Fundamentals Midterm Topic

Asepsis - Absence of infection

- Is the freedom from disease causing microorganisms

TWO TYPES OF ASEPSIS

● Medical asepsis - (a.k.a clean technique), practices that kill some microorganisms to prevent them
from spreading.

● Surgical asepsis - (a.k.a sterile technique), refers to those practices that keep an area or object free
of all microorganisms.

Infection - Is the growth of microorganisms in body tissue where they are not usually found.

TYPES OF INFECTION
● Local infection - is limited to the specific part of the body where the microorganisms remain
● Systemic infection - if the microorganisms spread and damage different part of the body
Bacteremia - when a culture of the individual’s blood reveals microorganisms
Septicemia - When bacteria results in systemic infection
● Nosocomial infection - are classified as infections that originate in the hospital
● Iatrogenic infections - are direct results of diagnostic or therapeutic procedures.

Pathogen - Infection agent (not all)

- Is the ability to produce disease; thus, a pathogen is a microorganism that causes disease.
Sepsis - Is the condition in which acute organ dysfunction occurs secondary to infection.

Virulence - ability to produce disease

Communicable disease - are illnesses that spread from one person to another or from an animal to a person
or from a surface or a food.

Four major categories of microorganisms cause infection in humans

● Bacteria - are by far the most common infection causing microorganisms.
● Viruses - consists primarily of nucleic acid and therefore must enter living cells in order to reproduce.
● Fungi - include yeasts and molds
● Parasites - live on other living organisms

Factors of Susceptibility 5F
● Age - resistance to infection - Food - Fomites
● Heredity - nature & number of physical - Feces - Fingers
● Nutrition -nature of emotional stressors - Flies
● Medical therapies - radiation

Antiseptic - Agents that inhibit the growth of some microorganisms

Disinfectant - Agents that destroys pathogens other than spores

Prevention/Control
1. Isolation - refers to measures designed to prevent the spread of infections or potentially infectious
microorganisms to health personnel, clients and visitors.
2. PPE ( Personal Protective Equipment) - Equipment worn to minimize exposure to hazards
Gloves -
Mask - worn to reduce the risk for transmission of microorganisms by the droplet and airborne routes
and by splatters of body substances.
Gown - worn during procedures when the nurse’s uniform is likely to become soiled.
Googles -

Bacteriostatic - the agent prevents the growth of bacteria

Bactericidal - it kills bacteria
6 CHAIN IN INFECTION

Weakest link in the chain..

● The means of transmission is the weakest link in the chain of infection
● The only link we can eliminate entirely
● Infection control efforts-aimed at preventing the transport of germs from the reservoir to the susceptible
host.

1. The infectious agent

● Infectious agents (pathogens)- bacteria, viruses, fungi and parasites
● The virulence of these pathogens depends on their number, potency, ability to enter and
survive in the body, and susceptibility of the host
● Viruses are intracellular parasites; they can only reproduce inside a living cell
● HIV and hepatitis B and C, have the ability to enter and survive in the body for years
before symptoms of disease occur

2. Reservoir
● any person, animal, arthropod, plant, soil or substance (or combination of these) in which an
infectious agent normally lives and multiples
● The infectious agent depends on the reservoir for survival, where it can reproduce itself, that it
can be transmitted to a susceptible host.
● Animate reservoirs include people, insects, birds and other animals
● Inanimate reservoirs include soil, water, food, feces, intravenous fluid and equipment

3. Portal of exit
● means by which a pathogen exits from a reservoir.
● For a human reservoir, the portal of exit can include blood,, respiratory secretions, and
anything exiting from the gastrointestinal or urinary tracts.
● Once a pathogen has exited the reservoir, it needs a mode of transmission to transfer
into a host.
● Accomplished by entering the host through a receptive portal of entry.

4. Mode of transmission
● After a microorganism leaves its source or reservoir, it requires a means of transmission to
reach another individual or host through a receptive portal of entry.
● Vector-borne
● Transmission by an animate intermediary, an animal, insects, or parasite that transports the
pathogen from reservoir to host.
● Transmission takes place when the vector injects salivary fluid by biting the host, or deposits
feces or eggs in a break in the skin. Mosquitoes are vectors for malaria virus. Rodents can be
vectors for hantavirus.

● The transport of droplet nuclei over larger distances is primarily driven by ambient air flows, and
indoor environment such as homes, offices, malls, aircraft, and public transport vehicles
● Indirect Contact
● Both vehicle-borne and vector borne contact
● A vehicle an inanimate go between, an intermediary between the portal of exit from the reservoir
and the portal of entry to the host.
● Inanimate objects ex: cooking or eating utensils, handkerchiefs and tissues, soiled laundry,
doorknobs and handles and surgical instruments and dressing are vehicles that can transmit
infection.
● Blood, serum, plasma, water, food, and milk also serve as vehicles.
● Aerosols are small particles(<5um)- rapidly evaporate in the air, leaving behind droplet nuclei,
small & light enough to remain suspended in the air for hours
● Airborne transmission occurs when the residue of evaporated droplets from an infected person
remains in the air long enough to be transmitted to the respiratory tract of a susceptible host.
 ● Once infectious droplets and particles are exhaled, they move outward from the source. The risk
for infection decreases with increasing distance from the source and increasing time after
exhalation.

Airborne (Aerosol) Transmission

● Exposure occurs in three principal ways:
● (1) inhalation of very fine respiratory droplets and aerosol particles,
● (2) deposition of respiratory droplets and particles on exposed mucous membranes in the mouth, nose,
or eye by direct splashes and sprays,
● (3) touching mucous membranes with hands that have been soiled directly by virus-containing
respiratory fluids or indirectly by touching surfaces with virus on them.

a sneeze in progress, revealing the plume of salivary droplets as they are expelled in a large cone-shaped
array from this man’s open mouth, therapy illustrating the reason for covering your mouth when coughing or
sneezing in order to protect others from germ exposure

5. Portal of entry
● Infectious agents get into the body through various portals of entry, including the mucous
membranes, non-intact skin, and the respiratory, gastrointestinal, and genitourinary tracts.
● Pathogens often enter the body of the host through the same route they exited the reservoir,
e.g., airborne pathogens from one person’s sneeze can enter through the nose of another
person.
6. Susceptible host
● The final link in the chain of infection is a susceptible host, someone at risk of infection
● Infection does not occur automatically when the pathogen enters the body of a person whose
immune system is functioning normally. When a virulent pathogen enters an immune-
compromised person, infection generally follows.
● Exposure to a pathogen results in infection depends on several factors related to the person
exposed (the host), the pathogen (the agent), and the environment. Host factors that influence
the outcome of an exposure include: presence or absence of natural barriers, functional state
of the Immune system, and presence or absence of an invasive device.

● To stops germs from spreading is by interrupting this chain