pathways
o Eliminate means of transmission
o Block exposure to anti-pathways
o Reduce or eliminate the susceptibility of potential
hosts

Cis and Trans | BSMT 2B&C

• All of these methods contribute to infection prevention and
controls.

Elimination Removal of hazard and associated

risks
Substitution Replacement of the hazards to a
less toxic or non-
toxic substance
Engineering Controls Isolation of worker from the hazard
Eg. Biosafety cabinet
Administrative Changing how people work
Controls
PPE Protecting workers with PPE ISOLATION PROCEDURES

• Process of separating patients with certain transmissible

INFECTION CONTROL METHODS infections from contact with other patients and limit their
contact with hospital personnel and visitors
HAND HYGIENE
Quarantine
• One of the most important means of preventing the spread
of infection provided that it is achieved properly and when • process of separating and restricting the movement of
required people who were exposed to a contagious disease to see if
• It includes the use of alcohol-based antiseptic hand they become sick
cleaners and handwashing

PERSONAL PROTECTIVE EQUIPMENT

• Protective clothing and other items worn by an individual

to protect mucous membranes, airways, skin, and clothing
from contact with infectious substance
• Includes:
o Gloves
o Gowns
o Lab coats
Protective/Reverse Isolation
o Mask, face shields, goggles,
o Respirators • Used for patients who are highly susceptible to infections
• Protective measures are taken to keep healthcare workers
and others from transmitting infection to the patient rather
PROPER DONING AND DOFFING OF PPE
than vice versa
When putting on PPE (GMG)

1. the gown is put on first Universal Precaution

2. then, the mask is worn
3. lastly, the gloves are slipped on • Under UP, the blood and certain body fluids of all individuals
were considered potentially infectious.
When removing PPE

1. Gloves: the outside of gloves are contaminated

2. Gown: the front of the gown and sleeves will be
contaminated
3. Eye protection: the outside will be contaminated
4. Respiration
5. Hand washing

Cis and Trans | BSMT 2B&C

 PERSONAL WELLNESS

• Requires a holistic approach

• Proper nutrition
• Rest and exercise
• Personal Hygiene
• Back Protection
• Stress Management

PROPER NUTRITION

• Good balance of carbohydrates, fats, proteins, vitamins,

minerals, and fiber
• Avoid processed foods with chemical additives or
sweeteners

REST AND EXERCISE

• Relaxation; enough sleep

• Regular physical activity

PERSONAL HYGIENE

BACK PROTECTION

STRESS MANAGEMENT

Cis and Trans | BSMT 2B&C