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Transcript
BLOODBORNE PATHOGENS
“Microorganisms & the Chain of Infection”
OSHA Standard 29 CFR 1910.1030
Microorganisms &
the Chain of
Infection
Bloodborne
Pathogens
(BBP)
FourFOUR KINDS Kinds
 Bacteria
 Viruses
 Protozoa – think parasite
 Fungi and their eggs – called
spores (think yeast infections
and athlete’s foot)
Microorganism
 Plant or animal so small it can only be
seen with a microscope.
 On all surfaces of our body and
surfaces around us
 Few areas are not covered: brain,
blood stream, lungs, areas
surrounding internal organs
Bacteria
Image: The bacteria that
causes meningitis
Bacteria
Viruses
Image: Human
Immunodeficiency Virus
Bacteria
Viruses
Protozoa
Image: Protozoa that
causes Malaria
Bacteria
Viruses
Protozoa
Fungus/Fungi
Image: Candida albicans, the
fungus that causes yeast infection
NORMAL FLORA -Bacteria
 When a microbe lives on us without harming
us or
 Provides a benefit or protection to us.
 This relationship is called: mutually beneficial
 Examples:
 Escherichia coli (E. Coli) in our bowels
 Produces Vitamin K as byproduct which helps
with clotting of blood.
 Staphylococcus aureus – on skin and resp. tract
MRSA
Normal flora
can cause
infection when
transmitted to
a place not
normally
found or the
right
opportunity
exist – called
opportunistic.
In 1993
An E. coli outbreak resulted in the death of four
children and severe illness for hundreds more
when undercooked beef was ingested .
The following is how the infectious agent, E. coli
infected the vulnerable host – the children.
We have seen numerous E. coli and bacterial
outbreaks in our food sources since then. Most
recent involved sprouts; hummus, dips and
walnuts – May 2014
INFECTIOUS AGENT
E. COLI
Vulnerable
Host
Reservoir
Port of Entry
Port of Exit
Means of
Transmission
Infectious
Agent
RESERVOIR
Vulnerable
Host
BOWEL OF COW
WHERE E. COLI LIVE
Port of Entry
Port of Exit
Means of
Transmission
Infectious
Agent
Vulnerable
Host
Reservoir
PORT OF EXIT
SLAUGHTER HOUSE
WHERE ENTRAILS
WERE LEAKING AS
THEY WERE MOVED
OVER MEAT
Port of Entry
Means of
Transmission
Infectious
Agent
Vulnerable
Host
Reservoir
Port of
Entry
Port of Exit
MEANS OF
TRANSMISSION
HOW IT MOVED
FROM EXIT POINT
TO ENTRY POINT
OF NEW HOST. E.
COLI MIXED
Infectious
Agent
Vulnerable
Host
Reservoir
PORT OF ENTRY
Port of Exit
UNDERCOOKED
HAMBURGER
Means of
Transmission
Infectious
Agent
VULNERABLE
HOST
Reservoir
INGESTED
HAMBURGER
Port of Entry
Port of Exit
Means of
Transmission
This incident led to restaurants posting warning
messages against undercooked meats; a
national movement motivated by the US
Department of Health.
Infectious
Agent
Staph.
aureus
VULNERABLE
HOST
Reservoir
Port of Entry
Port of Exit
Means of
Transmission
Infectious
Agent
Staph. aureus
Reservoir
Normal flora
of skin and
nose
VULNERABLE
HOST
Port of Entry
Port of Exit
Means of
Transmission
Infectious
Agent
Staph.
aureus
Reservoir
VULNERABLE
HOST
Normal flora
of skin and
nose
Port of Exit
Port of Entry
Means of
Transmission
Care of
wound,
urine, lungs
Infectious
Agent
Staph.
aureus
Reservoir
VULNERABLE
HOST
Normal flora
of skin and
nose
Port of Exit
Port of Entry
Care of wound,
urine, lungs
Means of
Transmission
Fail to wear gloves or
wash hands b/t pts.
Infectious
Agent
Staph.
aureus
Reservoir
VULNERABLE
HOST
Normal flora
of skin and
nose
Port of Entry
Touches open
wound with
contaminated
hands
Port of Exit
Care of wound,
urine, lungs
Means of
Transmission
Fail to wear
gloves or wash
hands b/t pts.
Infectious
Agent
VULNERABLE
HOST
Staph.
aureus
Reservoir
WOUND, AGE,
CANCER,
IMMUNE
SYSTEM
Normal flora
of skin and
nose
Port of Entry
Port of Exit
Touches open
wound with
contaminated hands
Care of wound,
urine, lungs
Means of
Transmission
Fail to wear
gloves or wash
hands b/t pts.
Why MRSA from normal Staph?
 Methicillin Resistant Staphlococcus Aureus
 Resistant to commonly used antibiotics
 Hospital acquired and community acquired
 Spread by skin-to-skin contact
 Begins as small red bumps (pimples, boils or
spider bites) that turn into abscesses
 Why?
 Overuse of methicillin based antibiotics
 Not taking entire course of antibiotics
Viruses
Two primary
bloodborne
pathogens
Human
Immunodeficiency
Virus (HIV)
Hepatitis
(HBV/HCV)
HIV
 Human Immunodeficiency Virus – lentivirus
 Causes acquired immunodeficiency
syndrome
 Progressive failure of the immune system
 Allows life-threatening opportunistic
infections and cancers to thrive
 Infections with transfer of blood, bodily
fluids.
HEPATITIS B
 Infectious illness of the liver
 Epidemic in Asia and Africa
 Transmitted by exposure to infectious blood
or bodily fluids, transfusions, dialysis,
tattooing, etc.
 No treatment; most adults clear infection
spontaneously.
 Treatment to stop virus from replicating:
PEGlated interferon
 Vaccine for prevention
Hepatitis C
 Affects primarily the liver
 Caused by the hepatitis C virus HCV
 Chronic infection leads to cirrhosis and liver




