MIDTERM EXAM

COVERAGE
1. MEDICAL AND SURGICAL ASEPSIS
2. PHYSICAL AND CHEMICAL METHODS
OF STERILIZATION
3. ANTIMICROBIAL AGENTS
 TOPIC 1.
MEDICAL AND SURGICAL ASEPSIS
Terminologies Related to Chain of Infection
 1.Chain of infection – how an individual acquires the
infectious agents and includes the infectious agent,
the source of infection or its reservoir, how the
organism is transmitted, and the organism’s portal of
entry into the susceptible host.
 2. Mode of transmission – the manner in which the
infectious organism is acquired by the host.
 3. Standard precautions – the specific measures used
to prevent the spread of infection among all patients
and healthcare workers, including measures to
protect them from contaminated blood and other
body fluids
Terminologies Related to Chain of Infection
 4. Contamination– denotes contact of a sterile or aseptic item
with microorganisms. Medically aseptic items become
contaminated if they get in contact with disease producing
organisms. Sterile items become contaminated if they get in
contact with items that are not sterile.
 5. Decontamination– the process where physical or chemical
means are used to remove, inactivate, or destroy pathogens on
a surface or item making them safe for handling or use and
incapable of transmitting infectious agents.
 6. Disinfection – the process of using physical or chemical
means to destroy pathogens, excluding the spores.
Terminologies Related to Chain of Infection
 7. Sterilization– the process by which all pathogens are
destroyed, including the spores.
 8. Antiseptic– a chemical solution that inhibits the growth
of some microorganisms. Most antiseptics can be used
directly on the skin (e.g., alcohol and iodine).
 9. Healthcare associated infection – any infection that is
acquired during the time a patient is admitted in a
healthcare facility. The most common healthcare
associated infection is the urinary tract infection (UTI).
Terminologies Related to Chain of Infection
 10. Iatrogenic infection – infection that is acquired in the
course of undergoing diagnostic tests or therapeutic
procedures.
 11. Occupational exposure – the acquisition or exposure to
an infectious agent of a healthcare worker during the
course of his/her work.
 12. Personal protective equipment(PPE) – specialized
equipment and attire used by healthcare workers to
protect them from infections. These include gloves, masks,
gowns, and goggles.
Sepsis VS. Asepsis
 Sepsis - is a clinical condition where infectious
agents are spread throughout the body of an
individual from a localized site of infection and
manifest with symptoms of organ damage.
 Asepsis- is the absence of disease producing
organisms and is divided into medical asepsis and
surgical asepsis.
Medical Asepsis vs Surgical Asepsis
 Medical asepsis - is aimed at reducing the number of
disease producing organisms to prevent its spread from
healthcare workers to the patients and vice versa.
 Handwashing
 Standard precautions
 Transmission based precautions
 PPE
 Surgical asepsis - is aimed at total elimination of disease
producing organisms particularly in areas in the body
where surgical procedures will be performed as well as the
location
where the surgical procedure will be carried out.
 Care of surgical wounds
 Surgery
 Catheter insertion
Handwashing vs PPE
 Handwashing - is the most basic and universally accepted
measure used to prevent the spread of infection. Routine
handwashing for at least 15 seconds with a 10 second rinse
is recommended.
 Personal protective equipment (PPE) - are specialized
equipment and attire used in healthcare facilities to
protect not only the healthcare workers but also the
patients and visitors against infections. These include
masks, gowns, and goggles.
Isolation Precautions
 1. Proper handwashing
 2. Use of Personal Protective Equipment
 3. Proper handling and disposal of secretions and
excretions
 4. Proper handling and disposal of soiled linen and
equipment
 5. Environmental control
 6. Prevention of injury from sharp devices
 7. Patient placement
Transmission based Precautions
 1. Contact Precautions – prevent the spread of infection
transmitted through touching of patients or items in the
room where infectious agent is present
 2. Droplet Precautions – prevent transmission of infections
spread in tiny droplets caused by coughing and sneezing.
 3. Airborne Precautions – prevent transmission of infections
spread through the air from one person to another.
Contact Precautions
 Diseases/Infections
 A- Abscess (Major drainage)
 B- Bronchiolitis (Parainfluenza)
 C- Cutaneous (Herpes zoster, Varicella, Impetigo)
 D- Diarrhea (Norovirus, Rotavirus, Hepatitis A)
 E- Eyes (Conjunctivitis)
 F- Funky/Feisty (MRSA and VRE)
Airborne Precautions
 Diseases/Infections
 M- Measles (Rubeola)
 T- Tuberculosis
 V- Varicella-zoster (Chickenpox, Shingles)
Droplet Precautions
 Diseases/Infections
 Mycoplasma Pneumonia  Parvovirus B19
 Pertussis (Whooping cough)  German measles
 Mumps  Adenovirus

