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Copyright IAHCSMM 2007
Microbiology
ANES 1502Anesthesia Technology Fundamentals I
College of DuPage
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Objectives:As a result of successfully completing this chapter,
students will be able to:
Define the term, “microbiology,” and tell why Central Service Technicians must know about it.
Restate basic facts about microorganisms.
Identify common ways to identify and classify microorganisms:By shapeBy color changeBy need for oxygen
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Objectives: Explain environmental conditions necessary for
bacterial growth and summarize.
Provide basic information about non-bacterial organisms:Viruses ProtozoaFungi
Describe how microorganisms are transmitted between persons and places.
Review basic procedures to control and kill microorganisms.
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Microbiology
Impact on the Central Service Department.
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Central Service’s Primary Function
Infection Control
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Infection Control Services include:
Cleaning
Disinfection
Sterilization
Sterility Maintenance
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Central Service Protects patients from
harmful microorganisms.
Must understand basic microbiological principles to provide that protection.
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Worker Safety Central Service
Technicians must also have a basic understanding of microbiology to protect themselves from pathogens that may be present during their routine duties.
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Microbiology
The study of microorganisms. The science which treats the nature, life and action of
microorganisms.
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It is impossible to see microorganisms without a microscope.
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Central Service Technicians
Must learn to see microorganisms with their “mind’s eye”.
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Looking Through A Microscope:
A magnified picture of a contaminated needle illustrates what the naked eye cannot see.
Microorganisms can pose a threat to both patients and employees.
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Contamination
The state of being soiled or infected by contact with infectious
organisms or other material.
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To Effectively Control Microorganisms, Central Service Technicians must understand:
Basic facts about microorganisms.
How microorganisms are identified and classified.
How they grow.
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To Effectively Control Microorganisms, Central Service Technicians must understand:
What conditions they need to grow and reproduce.
How they are transmitted from person-to-person and place-to-place.
How they can be controlled and killed.
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Basic Facts About Microorganisms
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Not All Microorganisms are Harmful
Microorganisms are necessary for our existence.
Microorganisms help with: Food Development Decay of Leaves
and other natural waste
Sewage Treatment And more.
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Size and Structure of Bacteria
Most bacterial cells are 1-2 microns in size.
A micron is 1/25,000 of an inch.
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Cell Wall the structure that
surrounds the cell and helps it maintain
its shape.
Cell Membrane Allows some liquids and gasses
to seep in and out of the cell.
Cytoplasm -a generally clear jelly like
material that fills the cell. The cell's chemical reactions and
protein syntheses are carried out in the cytoplasm.
Nucleus the controlling unit of the cell.
It regulates growth, the use of food, and the production of new
cell components.
Flagella- thread like "tails" attached
to the cell that enable it to move through liquid.
Capsule A mucous material
that surrounds the wall of some cells and provides
protection.
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SporeA microorganism capable of forming a thick wall around itself that enables it to survive in adverse conditions; a resistant form of bacteria.
*Bacterial spores pose specific challenges to Central Service Technicians.
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More About Cells:
Cells are the basic units of all living organisms (plants, animals, and bacteria).
They are the smallest unit that can live, grow, and reproduce.
They have different sizes and shapes.
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Identification and Classification of
Microorganisms
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Common Way to Identify and Classify Microorganisms include:
Bacteria are often classified by their: Shape Color Change Need for Oxygen
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Classification by Shape
Bacteria are divided into 3 main groups by shape: Cocci are round or spherical shaped
and occur in pairs, clusters, or chains.
Rods (bacilli) may be large and brick-shaped or small and stick-like.
Spirals vary from comma-shaped to longer bacteria with many twists.
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Cocci (Round) Example: Staphylococcus aureus
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Bacillus (Rods)Example: Pseudomonas aeruginosa
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Spirillum (Spirals)Example: Helicobacter pylori
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Bacteria are Classified by Color Change
Bacteria are normally clear, color change occurs when bacteria are subjected to certain tests (stains).
Common Stain Tests Gram Stain Ziehl-Neilson Stain
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The Gram Stain
In 1884, Hans Christian Gram, a Danish doctor working in Berlin, developed a process to divide bacteria into two groups.
