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Sepsis
Microbial contamination
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Aseptic
- an environment or procedure that is free of contamination by pathogens
- antimicrobial chemicals, expected to destroy pathogens but not to achieve sterilization
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Disinfectant
non-living surface
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Sterilization
removal of all microbial life (heat, filtration)
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Sanitization
for utensils
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Bacteriostatic
inhibits bacterial reproduction
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Effectiveness of antimicrobial treatment depends on:
- number of microbes
- environment
- time of exposure
- microbial characteristics
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Action of antimicrobial agents: Alteration
- alteration of cell walls and membrane
- alter permeability
- breakdown lipid components
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Action of antimicrobial agents: Protein damage
- damage to protein structure
- disrupts structural proteins
- denatured enzymes cause a decrease in cellular activity
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Action of antimicrobial agents: Nucleic acid damage
- damage to nucleic acidsloss of genetic information leads to a decrease in metabolic activity
- can produce fatal mutants
- can halt protein synthesis through action on RNA
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The selection of microbial control methods
- ideally, agents should be:
- inexpensive
- fast acting
- stable during storage
- capable of controlling all microbial gowth while being harmless to humans, animals, and objects
- is this feasible? no
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Factors affecting the efficacy of antimicrobial methods
- site to be treated
- relative susceptibility of microorganism
- effectiveness of germicides classified as high, iintermediate, or low
- environmental conditions
- temperature
- pH
- organic material
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Phenol coefficient
- compare other disinfectants and antiseptics to phenols effectiveness at controlling microbes under standardized conditions
- greater than 1.0=product is more effective than phenol
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Use dilution test
- expose contaminated cylinders to various dilutions of antimicrobial agents
- incubate cylinder for 48 hours and check growth
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Kelsey-Sykes capacity test
- expose bacterium to suitable concentration of disinfectant
- return to growth medium and check turbidity
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In-use test
swabs of object are taken pre/post disinfectant and grown
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Heat related methods of microbial control
- effects of high temperatures
- denaturation of proteins
- interference with integrity of cytoplasmic membrane
- disruption of structure and function of nucleus
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Thermal death point
lowest temperature that kills all cells in broth in 10 minutes
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Moist heat
denatures proteins
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Pasteurization
significant number reduction (esp. spoilage and pathogenic organisms) does not sterilize! Destroyed TB.
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Classic holding method of Pasteurization
63° C for 30 min
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Flash Pasteurization (HTST)
72° C for 15 sec. most common in us. thermoduric organisms survive
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Ultra high temperature (UHT)
- 140° C for <1 sec
- technically not pasteurization because it sterilizes
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Dry heat
- kills by oxidation
- denatures proteins and oxidizes metabolic and structural chemicals
- used for materials that cannot be sterilized with or damaged by moist heat
- flaming of loop
- incineration of carcasses
- bird flu
- mad cow disease
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Refrigeration and freezing
- decrease microbial metabolsm, growth and reproduction
- chemical reactions occur slower at low temperatures
- liquid water not available
- psychrophilic microbes can multiply in refrigerated foods
- refigeration halts growth of most pathogens
- slow freezing more effective than quick freezing
- organisms vary in susceptibility to freezing
- exceptions: listeria monocytogenes
- refrigeration: 0-7° C
- freezing: below 0° C
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Physical methods of microbial control by filtration
- Air filtration uses high efficiency particulate air (HEPA) filters. effectie to 0.3 um
- Membrane filters for fluids
- pore size for bacteria: 0.2-0.4 um
- pore size for viruses: 0.01 um
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Osmotic pressure
- high concentrations of salt or sugar in foods to inhibit growth
- cells in a hypertonic solution of salt or sugar lose water; cell desiccates
- fungi have greater ability than bacteria to survive hypertonic environments
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Physcial methods of microbial control by radiation
radiation damages DNA: sterilization of medical equipment and foods
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Chemical methods of microbial control
- affect microbes cell walls, cytoplasmic memebranes, proteins, or DNA
- effect varies with temperature, length of exposure, and amount of organic matter
- also varies with pH, concentration, and age of chemical
- tend to be more effective against enveloped viruses and vegetative cells of bacteria, fungi, and protozoa
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Phenol and Phenolics
- disrupts cell membranes
- effective in presence of organic matter and remain active for prolonged time
- commonly used in health care settings, labs and homes
- pheno (carbolic acid) historical significance
- phenolics: creosol (lysol)
- bisphenolics
- hexachlorophene: pHisoHex
- triclosan: toothpaste, antibicterial soaps
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Alcohols
- are bactericidal, fungicidal, and virucidal against enveloped viruses
- ineffective against fungal spores and bacterials spores
- denature proteins and disrupt cytoplasmic membranes
- evaporate rapidly and inactivated by organic debris
- 70%(optimal concentration) more effective than 90%
- used in hand santizers and cosmetics
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Halogens: oxidizing agents
- intermediate- level antimicrobial chemicals
- iodine
- chlorine
- bromine
- fluorine
- iodine: medically used as a tincture or iodophores
- betadine
- sodium hypochlorite (bleach)
- chlorine treatment of drinking water
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Oxidizing agents
- peroxide kill by oxidation of microbial enzymes
- effective against anaerobic microorganisms of deep wounds
- hydrogen peroxide can disinfect and sterilize surfaces of objects
- 3% or higer
- catalase neutralizes; not useful for treating open wounds
- staphylococcus aureus
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Surfactants
"surface active" chemicals that reduce surface tension of solvents to make them more effective at dissolving solutes
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Heavy metals
- ions are antimicrobial because they alter the 3-D shape of proteins, inhibiting or eliminating their function
- low-level bacteriostatic and fungistatic agents
- 1% sliver nitrate to prevent blindness caused by N gonorrhoeae
- thimerosal used to preserve vaccines
- copper controls algal growth in reservoirs, fish tanks, swimming pools, and water storage tanks; interferes with chlorophyll
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Aldehydes
- inactivate proteins by cross-linking with their function groups (-NH2, -OH, -COOH, -SH)
- compounds containing terminal -CHO groups
- glutaraldehyde
- formalin used in embalming and disinfection of rooms and instruments
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Bacterialcidal
kills bacteria
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Bacteria subjected to heat or antimicrobial chemicals die at what rate
A constant rate
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How is the antimicrobial efficacy evaluated?
microbial death rate
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Thermal death time
time to sterilize volume of liquid at set temperature
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Autoclave
- steam under pressure
- most dependable sterilzation method
- steam must directly contact material to be sterilized
- pressurized steam reaches higher temperatures
- normal autoclave conditions: 121.5 C for 15 min
- prion destruction: 132 C for 4.5 hours
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Ionizing radiation
x rays, microwave
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Nonionizing radiation
- UV
- most effective wavelength~260 nm
- actively dividing organisms are more susceptible
- used to limit air and surface contamination
- germicidal lamps
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Soaps and detergents
good degerming agents but not antimicrobial
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Quats
- quaternary ammonium compounds
- colorless, tasteless, harmless to humans, and antimicrobial; ideal for many medical and industrial application
- most effective against gram +
- pseudomonads live in them
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