Preventing Perioperative Disease Transmission

Absence of microorganisms

Device to accomplish steam or gas sterilization

Amount of gross organic debris or the number of microorganisms on an object at any given time

A method for testing the sterilization capability of a sterilizer; contains microorganisms that are killed when exposed to a sterilization process; only method of guaranteeing the sterility of an item(s)

Specifically designed for use with a prevacuum steam sterilizer to test for air entrapment

Mechanical process used by ultrasonic cleaners during which air pockets implode to dislodge debris and soil from the crevices and serrations of surgical instruments and equipment

A method of cleaning instruments in which the chosen cleaning solution uses the process of binding ions, such as iron and magnesium, in the solution to prevent their deposit on the surface of surgical instruments

Internal or external monitor that changes color when exposed to the sterilization process; only indicates that the sterilization process has occurred; it does not guarantee the sterility of the item

The growth and collection of microbes into a group that lives in a particular area, such as the colonization of S. aureus in the nares of humans

Soiled with gross debris or by the presence of microbes

A general term used to describe the various types of flexible or rigid scopes used to view the body’s internal structures

Sterility determined by how a sterile package is handled rather than time elapsed; the package is considered sterile until opened, or until the integrity of the packaging material is compromised

A process of quickly sterilizing unwrapped items (such as a surgical instrument that has been dropped on the floor and is needed right away) using prevacuum or gravity steam sterilizers

Placing an item in a container so it is completely covered by a liquid, such as immersing a surgical instrument in glutaraldehyde

Complete, with no breaks or tears

Level of disinfection in which most microorganisms are killed except spores

Calendar days that are sequentially numbered through the year; often used when maintaining sterilization records (i.e., February 1 would be the 32nd day of the Julian calendar)

The opening in a tube or vessel

Microorganism that is capable of causing disease

The condition of being permeable; capable of allowing the passage of fluids or substances

Area of sterility maintained by the surgical team during a procedure

Methods used to prevent contamination of the sterile field and prevent the patient from acquiring a postoperative wound infection

(1) Procedure to render an individual incapable of reproduction; (2) process by which all microorganisms, including spores, are destroyed

A machine used to remove minute organic particles and soil from the areas of instrumentation hardest to reach by manual or other mechanical methods of cleaning; the washer utilizes the process of cavitation for cleaning instruments

Microbes that live on the skin and inside the human body (e.g., bacteria, fungi, viruses, and protozoa).  Also referred to as "opportunistic pathogens."

The relationship between human hosts and indigenous flora;  _____ refers to both organisms

The multiplication of organisms in the tissues of a host.

Both organisms benefit from and depend on one another to a certain extent. (e.g., Escherichia coli, colonizes within the human intestine, obtains nutrients from the food that humans eat; E. coli produces vitamin K, which is essential to to blood-clotting process in humans.)

Two organisms work together to achieve a result neither could obtain alone. (e.g., Fusobacteria and spirochetes work together to cause a disease known as trench mouth)

One organism benefits but second organism neither benefits nor is harmed. (e.g., Indigenous microflora on the skin of humans obtain nutrients, but do not affect the skin or human body.  To a certain extent they benefit humans by occupying space and preventing other potentially harmful microbes from colonizing, a process referred to as competitive exclusion. 

Two organisms occupy the same area with with no effect on each other.

One microorganism inhibits or interferes with the growth of another. (e.g., a microbe produces waste products that are toxic to the neighboring microbes)

One organism benefits and the host is harmed. (e.g., Endoparasites, such as intestinal worms, cause an infection and deplete the body of nutrition)

CHARACTERISTICS OF BACTERIA

Size, shape, and arrangements of bacteria

Round-shaped bacteria

Paired bacteria

Chain of bacteria

Cluster of bacteria

A bacterial cell intermediate in morphology between a coccus and a bacillus.  While still rod shaped, coccobacilli are so short and wide that they resemble cocci.

rod-shaped bacteria

spiral-shaped bacteria

Bacteria that lose normal shape due to adverse environmental conditions; one normal conditions are reestablished cells revert to normal shape.