 Influenza (Flu)  Pneumonia

 Diphtheria (Pharyngeal)  Epiglottitis

 Streptococcus (Pharyngitis,  Rhinovirus

Scarlet Fever)
 Meningitis (Neisseria)
 Plague (Pneumonic)
VLOG MAKING
 CREATE A 3-5 MINUTES MINI-VLOG WITH THE CONTENT OF
EDUCATING THE PUBLIC ABOUT INFECTIOUS DISEASES.
* MODES OF TRANSMISSION
* STEPS IN PREVENTING THE SPREAD OF INFECTIOUS
DISEASES
* IMPORTANCE OF PROPER HANDWASHING
* IMPORTANCE OF VACCINATION
 INDIVIDUAL OR BY PAIR
 LANGUAGE OF COMMUNICATION (ENGLISH, FILIPINO, OR
VERNACULAR)
 POST YOUR VLOG ON THE FB PAGE CREATED BY YOUR
INSTRUCTOR
 DEADLINE WILL BE ON APRIL 8, 2024 @ 11:59 PM
 SCORING RUBRICS
CRITERIA 20 POINTS 15 POINTS 10 POINTS 5 POINTS

Content Appropriate, engaging, Appropriate and Vlog and comments done, Vlog is not engaging,
Quality reflective and relevant respectful to others. but lacks engagement, irrelevant or difficult to
to the theme. Vlog is Vlog has a purpose analysis or may be off topic. follow in meaning.
reflective, make about the theme and is
connections beyond the reflective.
text.
Speech and Vlog has originality, Speech is fluent. Vlog Vlog may contain several Vlog may contain significant
Grammar emphasizing important may contain one or two errors in grammar. Speech errors in grammar, errors may
points; contains no errors in grammar. lack fluency cause confusion for the
errors in grammar. viewer. Speech is choppy.
Video Video is well lit and Video is well lit and Video is fairly well lit within Camera may be jerky, making
quality frames subject frames the subject minimal movement. Subject it difficult to view, poorly lit,
appropriately. Editing within the frame is usually within the frame. or subject not clearly in
enhances cohesiveness without excessive video.
of vlog. movement.
Sound Sound is clear and Vlog is understandable Vlog is somewhat difficult to Vlog is too difficult to hear or
Quality volume is appropriate. and volume is hear or is occasionally too is too loud.
appropriate. loud.
Engagement Vlog has gained more Vlog has gained many Vlog has gained little Vlog has gained no reactions
reactions. reactions. reactions. at all.
PHYSICAL AND CHEMICAL METHODS OF
STERILIZATION
PHYSICAL METHODS OF STERILIZATION

PHYSICAL STERILIZATION
Heat
Radiation
Filtration
PHYSICAL METHODS OF STERILIZATION (HEATING)
Factors that can affect the process of sterilization
through heating:
 Nature of the heat
 Temperature and time
 Number of microorganisms
 Nature of microorganisms
 Type of material
 Presence of organic material
Types of Heat
1. Moist Heat- its main mechanism of action is to
cause coagulation and denaturation of proteins.
Temperature below 100 degrees Temperature of 100 degrees Temperature above 100 degrees
Celcius Celcius Celcius
Pasteurization Boiling Autoclave (Steam under pressure)

Vaccine Bath Fractional sterilization

(Tyndallization)

Serum Bath

Inspissation
Types of Heat
2. Dry Heat- it is used to sterilize materials in enclosed
tubes, oils, jellies, powders, and glasswares such as
test tubes and Petri dishes.

Red Flame
Open Flame
Incineration
Hot air oven
Infrared rays
RADIATION
 UVLight/Non-ionizing  Ionizing Radiation
Radiation a. Electron Beams
b. Electromagnetic rays
(Gamma rays)
FILTRATION
 Itis used for liquid solutions that will be destroyed
by heat or freezing such as serum, antibiotic
solutions, or urea solution.
 This method can be used to remove bacteria from
culture media.
CHEMICAL METHODS OF STERILIZATION
CHEMICAL STERILIZATION
Alcohols
Aldehydes
Phenolics
Oxidizing agents
Quaternary ammonium compounds
Ethylene oxide gas
CHEMICAL METHODS OF STERILIZATION
Factors that can affect the efficacy of a
chemical agents.
1. Concentration and potency of the
chemical agent.
2. Duration of exposure
3. Temperature
4. Nature of surrounding medium
5. Nature of the organism
6. Number of organism
CHEMICAL METHODS OF STERILIZATION
Characteristics of a Good Chemical Agent
CHARACTERISTICS OF A GOOD CHEMICAL AGENT

1. It should be broad spectrum, able to 7. It should be soluble in water and easy to

destroy a wide variety of microorganisms. apply.

2. It should be fast acting, able to destroy 8. It should leave a residual antimicrobial

microbes within a short period of time. film on the treated surface.

3. It should be active in the presence of 9. It should have high penetrating power.

organic matter.

4. It should be active in any pH. 10. It should not expensive and must be
easily available.

5.It should be stable. 11. It should be safe under storage.

