CHAPTER 32 Principles of Asepsis © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-2 Learning Outcomes 32.1 Explain the historical background of infectious disease prevention 32.2 Identify the types of microorganisms that cause disease 32.3 List some infectious diseases, and identify their signs and symptoms 32.4 Discuss the importance of preventing antibiotic resistance in a health-care setting 32.5 Describe ways you can help prevent antibiotic resistance in health-care settings © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-3 Learning Outcomes (cont.) 32.6 Explain the disease process 32.7 Explain how the body’s defenses protect against infection 32.8 Describe the cycle of infection 32.9 Identify and describe the various methods of disease transmission 32.10Explain how you can help break the cycle of infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-4 Introduction Our bodies are amazing structures that defend us against infections under normal circumstances You will learn about: – Disease-causing microorganisms – How the body fights disease – Ways infections occur – Antibiotic-resistant organisms – Importance of patient education on the proper use of antibiotics © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-5 History of Infectious Disease Prevention • Throughout history people have attempted to discover – Causes of infection – How to prevent infections – How to treat infections © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d History of Infectious Disease Prevention 32-6 (cont.) Scientist Contribution Edward Jenner (1749–1823) • Developed first effective vaccine • Used cowpox to vaccinate against smallpox Ignaz Semmelweis (1818–1865) and Oliver Wendell Holmes (1809– 1894) • Promoted handwashing as a means of reducing the spread of puerperal fever to women in childbirth © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d History of Infectious Disease Prevention 32-7 (cont.) Scientist Contribution Louis Pasteur (1822–1895) • Helped develop the germ theory of infectious disease, stating that disease is caused by microorganisms Joseph Lister (1827–1912) • • Helped develop germ theory Introduced aseptic techniques through the use of antiseptics on wounds, surgical sites, and surgical instruments © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d History of Infectious Disease Prevention 32-8 (cont.) Scientist Contribution Robert Koch (1843–1910) • Developed a set of proofs, known as Koch’s postulates, claiming that microbes cause disease Sir Alexander Fleming (1881–1955) • Discovered penicillin © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d History of Infectious Disease Prevention 32-9 (cont.) • Remarkable advances in the past century • Threat of infection still present – New infectious diseases • AIDS • Ebola – Resistant diseases • MRSA • VRSA • Multidrug-resistant TB © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-10 Apply Your Knowledge Why is the threat of infection still present even though great advances have been made in controlling infections over the past century? ANSWER: The threat of infection is still present because of new diseases and diseases that have become resistant to treatments © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-55 Apply Your Knowledge What is the difference between active and passive immunity? ANSWER: Active immunity is long-term immunity in which the body produces its own antibodies Passive immunity results when antibodies produced outside the body enter the body Both can be natural or artificial Impressive! © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-56 Cycle of Infection • A reservoir host – animal, insect, or human body capable of sustaining pathogen growth – Carrier – unaware of presence of pathogen – Subclinical case – unnoticeable infection – Endogenous infection – normally harmless microorganisms become pathogenic – Exogenous infection – pathogen introduced into the body Click for Cycle of Infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-57 Cycle of Infection (cont.) • Means of exit – how the pathogen leaves the host – Nose, mouth, eyes, or ears – Feces or urine – Semen, vaginal fluid, or other reproductive discharge – Blood or blood products Click for Cycle of Infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-58 Cycle of Infection (cont.) • Means of transmission – how a pathogen spreads to a host – – – – – – Touching Airborne • Direct Blood-borne • Indirect through During pregnancy or birth fomites Foodborne – Inanimate reservoir of pathogens Vector-borne • Living organism that carries microorganisms to another person – Drinking glass, door knob, etc Click for Cycle of Infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-59 Cycle of Infection (cont.) • Means of entrance – Enter through any cavity lined with mucous membrane • Mouth, nose, vagina, rectum • Ears, eyes, intestinal tract, urinary tract, reproductive tract, breaks in the skin Click for Cycle of Infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-60 Cycle of Infection (cont.) Susceptible host Individual with little or no immunity to infection by a pathogen Host factors influencing susceptibility Age Genetic predisposition Nutritional status Other disease processes Stress levels Hygiene habits General health – Pathogen factors • Number and concentration • Virulence • Point of entry Click for Cycle of Infection © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-61 Cycle of Infection (cont.) Back © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-62 Cycle of Infection (cont.) • Environmental factors – Dense populations – Animals – unpasteurized milk – Insects – Economic and political factors – Availability of transportation – Population growth rates – Sexual behavior © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-63 Breaking the Cycle • Asepsis – condition in which pathogens are absent or controlled Maintain strict housekeeping standards Adhere to government guidelines to protect against disease Educate patients in hygiene, health promotion, and disease prevention © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-64 Apply Your Knowledge What are fomites? ANSWER: Fomites are inanimate objects such as clothing, water, and food that serve as a means of transportation for microorganisms Nice Job! © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-65 In Summary 32.1 Infection control has been a problem throughout history Though there