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Introduction to SUR 111 Perioperative Patient Care Microbiology The study of microorganisms Microorganisms are life forms that cannot be seen with the naked eye Determining life: Able to reproduce Ingest and metabolize food Eliminate waste Irritable (respond to stimuli) Able to mutate or change genetic make up Taxonomy (Classification) Kingdoms Animal (Eucaryotic cells) Plant Protista (protozoans) Fungi ________________________ Monera (bacteria) (Procaryotic cells) ONE MORE THING: VIRUSES (Virion) Neither Procaryotic or Eucaryotic Arguable as to whether or not these are life forms as they do not display the five characteristics of life Are obligate intracellular parasites Means reproduction dependant on a cell host There are viruses that can infect or live in a bacteria: Bacteriophages Smallest microorganism (need an electron microscope to see) This is a viron! Bacteriophages Eucaryotic verses Procaryotic Eucaryotic You, You, You! are composed of eucaryotic cells! Have a true nucleus Have a nuclear membrane Chromosome encapsulated More advanced Procaryotic Bacteria in this class No nuclear membrane Chromosome floats in cytoplasm Our Focus Viruses & Bacteria BACTERIA Bionomical System of Nomenclature (Scientific Name) Genus First letter of capitalized Italicized or underlined May see abbreviated capital letter/period Example: E. for Escherichia Species All lower cased Italicized or underlined Example: coli Correct forms: Escherichia coli or E. Coli or Escherichia coli or E. Coli Procaryotic Cell Structure 1. 2. 3. Standard Equipment Capsule • Slime layer • Outer covering • Protection • Movement (like slugs) Cell membrane • Regulation of things moving in and out of cell DNA (1 chromosome) • Reproduction • Called binary fission 1. • 1. 2. Optional equipment Cell Wall • Protection • Morphology (shape) • Peptidoglycan protein determines staining (gram positive or gram negative) Flagella • Movement Pili • Attachment Endospores (spores) • For Ultimate hibernation • Survival mechanism Identifying Bacteria Gram Positive Turns slide purple Thick peptidoglycan layer stabilized by techoic acid Allows staining agent to permeate and stay visible Gram Negative Turns red/pink Thin peptidoglycan layer Doesn’t absorb staining agent Gram Positive Gram Negative Identifying Bacteria Gram Indeterminate Do not stain because they have no cell wall Morphology (Shape of Bacteria) Bacillus (bacilli) Rod shaped Coccus (cocci) Round or circular Are other shapes you’ll learn in microbiology course: Vibrio curved Spirillium (2 curves) ~ Spirochete (many curves) w Coccobacillus (football shape) Morphology Continued Are bacteria with no cell wall (remember gram indeterminate?) Shape is undefined as a result of no cell wall and are referred to as polymorphic or pleomorphic in shape Polymorphic or pleomorphic just means these bacteria can occur in many different shapes Arrangements of Bacteria (How they connect to one another) FOCUS Cocci Bacilli Arrangement determined by how they split (reproduction) Splitting in two = Binary Fission Cocci Strepto = chain Above = Streptococci Staphylo = cluster Above = Staphylococci Other Arrangements for Cocci Diplococci Tetracocci Bacilli Steptobacillus Strepto = chain Physiology Temperature Ranges Gas Requirements Fragility Hardiness Fastidious Carbon sources Energy sources Gas Requirements Aerobic Must Anaerobic Must have oxygen to survive have carbon dioxide to live Strict Anaerobes Placed in oxygen, will die Facultative Can tolerate both conditions Fragility Fragile bacteria are: Easily destroyed Do not live outside their normal environment Hardiness Hardy bacteria: Tolerate many environments Likely are spore producers Difficult to destroy Fastidious Fastidious bacteria: Have strict growth requirements Grow well under certain conditions Sterilization Microorganisms must be removed from anything that is to be used inside the human body prior to surgical procedures Sterilization is the term used to describe the absence of all microorganisms including spores Factors in Achieving Sterilization Types of sterilization Various Method methods of dependent upon item being sterilized Considerations with sterilization Monitoring successful sterilization Physical indicators Chemical indicators Biological indicators Will cover in depth within coming weeks Roles in Surgery Sterile team members Nonsterile team members Surgical technologists are sterile team members however they may function in a nonsterile role Surgical technologist are an integral part of the surgical team Principles of Asepsis Only sterile items are used in the sterile field A sterile barrier must be considered contaminated after it has been penetrated Edges of a sterile package or container are considered contaminated after it has been opened Gowns are considered sterile only from shoulder level to table level and the sleeves to two inches above the elbow Only horizontal surface of a table is considered sterile Sterile persons or items touch only sterile areas. Nonsterile persons or items only touch nonsterile areas. Movement in and around the sterile field must not compromise or contaminate that field All items and areas of doubtful sterility must be considered contaminated. If in doubt, throw it out! Surgical Attire Personal hygiene observed No jewelry, nails trimmed and clean (not over fingertips, no nail polish, no cuts/abrasions/rashes on skin Scrubs with strings tucked Hair covered (long hair tied back and covered) Foot covers (booties) PPE (personal protective equipment) Hair cover Shoe covers (removed prior to leaving OR department) Mask (worn properly in restricted areas and removed at proper times) Sterile Gown Sterile Gloves Clean Gloves (worn when doing nonsterile activities) Where Do I Wear Various Articles of Surgical Attire? Must understand OR Traffic Patterns Unrestricted Semi-restricted Restricted Some facilities do not have a semi-restricted area, only unrestricted and restricted Let’s practice and begin recognizing our Surgical Attire and where to wear it