Infection Control
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| Chain of infection | Pathogen-Reservoir Host -Portal of Exit- Mode of transmission-Portal of entry- Susceptible Host
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| Pathogenic Agents | Bacteria , Rickettsia ,Fungi , Parasites, Viruses
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| Reservoir Host | Harbors the pathogenic agent.
Provides environment for growth.
Moist mucous membranes
Mouth
Saliva
Skin
Feces
Wounds
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| Portal Of Exit | Means by which the pathogen escapes the reservoir host.
Respiratory tract: Mouth, nose, throat—saliva, sneezing, coughing, talking.
Eyes and ears
GI tract: Feces, vomitus
Urinary tract:
Reproductive tract:
Non-intact skin:
Wounds
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| Mode of transmission | The means by which the pathogen is passed on to another host.
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| Direct Contact | Physical, droplets—aerosols/
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| Indirect Contact | Intermediate objects
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| Airborne | Droplet nuclei, e.g. TB, influenza, varicella, and rubeola.
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| Common vehicle | Contaminated food and water.
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| Vector | Intermediate hosts, e.g. insects.
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| Portal of entry | The means by which a pathogen enters a host.
Same as the portals of exit.
Body orifices
Mucous membranes
Non-intact skin
Indwelling devices
Invasive procedures
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| Susceptible Host | Persons at risk of acquiring the infection.
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| Incubation | Time between exposure to appearance of SS.
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| Prodromal | Time between SS and definitive illness.
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| Invasive: | Illness fully apparent—acme: peak SS.
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| Decline | Decreasing SS
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| Convalescence: | Repair and recuperation.
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| Sequelae | Persisting disease aftereffects.
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| Resident flora (normal flora) | Normally reside in epidermis and dermis
Generally harmless and nonpathogenic
Difficult to remove (attached to deeper skin layers)
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| Transient flora | Grow in epidermis (superficial skin layers)
Picked up in the course of daily activities
Often pathogenic
Easily removed.
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| Compromised host: | Dehydration
Cilia damage
Cancer
AIDS
Diabetes
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| Communicable infections | Infections transmitted from person to person.
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| Nosocomial infection | infections acquired in hospitals and health facilities.
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| Medical Asepsis | Objects or areas that are free of pathogenic (infectious) material.
Nonpathogenic agents may be present.
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| Hand Washing | When the hands are visibly soiled with dirt or body fluids.
Should be performed before assisting with surgery, before eating, and after bathroom use.
Use of antimicrobial soap: Triclosan, chlorhexidine, hexachlorophene.
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| Hand Rub | Alcohol based: 60 – 90% methanol.
Typ.es: Gels, lotions, foams
Used if hands are not visibly soiled.
Repeated hand washing leads to dryness, irritation, chapping, and dermatitis.
Effective at removing transient flora and reducing bacterial count.
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| Han washing Vs. Hand Rub | Hands should be sanitized between patients.
After handling specimens and contaminated materials
After bathroom use
Before leaving the lab or clinic
Before eating.
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| Handwashing Procedure | Remove jewelry except wedding rings.
Turn on water faucet, wet hands, and apply antibacterial soap.
Lather while keeping the fingers pointed downward.
Scrub between fingers and over hands ten times or approximately 30 seconds.
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| Handwashing Procedure Cont. | Scrub the palms using the tips of the fingers (or use a manicure stick).
Rinse so that the water flows downward from the wrist to the finger tips.
Turn water off with paper towel; discard. Dry hands with a clean paper towel and discard.
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| Hand Rub Procedure | Make sure hands are unsoiled, remove jewlery, apply agent to palm of hand, gel or lotion dime size, foam walnut size, spread on handand 1/2 inch above wrist, rub hands until dry
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| Sanitization | Process of cleaning or freeing materials such as instruments from dirt.
Requires the use of a scrub brush and detergent.
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| Detergent | Wetting agent that mechanically removes bacteria, emulsifies fats and oils, and dissolves high protein substances, e.g. blood.
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| Ultrasound | A device containing a detergent solution that passes sound waves and vibration through the liquid to loosen contaminants from instruments.
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| Antiseptic: | A sanitizing agent used on the skin
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| Disinfection | Process of removing infectious material from objects
Boiling. Chemical: Soap, alcohol (isopropyl), acids (phenol), alkalies (sodium hypochlorite), and formaldehyde.
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| Ultraviolet radiation: | Surface microbes.
