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Chapter 22

This chapter explores the impact of infectious diseases and the importance of infection control in preventing their spread. It covers topics such as the discovery of germ theory, pharmacologic agents like antibiotics and vaccines, and the process of infection. It also discusses the body's defense mechanisms against infection, stages of infectious diseases, and reporting and surveillance of infectious diseases.

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Chapter 22

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  1. Chapter 22 Infection Control and Medical Asepsis

  2. Impact of Infectious Diseases • Discovery of germ theory: Louis Pasteur and Robert Koch • Pharmacologic agents: antibiotics and vaccines • Edward Jenner: smallpox vaccine • Epidemiology: history, cause, patterns of infectious diseases

  3. Impact of Infectious Diseases • Infection control and prevention • Resistant microorganisms • Bloodborne pathogen transmission • Increased immunosuppressed populations • Global access • Effect infectious diseases have on lifestyles

  4. The Process of Infection • Caused by pathogenic microorganisms capable of causing disease • Normal flora • Similar steps occur in all infectious diseases • MAs must apply theory of disease growth and transmission

  5. The Process of Infection • Growth requirements for microorganisms • Oxygen • Lack of or no oxygen • Moisture • Nutrition • Temperature • Darkness • Time • Neutral or slightly alkaline pH

  6. Infection Cycle • Infectious agent • Reservoir • Portal of exit • Means of transmission • Portal of entry • Susceptible host

  7. Infection Cycle • Infectious agents • Viruses • Bacteria • Fungi • Parasites • Rickettsia • Prions

  8. Infection Cycle • Reservoir • Source of a pathogen • Portal of exit • Method by which infectious agent leaves reservoir

  9. Infection Cycle • Modes of transmission • Direct contact • Droplet • Airborne • Vector • Portal of entry • Enter susceptible host

  10. Infection Cycle • Susceptible host • Number and specific type of pathogen • Duration of exposure to pathogen • General physical condition • Psychological health status • Occupation or lifestyle environment • Presence of underlying diseases or conditions • Youth or advanced age

  11. Infection Cycle • Susceptible host • Nosocomial infection or healthcare-associated infections (HAI) • Rise of antibiotic resistant bacteria

  12. The Body’s Defense Mechanisms for Fighting Infection and Disease • The body’s natural barriers • Physical • First line of defense • Skin and associated accessories • Chemical • Tears, sweat, mucus, saliva, gastrointestinal secretions, vaginal secretions • Cellular • White blood cells

  13. The Body’s Defense Mechanisms for Fighting Infection and Disease • Inflammatory response • Response when body invaded by pathogen or physical trauma • Nonspecific response • Redness, heat, swelling, pain • Antibiotic therapy

  14. The Body’s Defense Mechanisms for Fighting Infection and Disease • The immune system and immunity • Protect against pathogens and abnormal cell growth • Cell-mediated immunity: attacks against viruses, fungi, organ transplants, cancer cells • Humoral immunity: antibody mediated system

  15. The Body’s Defense Mechanisms for Fighting Infection and Disease • The immune system and immunity • Recognition of invader • Growth of defenses; multiplication of helper T cells and B cells • Attack against infection • Slowdown of immune response after death of infectious agent

  16. The Body’s Defense Mechanisms for Fighting Infection and Disease • The immune system and immunity • Resistance: after exposure to pathogen; antigen–antibody reaction • Naturally acquired active immunity • Artificially acquired active immunity • Congenitally acquired passive immunity • Artificially acquired passive immunity

  17. The Body’s Defense Mechanisms for Fighting Infection and Disease • The immune system and immunity • Specific defenses: things that protect us against specific pathogen • Nonspecific defenses: not so particular • Immunization: provides immunity with active or passive vaccines • Live attenuated (changed) pathogens • Pathogenic toxins • Killed pathogens

  18. Stages of Infectious Diseases • Incubation • Prodromal • Acute • Acme • Declining • Convalescent • Sequelae

  19. Disease Transmission • Consider each patient potentially infectious for AIDS, hepatitis B and C, other bloodborne pathogens • Apply techniques of Standard Precautions

  20. HIV and Hepatitis B and C • HIV and AIDS • AIDS caused by bloodborne virus HIV • HIV responsible for T-cell destruction • Carried in semen, blood, other body fluids • No curative treatment of HIV infections • Antiviral drugs used to slow process

  21. HIV and Hepatitis B and C • Acute viral hepatitis diseases • Liver inflamed; hepatic cells destroyed • Several types of viral hepatitis • Risk for contracting HBV and HCV greater than for contracting HIV • No vaccine to prevent HCV • No treatment after exposure to prevent infection • Medication:immunomodulators

  22. Reporting Infectious Disease • Certain infectious diseases must be reported to state and county health departments • CDC requires information reported to them • Notifiable Disease Surveillance System • Helps CDC control spread of infection

  23. Standard Precautions • Blood and body fluids • Blood, secretions, excretions • Personal protective equipment • Gloves, mask, gown, goggles/face shield • Needlestick • Contaminated needles never recapped, broken off, removed from syringes, manipulated • Disposed of in approved puncture-proof container designated for sharps

  24. Standard Precautions • Blood • All body fluids, secretions, excretions regardless of whether they contain visible blood • Nonintact skin • Mucous membranes Personal protective equipment (PPE) >>

  25. Standard Precautions • Transmission-based precautions • Airborne, contact, droplet precautions • Use of barriers (gown, mask, goggles, gloves, cap) Biohazard puncture-proof sharps container>>

  26. Standard Precautions • Disposal of infectious waste • Items in contact with patient blood or body fluids • Place in appropriate biohazard containers • Incinerated (burned) or sterilization by autoclave

  27. Removing Contaminated Gloves

  28. Standard Precautions • Federal organizations and infection control • CDC: studies pathogens and diseases • Standard Precautions • Transmission-Based Precautions • Guideline for Isolation Precautions • Personal protective equipment (PPE) • Respiratory hygiene/cough etiquette

  29. OSHA Regulations • The Bloodborne Pathogen Standard • Methods of compliance to prevent exposure • Universal Precautions • Engineering and work practice controls • Personal protective equipment (PPE) • Cleanliness of work areas • Hepatitis B vaccine • Follow-up after exposure • Medical records

  30. OSHA Regulations • Please refer to the video library on the Instructor Resources CD to view video “OSHA Guidelines.”

  31. OSHA Regulations and Students • Students with potential exposure to chemicals and bloodborne pathogens should follow OSHA safety procedures • Students do not fall under OSHA guidelines • Potential increases when invasive procedures performed

  32. Medical Asepsis • Hand washing • Cleaning and disinfecting contaminated surfaces • Standard and Transmission-Based Precautions

  33. Medical Asepsis • Disinfection • Sterilization Medical assistant sanitizing instrument>>

  34. Bioterrorism • Use of biologic weapons (pathogenic microorganisms) to create fear • Agents can spread through air, food, water • Can be very difficult to detect and difficult to protect against • Most dangerous: anthrax, botulism, pneumonic/bubonic plague, smallpox, tularemia

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