Chapter 16

• CDC
• FDA
• OSHA
• EPA
• CLIA

CDC

FDA

OSHA

Environmental Protection Agency

Clinical Labratory Improvement Act- regulates the handling of specimens/ lab safety

entry into the body of an infectious agent (a microorganism)that then multiplies and causes tissue damage

microorganisms capable of causing disease

toxins and endotoxins

illness and disease

change in tissue/cell functionthat can be detected by exam or tests

strength of pathogen

communicable

• -reside on skin
• -body cavities
• -intestines
• harmless but can become pathogenic if destroyed

pathogen

able to produce disease or damage

Opportunistic

any bacteria

these are the ones that are given an antibiotic to treat (e-coli,staph, strep, pseudomonas)

• Bacteria
• Prions
• Viruses
• Protozoa
• Rickettsias
• Fungi
• Helminths
• mycoplasmas
• Chlamydia

• Single-cell microorganisms lacking a nucleus
• Reproduce every few minutes up to several weeks
• Classified according to need for oxygen, shape, and Gram staining
• have a need for oxygen

need oxygen to grow and thrive

can grow only without oxygen

• Gram-positive bacteria retain the stain
• Gram-negative bacteria take up couterstain

• round
• rod-shaped
• spiral or corkscrew shaped

• Identified by growing a cultue CBC
• Snsitivity testeing determines which antibiotic can kill the organism
• some are drug resistant

• Methicillin-MRSA
• Vancomycin-VRE
• Extended-ESBL, ghonorrhea and CDIF
• Penicillan resistant- Strep

• protein particle
• lack nucleic acids
• do not trigger an immune response
• cause degenerative neurological disease such as Mad cow disease

Creutzfeldt-Jacob

• extremely small
• can only be seen with an electron microscope
• composed of  particles of nucleic acid
• DNA or RNA with a protein coat
• grow and replicate only with a living cell
• survival and replication depend on the host
• smallest of organisms and can lay dormat and reactivate

• some are minore like a cold
• some like hepatitis and HIV can be serious and lead to death
• require anti-viral medication-do not respond to antibiotics

• One-celled
• belong to the animal kingdom
• malaria
• amebic dysentery

• small round or rod shaped organism
• transmitted by bites of fleas,lice,mites, and ticks
• can multiply only in the host cells
• causes Rocky Mounted Spotted Fever and typhus

• tiny primitive organismsof the plant kingdom that contain no chlorophyll
• include yeast and mold
• feed off living animals and decaying matter
• Reproduce by use of spores
• cause candidiases and tinea pedis (athletes foot)

• Parasitic worms or flukes
• belong to animal kingdom
• Pinworms(which mostly affect children)
• Roundworms and tapeworms

• very small organism without a cell wall
• cause infections of respiratory or genital tract

Affects the genitourinary and reproductive tracmore common in the past 20 years

• live in or on other organisms
• ex.-tick with lyme disease
• include helminths-infectious worms like tapeworm, that lay eggs

An infectious disease is spread from one person to another; a continuous chain

• Causative Agent (link 1)
• Reservoir (link 2)
• Portal of Exit (link3)
• Mode of Transfer (link4)
• Portal of Entry (link5)
• Susceptible host (link6)

sudden, short, limited to expected

gradually increase over long period of time or lasts much longer than expected

presence of microorganism in or on host in large number with no active disease s/s. can cause infection given the right circumstances

• Acquired in a health care setting.
• resp. for millions of dollars of health care costs per year

• adhere to mucous surfaces or skin
• penetrate mucous membranes
• mutliply once in the body
• secrete harmful enzymes or toxins
• resist phagocytosis

infected wounds, waste or infected/ contaminated food or water

• good hand hygiene
• sterile technique

route by which pathogen leaves its host

Feces may transport typhoid bacillus from an infected person

• microorganisms are released by coughing or sneezing
• Measles,Mump,  respiratory pulmonary tuberculosis  can be transmitted via exiting the respiratory system
• skin and mucous membranes
• open wound

• Direct contact of excreta drainage from an ulcer, or infected wound, boil, chancre
• indirect contact with contaminated inanimate objects such as needles, eating utensils,and dressings
• vectors, such as mosquitos,that harbor infectious agents
• droplet infection-ex. sneezing or coughing
• Spread of infection from one body part to another
• vehicle-contaminated equipment such a comb or food

enter body through eyes,mouth, nose, trachea,skin, mucous membranes,needle punctures, thru placenta to baby

• Use only sterile and clean items
• use barrier precautions (gloves, masks, condoms)
• safely handle food and water
• use good personal hygiene
• avoid high risk behaviors
• use protection from insect bites and stings

• age
• state of health
• broken skin
• chemotherapy
• transplant
• burns

• teaching good health and hygiene habits
• Immunizations
• Hydration/Nutrition
• No fresh fruit or flowers
• Limit outside contact especially with the flu

• prolonged stress=decreased anti-inflammatory response
• sedentary lifestyle
• poor hygiene (body and oral)
• Illness=anything that weakens the immune system
• nutritional status
• medications
• presence od catheter,pacemaker
• age
• newborns
• adolescents=std's

• poor nutrition
• immobility
• poor hygiene
• chronic illness
• physiologic changes such as thin skin

• skin
• mucous membranes
• cilia
• kupffer cells in liver
• gastric secretions

• fever= slows the growth of pathogens
• leukocytes= engulf the invader
• phagocytosis= remove cellular debris
• inflammation
• interferons=stimulate antiviral preteins

• body secretions=tears,saliva,vaginal secretions
• inflammatory response

• body is increasing the wbc and blood flow and metabolism
• s/s heat redness,swelling, pain, decreased movement and function
• b and t cells

produce antibodies

• kill and destroy
• when b and t cells are not working immunity is compromised

• antigen-foreign things that cause response in the body
• antibodies

• body makes antibodies against/ and attacks itself
• lupus, sarcoidosis, myasthenia gravis, chronic fatigue

• WBC + Leukocyte differential -part of cbc
• WBC count greater than 11,000 usually indicates a bacterial infection or sever trauma
• differential indicates stage and severity of infection

• ESR red blood cell count and protein reactive
• when elevated= inflammatory process
• C&S= culture and sensitivity-shows the organism and medication that will be effective against

• localized protective response brought on by injury or destruction of tissue
• blood vessels dilate, bring more blood to the area causing edema and redness and purpose
• artificially acquired immunity- immunizations
• passive artificially acquired immunity -injecting antibodies derived from serum of infected person or animal

making the environment and object free from microorganisms

reducing number of organisms or reducing the risk of of transmission of organisms

• prevents the spread of infection 
• disinfecting contaminated items

infection-spread throughout the body-can result in organ failure 50% fatality rate when septic

this is one of the most effective ways to reduce the number of microorganisms on the handsgloves should be worn to prevent contact with body fluidshand washing before and after patient care

15-20 seconds

• 2 to 5 min
• water flow down towards elbows

• hand hygiene
• gloves
• mask, eye protection,face shield
• gown
• patient care equipment
• environmental control
• linens
• occupational health and blood borne pathogens
• patient placement

1 part chlorine to 10 parts water

warm water with air dry