6. It should be non-toxic, non allergenic, 12. It should not have a bad odor.
non-irritative, and non-corrosive.
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Damage to the Cell Membrane
1. Surface active agents- compounds have
long chain hydrocarbons that are fat-
soluble and charged ions that are
water-soluble.
a. Cationic Agents- (cetrimide and
benzalkonium chloride)
b. Anionic Agents- (soaps and bile salts)
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Damage to the Cell Membrane
2. Phenolic compounds- these act by disrupting cell
membranes as well causing precipitation of proteins and
inactivation of enzymes.
a. Phenol
b. Cresols
c. Chlorhexidine
d. Chloroxylenols
e. Hexachlorophene
f. Triclosan
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Damage to the Cell Membrane
3. Alcohols – disorganize the lipid structure of the cell
membrane, dehydrate cells and cause denaturation and
coagulation of cellular proteins.
a. Ethyl alcohol
b. Isoprophyl alcohol
c. Benzyl alcohol
d. Methyl alcohol
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Denaturation of Cellular Proteins
Substances that can cause denaturation or loss the normal
structure of proteins.
Denaturing Agents:
a. acids and alkalis
b. alcohol and acetone
c. phenol and cresol
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Modification of the functional groups of proteins and nucleic acids.
1. Heavy Metals- cause damage to the enzyme activity of bacteria.

a. Mercurials – are biocidal and are used as antiseptics.

b. Silver Compound – are bactericidal.
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Modification of the functional groups of proteins and nucleic acids.
2. Halogens- bactericidal oxidizing agents that can cause oxidation
of essential sulfhydryl groups causing inactivation of the enzymes.
a. Iodine – considered as the best antiseptic.
b. Chlorine – mainly used in the treatment of water.
c. Hydrogen peroxide – weak antiseptic.
CLASSIFICATION OF CHEMICAL DISINFECTANTS
Modification of the functional groups of proteins and nucleic acids.
3. Alkylating Agents
1. Aldehydes- damage nucleic acids by alkylation of amino,
carboxyl, or hydroxyl groups.
a. Formaldehyde – used for surface disinfection.
b. Glutaraldehyde – sporicidal and used as a cold sterilant in
sterilizing medical equipment.
2. Ethylene oxide – also sporicidal and is used in the gaseous
sterilization of heat sensitive materials or
equipment.
ANTIMICROBIAL AGENTS
Antibiotics
Antibiotics or antimicrobial- are substances produced from
microorganism or synthetically that are capable of inhibiting or
destroying microorganisms even at low concentrations.
Antimicrobial Agent
IDEAL CHARACTERISTICS OF ANTIMICROBIAL AGENT
1. It should be able to kill the microbial agent or inhibit its growth.
2. It must have a broad spectrum of activity.
3. It should not cause any damage or adverse effect to the patient.
4. It should remain stable when stored in either solid or a liquid
form.
5. It should be able to remain in specific body tissues long enough
for it to be effective.

6. It should be able to kill the organism or inhibit its growth before

it had a chance to mutate and develop resistance.

7. It must exhibit selective toxicity.

Antimicrobials Classification
1. Based on the spectrum of activity
2. Based on their antimicrobial activity
3. Based on their absorbability from the
site of administration
4. Based on their mechanism of action
Antimicrobials Classification
1. Based on the spectrum of activity
a. Broad spectrum antibiotics – are those
wide coverage of activity against a
wide spectrum of
microorganisms.
b. Narrow spectrum antibiotics – are those
with a limited coverage of
activity.
Antimicrobials Classification
2. Based on their antimicrobial activity
a. Bactericidal– if it is capable of killing the
microorganism.
b. Bacteriostatic – if it can only inhibit the
growth of organism.
Antimicrobials Classification
3. Based on their absorbability from the site of
administration
a. Locally-acting antibiotic – one that limits its
action at the site where it is administered.
b. Systemically-acting antibiotic – one that affects
several body system.
Antimicrobials Classification
4. Based on their mechanism of action
a. Agents that inhibit the synthesis of the bacterial cell
wall.
b. Agents that alter the function or permeability of
the cell membrane.
c. Agents that inhibit protein synthesis
d. Agents that act on nucleic acid
e. Agents that interfere with bacterial metabolic
pathways.
Antimicrobials Classification
4-a . Agents that inhibit the synthesis of the bacterial cell wall.
1. Penicillin-binding protein
2. Glycopeptides
Antimicrobials Classification
4-b . Agents that alter the function or permeability of the cell
membrane.
1. Cationic
2. Anionic
3. Neutral agents
Antimicrobials Classification
4-c . Agents that inhibit protein synthesis
30S
1. Aminoglycosides
a. Spectinomycin
2. Tetracycline
50s
1. Chloramphenicol
2. Macrolides
3. Lincinoids
Antimicrobials Classification
4-d . Agents that act on nucleic acid
1. Agents that inhibit DNA topoisomerases
2. Agents that inhibit RNA synthesis
Antimicrobials Classification
4-e . Agents that inhibit microbial metabolic pathways
1. Trimethoprin
2. Sulfonamides
 “THE BEST METHOD OF INFECTION
CONTROL IS PREVENTION, WHICH IS
SUCCESSFUL WHEN THE CHAIN OF
INFECTION IS SUCCESSFULLY BROKEN”