Asepsis

• Most microorganisms are harmless, and some are even beneficial in

that they perform essential functions in the body. Some
microorganisms found in the intestines (e.g., enterobacteria) produce
substances called bacteriocins, which are lethal to related strains of
bacteria.
• Some microorganisms are normal resident flora (the collective
vegetation in a given area) in one part of the body, yet produce
infection in another. For example, Escherichia coli, commonly referred
to as E. coli, is a normal tine but a common cause of infection of the
urinary tract
• An infection is the growth of microorganisms in body tissue where
they are not usually found. Such a microorganism is called an
infectious agent.
• If the microorganism produces no clinical evidence of disease, the
infection is called asymptomatic or subclinical
• A detectable alteration in normal tissue function, however, is called
disease. Microorganisms vary in their virulence (i.e., their ability to
produce disease). Microorganisms also vary in the severity of the
diseases they produce and their degree of communicability
• Asepsis is the freedom from disease-causing microorganisms. To
decrease the possibility of transferring microorganisms from one
place to another, aseptic technique is used
 Two Basic types of Asepsis

• 1. . Medical asepsis includes all practices intended to confine a

specific microorganism to a specific area, limiting the number, growth,
and transmission of microorganisms. In medical asepsis, objects are
referred to as clean, which means the absence of almost all
microorganisms, or dirty (soiled, contaminated), which means likely
to have microorganisms, some of which may be capable of causing
infection
• 2. Surgical asepsis, or sterile technique, refers to those practices that
keep an area or object free of all microorganisms; it includes practices
that destroy all microorganisms and spores (microscopic dormant
structures formed by some pathogens that are very hardy and often
survive common cleaning techniques). Surgical asepsis is used for all
procedures involving the sterile areas of the body. Sepsis is the
condition in which acute organ dysfunction occurs secondary to
infection.
 TYPES OF MICROORGANISMS THAT
CAUSE INFECTIONS

• Bacteria are by far the most common infection-causing

microorganisms. Several hundred species can cause disease in
humans and can live and be transported through air, water, food, soil,
body tissues and fluids, and inanimate objects.
• Viruses consist primarily of nucleic acid and therefore must enter
living cells in order to reproduce. Common virus families include the
rhinovirus (causes the common cold), hepatitis, herpes, and human
immunodeficiency virus.
• Fungi include yeasts and molds. Candida albicans is a yeast
considered to be normal flora in the human vagina.
• Parasites live on other living organisms. They include protozoa such as
the one that causes malaria, helminths (worms), and arthropods
(mites, fleas, ticks).
 TYPES OF INFECTIONS

• Colonization is the process by which strains of microorganisms

become resident flora. In this state, the microorganisms may grow
and multiply but do not cause disease. Infection occurs when newly
introduced or resident microorganisms succeed in invading a part of
the body where the host’s defense mechanisms are ineffective and
the pathogen causes tissue damage. The infection becomes a disease
when the signs and symptoms of the infection are unique and can be
differentiated from other conditions.
• A local infection is limited to the specific part of the body where the
microorganisms remain.

• If the microorganisms spread and damage different parts of the body,

the infection is a systemic infection.
• When a culture of the person’s blood reveals microorganisms, the
condition is called bacteremia.

• When bacteremia results in systemic infection, it is referred to as

septicemia. Unfortunately, septicemia has become more common
over time.
 Acute and Chronic Infections

• Acute infections generally appear suddenly or last a short time

• A chronic infection may occur slowly, over a very long period, and
may last months or years.
 NOSOCOMIAL AND HEALTH CARE–
ASSOCIATED INFECTIONS

• Nosocomial infections are classified as infections that originate in the

hospital. Nosocomial infections can either develop during a client’s
stay in a facility or manifest after discharge. Nosocomial
microorganisms may also be acquired by personnel working in the
facility and can cause significant illness and time lost from work.
• Health care–Associated nfections (HAIs)—those that originate in any
health care setting
• The microorganisms that cause nosocomial infections can originate
from the clients themselves (an endogenous source) or from the
hospital environment and hospital personnel (exogenous sources)
• A number of factors contribute to nosocomial infections. Iatrogenic
infections are the direct result of diagnostic or therapeutic
procedures
 CHAIN OF INFECTION

Etiologic Agent
The extent to which any microorganism is capable of producing an
infectious process depends on the number of microorganisms present,
the virulence and potency of the microorganisms (pathogenicity), the
ability of the microorganisms to enter the body, the susceptibility of the
host, and the ability of the microorganisms to live in the host’s body
Reservoir
There are many reservoirs, or sources of microorganisms. Common
sources are other humans, the client’s own microorganisms, plants,
animals, or the general environment. People are the most common
source of infection for others and for themselves. For example, the
person with an influenza virus frequently spreads it to others. A carrier
is a person or animal reservoir of a specific infectious agent that usually
does not manifest any clinical signs of disease.
Portal of Exit from Reservoir
Before an infection can establish itself in a host, the microorganisms
must leave the reservoir.
Method of Transmission
After a microorganism leaves its source or reservoir, it requires a means
of transmission to reach another person or host through a receptive
portal of entry. There are three mechanisms:
1. Direct transmission.
Direct transmission involves immediate and direct transfer of
microorganisms from person to person through touching, biting,
kissing, or sexual intercourse. Droplet spread is also a form of direct
transmission but can occur only if the source and the host are within 1
m (3 ft) of each other. Sneezing, coughing, spitting, singing, or talking
can project droplet spray into the conjunctiva or onto the mucous
membranes of the eye, nose, or mouth of another person.
2. Indirect transmission.
Indirect transmission may be either vehicle borne or vector borne:
a. Vehicle-borne transmission. A vehicle is any substance that serves as
an intermediate means to transport and introduce an infectious agent
into a susceptible host through a suitable portal of entry. Fomites
(inanimate materials or objects), such as handkerchiefs, toys, soiled
clothes, cooking or eating utensils, and surgical instruments or
dressings, can act as vehicles.
b. Vector-borne transmission. A vector is an animal or flying or
crawling insect that serves as an intermediate means of transporting
the infectious agent. Transmission may occur by injecting salivary fluid
during biting or by depositing feces or other materials on the skin
through the bite wound or a traumatized skin area.
3. Airborne transmission.
Airborne transmission may involve droplets or dust. Droplet nuclei, the
residue of evaporated droplets emitted by an infected host such as
someone with tuberculosis, can remain in the air for long periods. Dust
particles containing the infectious agent (e.g., C. difficile, spores from
the soil) can also become airborne. The material is transmitted by air
currents to a suitable portal of entry, usually the respiratory tract, of
another person
Portal of Entry to the Susceptible Host
Before a person can become infected, microorganisms must enter the
body. The skin is a barrier to infectious agents; however, any break in
the skin can readily serve as a portal of entry. Often, microorganisms
enter the body of the host by the same route they used to leave the
source
Susceptible Host
A susceptible host is any person who is at risk for infection. A
compromised host is a person at increased risk, an individual who for
one or more reasons is more likely than others to acquire an infection.
Impairment of the body’s natural defenses and a number of other
factors can affect susceptibility to infection. Examples include age (the
very young or the very old); clients receiving immune suppression
treatment for cancer, for chronic illness, or following a successful organ
transplant; and those with immune deficiency conditions.