Chapter 29: Infection Prevention and control

CHAIN OF INFECTION
INFECTIOUS AGENT
- Resident flora = permanent residents of skin and within body where they survive
and multiply without causing illne=ss
o Not virulent
- Transient microorganisms = attach to skin when a person has contact with another
person or object during normal activities
o Readily transmitted unless removed using hand hygiene
RESERVOIR
- Human reservoirs = acute or symptomatic; and those who show no signs of disease
but are carriers of it
- Spore = bacteria that is resistant to drying and can live on inanimate surfaces for
long periods of time
o C. DIFF = causes antiobiotic inducing diarrhea
- Bacteriostasis = preventing the growth and reproduction of bacteria
o Cold temperature
- Bactericidal = temperature or chemical that destroys a bacteria
MODES OF TRANSMISSION
- HAND HYGIENE = INTERRUPTING MODE OF TRANSMISSION
- Contact
o Direct: person-to-personal (fecal,oral)
o Indirect: personal contact of susceptible host with contaminated inanimate
object
o Droplet: large particles that travel up to 3 feet during coughing, sneezing or
talking
o Airborne: droplet nuclei or residue or evaporated droplets suspended in air
during coughing or sneezing or carried on dust particles
o Vehicles: contaminated items, water, drugs/solutions/blood/food
o Vector: bugs
INFECTIOUS PROCESS
- Incubation stage: period between entrance of pathogens and appearance of first
symptoms
- Prodromal stage: interval from onset of nonspecific signs and symptos to more
specific (microorganisms grow and multiply and patient may be capable of spreading
disease to others)
- Illness stage: patient manifests signs and symptoms specific to type of infection
- Convalescence: acute symptoms of infection disappear

NORMAL FLORA
- Use of broad spectrum antibiotics for treatment of infection can lead to
Suprainfection
 - Develops when they eliminate a wide range of normal flora, not just the ones
causing infection
- Normal bacterial floras are eliminated = body defenses reduced = allows disease
producing microorganisms to multiply causing illness

HAI
- Health care associated infections result from the delivery of health services in a
health crea facility
- Occur as the result of invasive procedures, antibiotic administration, the presence of
multidrug resistant organisms, and breaks in infection prevention and control
activities
- Major sites for HAIs = surgical or traumatic wounds, urinary and respiratory tracts
and bloodstream
- Exogenous infection = comes from microorganisms found outside the individual.
o Do not exist as normal floras
- Endogenous infection = part of patient’s flora becomes altered and an overgrowth
results
o Often happens when a patient receives broad-spectrum antibiotics that alter
normal floras
o Sufficient numbers of microorganisms normally found in one body site move
to another site
- Iatrogenic infections = caused by an invasive diagnostic or therapeutic procedure
o Use aseptic techniques

Systemic infections = cause more generalized symptoms than local

Fever, fatigue, nausea vomiting and malaise
Lympho nodes enlarged

Asepsis: abesnece of pathogenic microorganisms

Medical asepsis: basic. Breaks chain of infection. Use for ALL patients even when no infection is
diagnosed.
- Hand hygiene, barrier techniques and routine environmental cleaning

Cleaning = removal of organic material = blood or inorganic = soil from objects and surfaces
- Involve water, detergent/disinfectant and proper mechanical scrubbing
- Occurs before disinfection and sterilization
- PPE (face shiel/eyewear and dishwashing style gloves)
- Brush and detergent or soap are necessary
- Rinse contaminated object with cold water to remove organic material
- After rinsing, wash with soap and warm water
- Use brush to remove dirt or material in grooves and seams
 - Rinse in warm water
- Dry object and prepare for disinfection or sterilization

Disinfection = eliminates many or all microorganisms with exception of bacterial spores from
inanimate objects
- Disinfection of surfaces
- High level disinfection which is required for some patient care items like endoscopes
Sterilization = eliminates or destroys all forms of microbial life including spores
- Using steam, dry heat, hydrogen peroxide plasma, or ETO

Surgical asepsis = mask, eyewear cap, surgical hand scrub, steril gown and gloves