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Infection Control

Host

Host infection dependent upon:

Virulence of the organism

Resistance of the host

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Infection Control

Host

Increased susceptibility:

Diabetes mellitus

Lymphoma

Leukemia

Neoplasia Those treated with:

Corticosteroids, irradiation, certain antimicrobials,

immunosuppressive agents

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Infection Control

Host

Increased susceptibility:

Age

Chronic disease

Shock

Coma

Traumatic injury

Surgical procedure

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Infection Control

Host Most nosocomial pneumonias occur in surgical patients,

especially those who have had chest or abdomen procedures

Clearance mechanisms impaired Bacterial enters lower airway

Intubation

Anesthesia Surgical pain

Narcotics and sedatives

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Infection Control

Host

Surgical Patients with Highest Risk of Pneumonia

Elderly

Severely obese

COPD

History of smoking

Those with artificial airways

Endotracheal / Tracheostomy tubes

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Infection Control

Infection Control Strategies

Infection control aims to break the chain of events

causing the spread of infection

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Infection Control

Infection Control Strategies

1. Decrease host susceptibility

2. Eliminate the source of pathogens

3. Interrupt the transmission routes

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Infection Control

Decrease host susceptibility

Hospital efforts focus on employee

immunization and chemoprophylaxis

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Infection Control

Decrease host susceptibility

Immunizations

Hepatitis B

Varicella (chicken pox)

Rubella (German measles)

Measles

Pertussis (Whooping cough) When working with infants and children

Influenza

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Infection Control

Decrease host susceptibility

Chemoprophylaxis Postexposure Treatment

Bordetella pertussis (whooping cough)

Neisseria meningitis (meningococcal meningitis)

Bacillus anthracis (anthrax)

Influenza virus

HIV

Group A streptococci

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Infection Control

Eliminating Source of Pathogens

Procedure to remove pathogens from the

environment fall into two major categories

General Sanitation

Specialized Equipment Processing

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Infection Control

Eliminating Source of Pathogens

General Sanitation

Help keep overall environment clean Sanitary laundry management

Sanitary food preparation

Sanitary housekeeping

Environmental control of the air

Specialized ventilation systems

Environmental control of the water

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Infection Control

Eliminating Source of Pathogens

Specialized equipment handling Decontamination of equipment capable of spreading

infection

Cleaning

Disinfection Sterilization

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Infection Control

Specialized Equipment Handling

Cleaning

Removes dirt and organic material from equipment,

usually by washing

Failure to do this will render subsequent processing

ineffective !!!

Should be done in a designated Dirty area

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Infection Control

Specialized EquipmentHandling

Cleaning

Soaps, detergents, orenzymatic cleaners should beused

Some contain germicide

Automated washersavailable

(pasteurization / chemicaldisinfection cycle)

Must be rinsed and dried

Reassembled aseptically

Designated Clean area

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Infection Control

Specialized Equipment Handling

Disinfection

Destroys the vegetative form of pathogens on inanimate

objects except bacterial spores

Physical methods

Chemical methods

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Infection Control

Specialized Equipment Handling

Physical Disinfection

Pasteurization Submersion in a water bath

at temperatures below

boiling (70 C) for 30

minutes

Kills vegetative bacteria and

most viruses

Does not kill bacteria spores

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Infection Control

Specialized Equipment Handling

Chemical Disinfection

Low-Level

Intermediate

High-Level

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Infection Control

Specialized Equipment Handling

Low-Level Disinfectants

Kills most bacterial, some viruses and fungi

Will not kill Mycobacterium tuberculosis (TB) spores andnonlipid virus

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Infection Control

Specialized Equipment Handling

Low-Level Disinfectants

Acetic acid

Mostly used for homecare equipment

(1:3 white vinegar/water solution )

Quaternary ammoniums

Hospital usesurface disinfection, e.g., floors, countertops,walls, etc.

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Infection Control

Specialized Equipment Handling Intermediate Disinfectants

Kills all vegetative bacteria and fungi, but have variable

activity against spores and certain viruses

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Infection Control

Specialized Equipment Handling

Intermediate Disinfectants

Alcohol (70% Ethyl, 90% Isopropyl)

Not sporicidal

Surface disinfectant, e.g., stethoscopes, ventilators, etc.

Phenolics

Not sporicidal Surface disinfectant

(added to detergents to enhance germicidal activity)

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Infection Control

Specialized Equipment Handling

Intermediate Disinfectants

Iodophors (iodine + surace-active organic compounds)

Used on skin and tissue

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Infection Control

Specialized Equipment Handling

High-Level Disinfectants

Glutaraldehyde

Hydrogen peroxide

Peracetic acid

Chlorine (sodium hypochlorite)

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Infection Control

Specialized Equipment Handling

High-Level Disinfectants

Glutaraldehyde (Trade name: CIDEX)

Kills vegetative bacteria, Mycobacterium turburculosis, fungi,viruses and spores in

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Infection Control

Specialized Equipment Handling

High-Level Disinfectants

Hydrogen Peroxide

6% solution is bactericidal, fungicidal, viricidal in 10 minutes,

Sterilizes (sporicidal) in 6 hours

Does not produce harsh fumes

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Infection Control

Specialized Equipment Handling High-Level Disinfectants

Peracetic acid

Kills all microorganisms, including spores

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Infection Control

Specialized Equipment Handling High-Level Disinfectants

Sodium Hypochlorite

1:50 dilution kills vegetative bacteria, bacterial spores, and

Mycobacterium tuberculosis in 10 minutes

1:10 dilution used to clean blood spills

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Infection Control

Specialized Equipment Handling

Sterilization

Complete destruction of all forms of microbial life

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Infection Control

Specialized Equipment Handling

Sterilization Incineration

Dry heat

Boiling

Autoclaving

Ionizing radiation

Ethylene oxide

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Infection Control

Specialized Equipment Handling

Steam Sterilization (Autoclaving)

Steam under pressure Commonly 15 psi at 121 C for 15 minutes

Equipment must be cleaned and wrapped in muslin, linen, or

paper Most respiratory equipment can be damaged by this process

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Infection Control

Specialized Equipment Handling

Ethylene Oxide (EtO)

Toxic gas

Equipment must be cleaned and wrapped in muslin, paper, orpolyethylene using EtO indicator tape

Acute exposure may cause:

Airway inflammation

Nausea

Diarrhea

Headache

Dizziness

Convulsion

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Infection Control

Specialized Equipment Handling

Equipment Handling Procedure

Equipment handling procedures help prevent thespread of pathogens

Will be covered in Lab

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