Download Infection

SUR 111
Lecture 2
Terminology Related to
Asepsis and Sterile
Technique
 Review and learn the terms in table 7-1
page 143
 You must be familiar with these terms
Pathogens & Infection
 Pathogen
 Any microorganism that is capable of causing an
infection
 Infection
 Microorganism in a particular place
 Presence of or multiplication of microorganisms
 NOT necessarily causing problems
 Disease
 Showing signs or symptoms due to microorganisms
ARE causing problems
Infection
 Nosocomial Infection
 Hospital acquired infection
 Surgical Site Infection (SSI)
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Infection that is the direct result of surgery
Primarily caused by patient’s own normal flora (endogenous)
Can be caused by breaks in aseptic technique
Is a type of nosocomial infection
25% of all nosocomial infection
Typically do not become evident until after patient is
discharged from hospital
 Note table 7-3 page 134 for pathogens associated with SSIs
and their percentage rates
Sources of Microbial
Transmission
 Personnel
 Environment
 Patient
Pathogens associated
with SSIs
 Bacteria
 Escherichia coli
 Resides normally in lumen of intestines = resident flora
 If gets outside of intestinal lumen will cause infection (peritonitis)
that is life threatening
 Staphylococcus aureus
 Resides on your skin = resident flora
 Can reside in your nares (nostrils)
 Most commonly transmitted pathogen in the operating room
 Mycobacterium tuberculosis
 Causes disease tuberculosis
 Airborne pathogen transmitted by droplet nuclei (you can breath
it)
 Known affected surgical patients require special masks
Spore Producing Bacteria
 Bacillus and Clostridium genuses
 Are spore producers
 Highly resistant
 Bacillus stearothermophilus and Bacillus subtilis are the
biological indicators utilized in sterization to test that
autoclaves and ethylene oxide sterilization techniques are
working to destroy all microorganisms and their spores
(sterilization)
 B. stearothermophilus (steam sterilization)
 Notice stea beginning in stearothermophius to help
remember it’s for steam autoclaves
 B. subtilis (ethylene oxide or EtO)
Viruses
 Reliant on host cell for survival
 Viruses are the biggest risk health care
workers face
 Note table 7-4 page 145 for viral
pathogens
Prevention of Staff
Imposed SSIs
 Human error/breaks in sterile technique
 Must be documented if occur
 Failure to recognize and correct a breach in
sterile technique is wrong as it is negligence
 Surgical conscience
 Basis for practice of strict adherence to sterile
technique that involves honesty and moral integrity
and must be upheld by all surgical team members at
all times
 There can be NO compromise of sterile technique
Environment
 Fomite
 Inanimate objects on which microbes may reside
 OR furniture, your scrubs, your hair, your shoes, contaminated solutions,
contaminated dressing supplies such as tape that is reused
 Reason all operating rooms are cleaned after every surgical
procedure
 Airborne
 Laminar flow system (air moves from vents in ceiling out vents in near
the floor)
 Result of laminar flow is positive pressure (air is moving down so if a
door is opened the air rushes out the door not in the room)
 20 air exchanges per hour in an operating room via HEPA filters, 20%
of those being fresh air.
Patient
 Most SSIs are contracted through the
patient’s own endogenous or normal flora
 Preoperative prophylaxis with antibiotics
reduces risk of SSIs
Risk Factors for SSIs
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Age
Obesity
General physical health
Nasal carriers of S.aureus
Remote infections (infections
going on in another part of the
body at time of surgery)
 Ex. Yeast infection present
and patient is having surgery
in the groin area
 Preoperative hospitalization
(reason most surgeries are
performed the day of
admission)
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Smoking
Malnutrition
Diabetes
Malignancy (cancer)
Immunosuppression
Preoperative hair
removal
 Procedure type or
wound classification (see
page 293)
 Procedure duration
Principles of Asepsis
1. A sterile field is created for each
surgical
procedure
 See pages 153-155
Principles of Asepsis
2. Sterile team members must be
appropriately attired prior to entering the
sterile field
 See pages 154-155
Principles of Asepsis
3. Movement in and around the sterile
field must not compromise the sterile
field
 See page 155