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Gram Stain Procedure
The Gram stain is the most commonly used differential stain for determining cell morphology. Differential stains allow for distinguishing certain characteristics of cells, and the stains commonly use two or more stains. The Gram stain, which divides most clinically significant bacteria into two main groups, is the first step in bacterial identification.
The Gram stain process: 1. crystal violet, the primary stain: followed by iodine,
which acts as a mordant by forming a crystal violet-iodine complex, then alcohol, which decolorizes, followed bysafranin, the counterstain.
G+ organisms are purple G- organisms are red.
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Bacteria are Classified by their Need for Oxygen
Aerobic Bacteria – Capable of growing in the presence of free oxygen. Requires Oxygen.
Anaerobic Bacteria – Capable of growing in the absence of free oxygen. Does not Require Oxygen.
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How Bacteria Live and Grow
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Bacteria
Need the right conditions to grow.
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Temperature Requirements for Bacteria
*Mesophiles are often pathogenic to humans and grow well at body temperature.
Name Description Optimum Growth Temperatures
Psychrophiles Likes Cold Temperatures
59o F to 68o F (15o C to 20o C)
Mesophiles* Likes Moderate Temperatures
68o F to 113o F (20o C to 45o C)
Thermophiles Likes Warm Temperatures
122o F to 158o F (50o C to 70o C)
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Bacterial Reproduction
Bacteria reproduce by dividing.
This occurs approximately every 20 minutes.
This process is called Binary Fission.
This illustration above shows how E. coli reproduces.
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Resistant Microorganisms
Some microorganisms adapt and change to increase their chances of survival.
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Methicillin-Resistant Staphyloccus aureus (MRSA) -
Staphyloccus aureus bacteria that have developed a resistance to Methicillin, the drug of choice. MRSA usually occurs in patients who have been on antibiotic therapy for a long time.
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Vancomycin-Resistant Enterococcus (VRE)
Enterococcus bacteria that are no longer sensitive to Vancomycin.
Transmission can occur by direct contact, or indirectly via the hands of personnel.
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Non-Bacterial Organisms
Viruses, Protozoa, and Fungi
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Virus
One of a group of minute infectious agents that only grow in living tissue or cells.
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Viruses are Tiny Viruses are about 1000 times
smaller than bacteria.
If you were to enlarge a virus to the size of a baseball, the average bacterium would be the side of a pitcher’s mound, and one single cell from the human body would be the size of the entire ballpark. (www.Mayoclinic.com)
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Common Viral Diseases
Smallpox Rabies Yellow Fever Influenza Measles Acquired Immune Deficiency Syndrome (AIDS)
Mumps Polio Common Colds Shingles Cold Sores Warts Hepatitis
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Hepatitis Five distinct viruses, A, B, C, D, and E.
A is often implicated in foodborne illnesses.
B, C, D, and E are transmitted in body fluids.
There are vaccines available for A & B.
Hepatitis B Vaccine is strongly recommended for Central Service Technicians.
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Herpes Simplex Recurrent skin and mucous membrane
infections.
HSV Type 1 is associated with cold sores and fever blisters.
HSV Type 2 is associated with genital infections.
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Human Immunodeficiency Virus (HIV)
Causes AIDS
Occurs when the virus enters the blood stream.
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Protozoan
Any one-celled animal-like microorganism in the sub-kingdom of protozoa.
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Fungi Plant-like organism group that includes molds,
mushrooms, and yeasts without chlorophyll.
They live by feeding off living or dead organisms.
Fungi are involved in the production of most kinds of antibiotics.
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Fungi Several species of
fungi can cause respiratory disease in humans who inhale spores through dust, bird droppings, soil and other sources.
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Superficial Fungi Attack mainly epidermis,
hair, nails, and mucosal surfaces.
For example, Ringworm and Athlete’s Foot.
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Transmission of Microorganisms
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Transmission of Microorganisms
Microorganisms cannot move by themselves, but they have been called the World’s Greatest Hitchhikers.
Microorganisms can be transmitted by air currents, dust particles, in liquids, on solid objects like instruments and equipment…and by humans (us).
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Facts about Microorganisms We come in contact with thousands of types of
microorganisms each day.