• Varies with type of agar medium
• Shape, size, and color of a bacterial colony will be specific to the bacterial species grown on or in a particular nutrient medium
• Rate at which bacteria multiply is a key characteristics

Ability of a microbe to move by itself

Long thin structure attached to the outside of the cell; uses whipping motion to provide motility to the cell

Fine, short, hairlike extensions located on the surface of the cell; their coordinated, rhythmic movement allows the cell to move

e.g., carbon, oxygen, sulfur, nitrogen, hydrogen, phosphorus, vitamins, iron, calcium, copper, zinc

Bacterial species classified according to oxygen and carbon dioxide needs

Require level of oxygen found in a typical room

Require oxygen but at level lower than that found in room air (about 5% oxygen)

Will not grow if there is any amount of oxygen present in the environment

Able to survive in an environment that contains oxygen or no oxygen

Grow best in environment without oxygen but can survive in atmosphere that contains up to 15% oxygen

Grow best in high concentrations of carbon dioxide

• Ability to cause disease
• Release of exotoxins or endotoxins
• Presence of a protective capsule
• Direct damage by attaching to the host cells to invade tissues of the body

Secretion of waste products (enzymes, oxygen, methane, or carbon dioxide)

Microbiologists examine amino acid sequences of these proteins to determine the relationship of species to other types of bacteria.

Determining DNA or RNA sequence aids the microbiologists in determining the relationship between two different species or establishing information as related to a new strain of bacteria.

Used to prepare specimens for microscopic examination

Used to determine basic shape and structures of cell; single dye such as methylene blue is used and the cell is rinsed with water.

Cells are stained with crystal violet; washed with ethanol that removes purple stain from bacteria that don't retain the stain; red dye safranin is applied; specimen is rinsed with water.  continued to determined gram-positive or negative

Retains the crystal violet and therefore are purple color

Do not retain the crystal violet and are red from the safranin stain

Such as Mycobacterium tuberculosis, do not consistently stain red or purple

Used to identify bacteria classifed in the genus Mycobacterium.  Red dye (carbolfuchsin) is retained

• *Clostridium is one example
• When environment conditions are unfavorable, including extremes in temperature, dry enviroment, and a total lack of a source of food, the genetic material of the cell is enclosed in a protein capsule
• Can survive for a long time until favorable conditions are reestablished; the bacteria returns to its vegetative state and is able to grow and reproduce again.
• Not to be confused with reproduction, sporulation is a method of bacterial survival.
• They are difficult to destroy; therefore sterilization processes must also be able to kill spores.

COMMON BACTERIAL PATHOGENS

• Toxic shock syndrome
• Osteomyelitis
• Endocarditis
• Postoperative SSI

• IV catheter infections
• UTIs
• Prosthetic device infections
• Subacute bacterial infections
• Endocarditis

• Bacterial pneumonia
• Bacterial meningitis
• Otitis media
• Bacteremia

• Strep throat
• Tonsillitis
• Rheumatic fever
• Scarlet fever
• Necrotizing fasciitis

• Neonatal septicemia
• Neonatal meningitis

Dental caries

• Aerobi, Microaerophile Gram-Negative Bacilli, Spirochetes
• Chronic gastritis
• Stomach ulcers
• Peptic ulcers

• Anaerobic Gram-Positive Bacteria
• Gas gangrene infection
• Cellulitis
• Fasciitis

• Anaerobic Gram-Negative Bacilli, Coccibacilli
• Peritonitis

• Facultative Anaerobic Gram-Positive Cocci
• Urinary tract and bloodstream; associated with intra-abdominal abscesses and wound infections

• Gram-Positive; acid-fast bacillus positive; aerobic; coccus & bacillus shape
• Tuberculosis

• Aerobic Gram-Negative Cocci, Coccobacilli
• Pelvic inflammatory disease leading to salpingitis

• Aerobic, Microaerophile Gram-Negative Bacilli, Spirochetes
• Deep-tissue health care-associated infections in patients with burns, deep puncture wounds, and open bone fractures
• External otitis
• Keratitis
• UTIs
• Endocarditis in patients with prosthetic heart valves