Asepsis + Preventing Infection

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  1. What are the 6 parts of the chain of infection?
    • 1.infectious agent
    • 2. reservoir
    • 3. portal of exit
    • 4. mode of transmission
    • 5. portal of entry
    • 6. susceptible host
  2. Which are the 5 predictable stages
    of infection ?
    • 1. Incubation
    • 2. Prodomal Stage
    • 3. Illness
    • 4. Decline
    • 5. Convalescence
  3. What are MDRO's risk factors ?
    • -severe illness
    • - previous exposure to antimicrobial agents
    • - underlying diseases (e.g. diabetes)
    • - invasive procedures (e.g. dialysis)
    • -repeated contact with health care
    • -advanced age
  4. What is MRSA ?
    methicillin-resistant Staphylococcus aureus ?

    Bacteria usually lives on skin and in the nose without causing any problems.

    If a person gets infected the treatment is methicillin.

    If the bacteria is resistant MRSA can't be killed and is a major cause of complication and death.
  5. What is VRE ?
    vancomycin-resistant enterococci

    bacteria is normally a resident in the intestines and female genitale

    leading cause for healthcare related bacteremia, surgical wound infection and urinary tract infection
  6. What is C.diff. ?
    clostridium difficile

    development of unusually virulent strain of C.diff. (spores surfive days on sufaces)

    resistant to nearly all antibiotics

    virulent enough to cause sepsis, lasting intestinal damage and even death
  7. What are the 3 lines of defense ?
    Please describe
    1. Primary (skin, mucus, bile, eyes, mouth, vomiting, diarrhea)  - nonspecific

    2. Secondary (Activation of WBCs, phagocytes, release of toxins , histamines and heparin/ complete cascade and inflammation...) - nonspecific

    3. Tertiary (activation of immune response, B and T Lymphocytes: attach to antigen, phagocytosis, neutralization, agglutination, activation of complement and inflammation) - specific
  8. What are the 5 types of antibodies ?

    Please describe
    • IgM : encountered when antigen is encountered the first time
    • IgG: most common, response can fade over time, small enough to fit through placenta and breastmilk, injectable
    • IgE:primarily responsible for allergic response, subsequent exposure results in even more severe response
    • IgA: mucus membranes produce IgA around body openings to provide additional protection
    • IgD: form on surface of Bcells and trap the potential pathogen
  9. What factors increase host susceptibility ?
    • -developmental stage
    • - breaks in first line of defense
    • -illness and injury
    • - tobacco use
    • - substance abuse
    • -multiple sex partners
    • -environmental factors
    • -chronic disease (hypertension, diabetes, leukemia, aids,...)
    • -medications (NSAIDs, aome antibiotics, medication after transplants, chemotherapeutic agents)
  10. What is cleaning ?
    removal of visible soil (organic or non-organic) from objects and surfaces with water and detergent
  11. What is disinfection ?
    removal of virtually all pathogens from object with steam, gas, chemicals, ultraviolet light,

    reduces microbial population, but it does not guarantee that all pathogens are eliminated
  12. What are the 3 levels of disinfection ?
    • high level:   all pathogens removed except high level bacteria spores
    • intermediate-level: kills mycobacteria and most viruses and bacteria
    • low level: kills some viruses and bacteria
  13. What is Sterilizing ?
    elimination of all microorganism (except prions)

    used when absolute purity of an object is critical (e.g. needles for injection, intravenous catheters, surgical instruments, some wound dressings and chest tubes)
  14. What is standard precaution ?
    First tier of protection for preventing transmission of pathogens

    Applies to care of ALL patients
  15. What is transmission based precaution ?
    Second tier of protection

    outline precaution based on mode of transmission (contact, droplet, air)
  16. How can infections be classified ?
    • - Location (local or systemic)
    • - Primary or secondary
    • - Exogenous and endogenous
    • - Acute or chronic
  17. What is incubation ?
    Stage between invasion of pathogens and first appearence of symptoms.

    Patient does not suspect infection but is infected and can infect others (stage can last one day, months, even years -> like tuberculosis)
  18. What is Prodromal stage ?
    not all infections have this stage

    first appearance of vague symptoms (like mild throat irritation before cold)
  19. What is the illness stage ?
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Asepsis + Preventing Infection
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