failure
Spread primarily by blood-to-blood contact
Associated with IV use, poorly sterilized
medical equipment and transfusions.
New drugs developed for cure.
No vaccine for prevention.
Compare/Contrast
Bacteria
Virus
 Larger of microbes
 Smallest of life forms
 Complex biology
 Simplest life form
 Live outside cells of host
 Must live within cells of
 Able to reproduce without
host to survive
 Must use host’s genetic
material to reproduce
 Most harmful
host
 Many are beneficial to host
PREVENTION
HAND HYGIENE
WASH YOUR HANDS!
GERMS ARE EVERYWHERE
 Bacteria and viruses are everywhere.
 Some can survive for weeks on
surfaces such as countertops and
stethoscopes.
 Healthcare workers’ hands are the
most common way of transferring
germs to patients.
YOUR HANDS PICK UP GERMS
WHEN YOU . . .
 Touch the doorknob
 Shake a patient’s hand
 Take a patient’s pulse or blood pressure
 Help a patient move
 Cover your sneeze or cough with your hands
 Use the toilet
 Touch surfaces or objects in the patient care
areas
GERMS
 Use medical equipment in the patient care
area.
 Touch a patient’s clothing.
CLEAN YOUR HANDS
 CDC recommends washing with soap and
water ONLY :
 When they are dirty or visibly soiled with blood or
other bodily fluids.
 After using the restrooms
 Before eating
USE AN ALCOHOL BASE HAND RUB FOR ALL
OTHER HAND HYGIENE SITUATIONS !!!
USE OF ALCOHOL RUB
 Before direct patient contact
 Before inserting an invasive device
 Before moving from a contaminated
body site to a clean body site.
 After contact with a patient’s skin.
 After removing gloves.
HAND HYGIENE SITUATIONS
 During a typical patient hour, a healthcare
worker could have as many as 8-12 hand
hygiene moments.
 E.g., going from one patient to another
 Touching surfaces in patient rooms
 Touching medical equipment used on patient
HOW TO WASH WITH AN ALCOHOL
RUB
 Apply amount to palm of one hand
 Work product in between fingers
 Rub hands until dry. Make sure they are dry.
 Takes less time than soap/water.
 Convenient
 Efficiently kills germs
MRSA AND C. DIFF
 Gloves must be worn.
 Perform hand hygiene after glove
removal.
GLOVES
 Wear if there is a potential for contact with




blood or infectious materials, mucous
membranes or nonintact skin
Change gloves between patients.
Change gloves from a contaminated body
site to a clean body site.
Gloves are not a substitute for washing
hands!
Wash after removing gloves…
SUMMARY
 Practice hand hygiene after leaving a patient,




even if you didn’t touch the patient.
Bacteria can survive for long times on
surfaces (think computer keyboards)
Change gloves and wash hands after glove
contact.
Rub it in!
Have dispensers in convenient places to use.
References
 Diffen. Bacteria vs. Virus: Difference and Comparison.
Retrieved 12/1/2010 from
www.diffen.com/difference/Bacteria_vs_Virus
 Marler-Clark and Associates. Jack in the Box E. coli
Outbreak. Retrieved 11/4/2010 from www.aboutecoli.com 2010
 Wikipedia: Staphylococcus aureus. Retrieved 11/4/2010
from www.wikipedia.org