Introduction to SUR 111Perioperative Patient Care

Microbiology

The study of microorganisms Microorganisms are life forms that cannot be

seen with the naked eye Determining life:

Able to reproduce Ingest and metabolize food Eliminate waste Irritable (respond to stimuli) Able to mutate or change genetic make up

Taxonomy(Classification)

Kingdoms Animal Plant Protista (protozoans) Fungi________________________

Monera (bacteria)

(Eucaryotic cells)

(Procaryotic cells)

VIRUSES (Virion) Neither Procaryotic or Eucaryotic Arguable as to whether or not these are life forms as they do not

display the five characteristics of life Are obligate intracellular parasites Means reproduction dependant on a cell host There are viruses that can infect or live in a bacteria:

Bacteriophages Smallest microorganism (need an electron microscope to see)

This is a viron!

ONE MORE THING:

Bacteriophages

Eucaryotic verses Procaryotic

Eucaryotic You, You, You! are composed of

eucaryotic cells! Have a true nucleus Have a nuclear membrane Chromosome encapsulated More advanced

Procaryotic Bacteria in this class No nuclear membrane Chromosome floats in cytoplasm

Our Focus

Viruses

&

Bacteria

BACTERIA

Bionomical System of Nomenclature(Scientific Name)

Genus First letter of capitalized Italicized or underlined May see abbreviated capital letter/period Example: E. for Escherichia

Species All lower cased Italicized or underlined Example: coli

Correct forms: Escherichia coli or E. Colior

Escherichia coli or E. Coli

Procaryotic Cell Structure

Standard Equipment1. Capsule

• Slime layer • Outer covering• Protection • Movement (like slugs)

2. Cell membrane• Regulation of things moving in and out of cell

3. DNA (1 chromosome)• Reproduction • Called binary fission

Optional equipment1. Cell Wall

• Protection• Morphology (shape)• Peptidoglycan proteindetermines staining (gram positive or gram negative)

• Flagella• Movement

1. Pili • Attachment

2. Endospores (spores)• For Ultimate hibernation• Survival mechanism

Identifying Bacteria

Gram Positive Turns slide purple Thick peptidoglycan layer stabilized by

techoic acid Allows staining agent to permeate and

stay visible

Gram Negative Turns red/pink Thin peptidoglycan layer Doesn’t absorb staining agent

Gram Negative Gram Positive

Identifying Bacteria

Gram Indeterminate

Do not stain because they have no cell wall

Morphology(Shape of Bacteria)

Bacillus (bacilli)

Rod shaped

Coccus (cocci)Round or circular

Are other shapes you’ll learn in microbiology course:Vibrio curved

Spirillium (2 curves) ~Spirochete (many curves) wCoccobacillus (football shape)

Morphology Continued

Are bacteria with no cell wall (remember gram indeterminate?)

Shape is undefined as a result of no cell wall and are referred to as polymorphic or pleomorphic in shape

Polymorphic or pleomorphic just means these bacteria can occur in many different shapes

Arrangements of Bacteria (How they connect to one another)

FOCUS Cocci Bacilli

Arrangement determined by how they split (reproduction)

Splitting in two =

Binary Fission

Cocci

Staphylo = clusterAbove = Staphylococci

Strepto = chainAbove = Streptococci

Other Arrangements for Cocci

Diplococci

Tetracocci

Bacilli

SteptobacillusStrepto = chain

Physiology

Temperature Ranges Gas Requirements Fragility Hardiness Fastidious Carbon sources Energy sources

Gas Requirements

Aerobic Must have oxygen to survive

Anaerobic Must have carbon dioxide to live

Strict Anaerobes Placed in oxygen, will die

Facultative Can tolerate both conditions

Fragility

Fragile bacteria are: Easily destroyed Do not live outside their normal

environment

Hardiness

Hardy bacteria: Tolerate many environments Likely are spore producers Difficult to destroy

Fastidious

Fastidious bacteria: Have strict growth requirements Grow well under certain conditions

Sterilization

Microorganisms must be removed from anything that is to be used inside the human body prior to surgical procedures

Sterilization is the term used to describe the absence of all microorganisms including spores

Factors in Achieving Sterilization

Types of sterilization Various methods Method of dependent upon item being sterilized

Considerations with sterilization Monitoring successful sterilization

Physical indicators Chemical indicators Biological indicators

Will cover in depth within coming weeks

Roles in Surgery

Sterile team members Nonsterile team members

Surgical technologists are sterile team members however they may function in a nonsterile role

Surgical technologist are an integral part of the surgical team

Principles of Asepsis

Only sterile items are used in the sterile field A sterile barrier must be considered contaminated after it has been

penetrated Edges of a sterile package or container are considered

contaminated after it has been opened Gowns are considered sterile only from nipple level to the lowest

horizontal surface and the sleeves to two inches above the elbow

Only horizontal surface of a table is considered sterile Sterile persons or items touch only sterile areas. Nonsterile persons

or items only touch nonsterile areas. Movement in and around the sterile field must not compromise or

contaminate that field All items and areas of doubtful sterility must be considered

contaminated. When in doubt, throw it out!

Surgical Attire

Personal hygiene observed No jewelry, nails trimmed and clean (not over

fingertips, no nail polish, no cuts/abrasions/rashes on skin

Scrubs with strings tucked Hair covered (long hair tied back and covered) Foot covers (booties)

PPE (personal protective equipment) Hair cover Shoe covers (removed prior to leaving OR

department) Mask (worn properly in restricted areas and

removed at proper times) Sterile Gown Sterile Gloves Clean Gloves (worn when doing nonsterile

activities)

Where Do I Wear Various Articles of Surgical Attire? Must understand OR Traffic Patterns Unrestricted Semi-restricted Restricted Some facilities do not have a

semi-restricted area, only unrestricted and restricted

Let’s practice and begin recognizing our Surgical Attire and where to wear it