have been many advances, controlling infection continues to be a challenge for doctors 32.2 There is great variety in the types of pathogenic organisms Types of potentially infectious microorganisms include prions, viruses, bacteria, protozoans, fungi, and helminths © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-66 In Summary (cont.) 32.3 It is important to be familiar with the diseases that infect people so that you can protect your patients, coworkers, and yourself These diseases include but are not limited to chickenpox, croup, diphtheria, hepatitis, influenza, measles, mumps, and polio 32.4 Antibiotic resistance of microbial pathogens is a growing problem The number of infections for which there is little or no treatment is increasing It is the responsibility of health-care workers to use antibiotics wisely © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-67 In Summary (cont.) 32.5 The CDC began a campaign to prevent antimicrobial resistance There are four strategies outlined in the campaign: 1) prevent infection; 2) diagnose and treat infection appropriately; 3) use antibiotics carefully; and 4) prevent transmission of infections 32.6 There are numerous human pathogens These pathogens cause disease by damaging the body in a number of ways including depleting nutrients needed by cells, reproducing themselves within body cells, making body cells the targets of the body’s own defenses, and producing toxins that damage cells and tissues © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-68 In Summary (cont.) 32.7 The body is able to protect itself from disease through the use of several lines of defense These lines of defense may be nonspecific or specific 32.8 In order for an infection to occur, five elements must be in place There must be a reservoir host, a means of exit, a means of transmission, a means of entrance, and a susceptible host 32.9 Direct disease transmission occurs when the pathogen moves immediately from one host to another Indirect transmission is possible only if the pathogen is able to survive outside the host for some period of time © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32-69 End of Chapter 32 In today's world, new infections and diseases can spread across the country and even across the world in a matter of days, or even hours, making early detection critical ~ John Linder Member of the U.S House of Representatives, © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d [...]... after apparent recovery from strep throat – Autoimmune disorder – antibodies to streptococci cross-react with heart tissues – Symptoms – carditis, ECG changes, joint pain and inflammation, fever • Acute post-streptococcal glomerulonephritis – Inflammation of glomerulus of the kidney resulting in inadequate filtering of the blood – Symptoms – swelling of hands and feet, decreased urine output, hypertension,... Incidence – higher in urban centers • Transmission – Mycobacterium tuberculosis – Droplet © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 35 Infectious Diseases (cont.) Tuberculosis (cont.) • Increasing resistance to TB – Early diagnosis, prompt treatment – Compliance with treatment regimen • Preventing TB – Vaccination – BCG (not used in the U.S.) – Causes false-positive with TB skin... ll rights reserv e d 32- 26 Infectious Diseases (cont.) Meningitis • Inflammation and infection of protective coverings of brain and spinal cord and the fluids around them • Viral – milder form – Clears in 1 to 2 weeks without treatment – Aseptic meningitis © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 27 Infectious Diseases (cont.) Meningitis • Bacterial – serious, life-threatening,... of throat – Sore throat, swelling of pharyngeal mucosa, fever, headache, nausea, abdominal pain – Treat with antibiotics • Scarlet fever – Bacteria becomes systemic – Characteristic “strawberry rash” – Incubation 7 to 10 days – Isolate 7 days © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 32 Infectious Diseases (cont.) Streptococcal pharyngitis (cont.) • Rheumatic fever – Occurs... rights reserv e d 32- 36 Infectious Diseases (cont.) Tuberculosis (cont.) • Treating TB – Mantoux TB test • Positive test = Induration – skin turns red and becomes raised and hard • Positive result from immunization or exposure to TB bacteria – Treatment based on area affected and type of TB involved – Patients must complete entire course of treatment – 12 to 18 months on medication – Isolation © 2011... rights reserv e d 32- 24 Infectious Diseases (cont.) Influenza (Flu) • Symptoms – fever, chills, headaches, body aches, upper respiratory congestion • Isolation and commonsense precautions • Vaccines – Live, attenuated virus – nasal spray – Inactivated virus – IM injection • Annual vaccination – People at risk for complications • People older than 50 years old • People in close contact with persons at... immediate treatment – Vaccination available for people in high-risk groups – Symptoms – red, blotchy rash, confusion, delirium, light sensitivity, headache, fever and chills, nausea and vomiting, sleepiness, stiff neck – May spread through exchange of respiratory and throat secretions – Reportable to state or county health dept © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 28 Infectious.. .32- 11 Microorganisms and Disease • Microorganisms live all around us • Pathogens – Microorganisms capable of causing disease – Evade host defenses • People avoid infections most of the time – Many microorganisms are beneficial or harmless – Normal defenses resist infection – Conditions are not favorable for pathogens to grow and be transmitted © 2011 The McGraw... scabbed over • 1996 – live vaccine approved © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 18 Infectious Diseases (cont.) Common cold • • • Viral infections of upper respiratory tract No isolation needed Commonsense precautions to prevent spread – – – • Use tissues when coughing or sneezing Wash hands frequently Use disposable dishware, if possible Incubation – 2 to 3 days © 2011... reserv e d 32- 28 Infectious Diseases (cont.) Mumps • Viral infection – Primarily affects salivary glands • Incubation – 2 to 3 weeks • Pain related to inflammation of parotid gland and fever • Isolate until glandular swelling stops • Reportable to state or county health dept © 2011 The McGraw -Hill Com panies, Inc A ll rights reserv e d 32- 29 Infectious Diseases (cont.) Pertussis (Whooping Cough) • Highly