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| Dessication: | Preservative.
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| Sterilization | Process of completely destroying all microorganisms or infectious agents.
Process of completely destroying all microorganisms or infectious agents.
Chemical: Gluaraldehyde.
Autoclave: Steam under pressure.
Gas.
Oven: Dry heat.
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| Engineering Controls | Structural or mechanical devices designed to minimize exposure.
Hand washing facilities
Eye wash stations
Sharps containers
Biohazard labels
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| Work Practice control | Policies and procedures that promote the behaviors necessary to properly use engineering controls and personal protective equipment.
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| Personal protective equipment | PPE: Safety equipment that minimizes exposure beyond engineering controls.
Lab coats
Mask
Goggles
Face shields
Gloves
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| Universal Precautions | treat all blood, body fluids, secretions, excretions, and moist body substances as potentially infectious regardless of actual pathogenicity semen, vaginal fluid, breast milk,CSF, synovial, pleural fluid Saliva, feces, sputum, tears
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| Contaminated Sharps | contaminated object that can cut , puncture wound shall be placed in clearly labeled, puncture-resistant, leak-proof containers immediatel
Bending, shearing, or recapping needles is prohibited.
Must maintain a log of injuries from contaminated sharps.
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| Biohazard Labels | Will be placed on all devices and containers used to contain blood or OPIM.
Must be fluorescent orange or red.
Includes the biohazard symbol and the word, BIOHAZARD.
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| Regulated Waste | Waste that poses a threat to health and safety.
Contains liquid or dried blood or OPIM. Saturation v. spot.
Biological waste.
Body fluids or tissues.
Shall be placed in biohazard waste containers located in each clinical area.
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| Post-exposure Evaluation | When an employee incurs an exposure incident, it must be reported to that person’s supervisor and properly followed up.
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| Hepatitis A Virus (HAV) | AKA infectious hepatitis
Incubation: 2-6 weeks.
Transmission: Fecal-oral route.
S&S: Flu-like.
Prognosis: Rarely fatal, recovery within 6-10 weeks. Not chronic.
Vaccine preventable.
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| Hepatitis B Virus (HBV) | AKA serum hepatitis.
Most frequently reported occupational disease of health workers; usually though contaminated sharps injuries.
Transmission: Exposure to blood and body fluid. 0.0001 ml (100 l or 1/500 gt) of blood can cause transmission.
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| Hepatitis B Virus (HBV) | Risk: 0.06 to 0.3.
Incubation: 1-6 months (2-3 on average).
S&S: Flu-like.
Prognosis: most recover. 10% suffer from chronic infection. 25% of chronic sufferers die of liver failure.
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| Hepatitis B Virus (HBV) | Postexposure Prophylaxis: HBIG within 24 hrs to 7 days.
Vaccine preventable: HepB Vaccine: Three IM doses at 0, 1, and 6 months.
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| Hepatitis C Virus (HCV) | RNA virus of the Flaviviridae family
Incubation: 0.5 to 6 months.
Transmission: Blood, body fluids.
S&S: Flu-like.
Risk: 0.02.
Not vaccine preventable.
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| Hepatitis C Virus (HCV) | Prognosis: Its genetic diversity causes 55-85% of infected persons to become chronic carriers.
More than 20% of those having chronic HCV develop cirrhosis making it the leading reason for liver transplantations.
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| Hepatitis C Virus (HCV) | 1-5% of chronic disease sufferers will die of liver failure.
Not vaccine preventable.
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| Hepatitis D Virus (HDV) | Incubation: 0.5 to 5 months.
Transmission: Blood, body fluids.
Affects only those infected with HBV.
S&S: Intensified flu-like.
Prognosis: Frequently leads to chronic hepatitis. 30% fatality rate among chronic sufferers.
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| Hepatitis E Virus (HEV) | Incubation: 3-6 weeks.
Transmission: Fecal-oral route.
Rare in U.S.—seen in developing countries in epidemic proportions.
S&S: Flu-like.
Prognosis: Not chronic—10-20% fatality among pregnant contractors.
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| Human Immunovirus (HIV) | RNA virus of the retrovirus family.
Etiologic agent of AIDS.
Slowly attacks T-helper lymphocytes and macrophages.
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| Human Immunovirus (HIV) | Allows severe opportunistic infections and cancer.
Incubation period: 6 months to 7 years.
Transmission: Sexual contact, contaminated needles.
Risk: 0.003, 0.0009
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