Only about 1% are harmful to humans.
However, any microorganism can be harmful to patients whose defenses are compromised due to illness, injury or invasive procedure.
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Pathogenic
Disease-ProducingCentral Service Technicians Protect Patients from
Pathogenic Organisms
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For our Patients,The hospital is a very dangerous place.
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Our job is to protect them!
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Breaking the Chain of Infection
The infectious disease process is a complex relationship between the source, the host, and the environment.
Central Service Technicians can protect patients from infection by disrupting that process.
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The Chain of InfectionCausative
Agent
Reservoir of the Agent
Portal of ExitOf the Agent
from the Reservoir
Mode of Transmission
Portal of EntryInto the Host
Susceptible Host
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Causative Agent The microorganism that causes an infectious disease.
Characteristics that make microorganisms capable of causing disease: Invasiveness Pathogenicity Virulence Infectious Dose Viability in a free state. Ability to develop resistance to antimicrobial agents.
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Break the Chain of Infection by:
Eliminating the Causative Agent.
That can be accomplished by: Avoiding cross-contamination. Thorough Cleaning Disinfection Sterilization
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Reservoir of the Agent
The place where an infectious agent can survive.
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Break the Chain of Infection by:
Reducing Reservoirs
Central Service Technicians can Reduce Reservoirs by: Practicing Good Personal Hygiene and Health
Habits. Properly cleaning, disinfecting, and sterilizing
equipment, instruments, and utensils.
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Portal of Exit
The path by which an infectious agent leaves the reservoir.
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Portals of Exit Respiratory Tract - Through sneezing and coughing.
Genitourinary Tract – Through urine, vaginal secretions, and semen.
Gastrointestinal Tract – Through vomit or stools. Skin/Mucous Membrane – Through mucous or wound
drainage.
Blood – Through Blood transfusions or contact with blood.
Transplacental – Through the placenta from mother to baby.
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Break the Chain of Infection by:
Protecting yourself and others from exposure.
Central Service Technicians should: Practice proper waste disposal Wear appropriate Personnel
Protective Equipment (PPE) when they may come in contact with infectious substances.
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Mode of Transmission
The method of transfer of an infectious agent from the reservoir to a susceptible host.
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Modes of Transmission
Contact – Direct contact from person-to-person or droplet contact from coughing or sneezing.
Common Vehicle – Occurs when infectious agents are present in a vehicle such as food, blood, or water.
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Modes of Transmission
Airborne – Infectious agents found in tiny droplet nuclei or dust that are suspended in the air and may travel. For example, through a ventilation system.
Vector-borne – carried by insects (rare in U.S. Hospitals)
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Break the Chain of Infection by:
Central Service Technicians can disrupt the Mode of Bacterial Transmission by: Maintaining good hand hygiene Following good work practices for cleaning,
decontamination, disinfection and sterilization. Following airflow control guidelines. Following Standard Precautions guidelines.
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Portal of Entry
The path used by an infectious agent to enter a susceptible host.
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Portals of Entry Respiratory Tract Genitourinary Tract Gastrointestinal Tract Skin/Mucous Membranes Transplacental Parenteral
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Break the Chain of Infection by:
Central Service Technicians can disrupt the Chain of Infection by: Ensuring that equipment, utensils and
instruments are properly cleaned, disinfected, and/or sterilized.
Following Standard Precautions when handling contaminated items.
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Susceptible Host
A person or animal that lacks the ability to resist infection by an infectious agent.
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Host Susceptibility is affected by: Age
Disease
Nutritional status
Compromised immune status
Trauma
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The Chain of Infection**(from a CS Perspective)
Bacteria
Surgical Instrument
InstrumentInadequately
SterilizedBetween Patients
Patient # 1
InstrumentIntroduced
IntoPatient # 2
Patient # 2Infected
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What we can’t see CAN hurt us!
Millions of tiny bacteria, too small to see, inhabit our work area.
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Understanding Microorganisms Helps Central Service Technicians:
Prevent them from Reproducing
Control their Transmission
Destroy them.
Protect Patients, employees and ourselves.
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Preparedness
Understanding the basics about microorganisms is the first step in being prepared to fight them.
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Questions?
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