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By MaryAnn Custer MS, FNP
S. Pneumoniae
60,000 cases / year in 2000, 37,000 in 2002
Death in 14% of Hospitalized Adults
*Pneumococcal Vaccine
Up to 25 days (dust), Glass 1-11 days ,
7 days in Sputum
CAP
Influenza
3-4 Million Cases / Year in the US
6th Leading Cause of Overall Death
Highest in Children < 5, and Elderly
5th Leading Cause of Death in the Elderly
Prevention – Immunization
TB
Causes more Deaths Worldwide than Any Other Infectious Disease
Spread Person to Person - Aerosolized Droplets
Up to 70 days in Carpet, Clothes 45 days, Sputum 6-8 months
C – Difficile
Spore Forming Organism
Opportunistic Pathogen
Fecal-oral Transmission
May survive for extended periods outside Host
Listeria
Opportunistic Pathogen
Usually assoicated with food
Survives well in Soil, Water, Food, Feces
MRSA
 Methicillin Resistent Staphylococcus Aureus
 HA MRSA – Hospital Associated ~ 1961 - 50-70%
 Estimated Cost to Treat Between $3.2 – $4.2 billion/year
 Joint Commission National Patient Safety Goals and Institute
for Healthcare Improvement 5 Million Lives Campaign
 Respiratory, Urine, Wound Infections
 CA MRSA – Community Associated – mid to late ‘90s
 Skin and Soft Tissue
 Direct and Indirect Transmission
 Survival in Hospital Environment 1 – 56 days
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Norovirus
Cruise Ships – 2002
Previously Known as Norwalk – like Viruses. Changed in 2002
1968 – 1972 Outbreak of “Winter Vomiting Disease” in Norwalk, OH
Acute gastroenteritis – “stomach flu” or “24 hour bug”
Explosive vomiting, watery (non bloody) diarrhea, abd cramps, HA,
body aches, low-grade fever. 24-60 hours
#1 Cause of Foodborne Illness in US, causing about 2/3 of all
foodborne illness – 23 million infections, 50,000 hospitalizations, 300
deaths / year.
Transmission fecal-oral (food and water) – Direct & Indirect, also
airborne (inhale and swallow droplets)
Highly transmissible – as few as 10 viral particles may cause infection.
Only the “Common Cold” is reported more frequently.
Virus is stable on environmental surfaces – Non enveloped virus.
Quats work by disrupting the viral envelope and are ineffective on
non enveloped viruses.
“Getting Back to the Basics”
Cleaners and Disinfectants Hand Hygiene Products
Precision Blend System
Gloves, Masks, Gowns
Mops, Buckets, & Cleaning Cloths
Waste, and Biohazard Containers
Reduce the Risks of
Disease Transmission through….
PREVENTION
Epidemiologic Triangle
Environment
Causal Agent
Susceptible Host
Alter the Environment
HAND HYGIENE
Observe Standard Precautions
Combination of Universal Precautions and Body
Substance Isolation.
Wear personal protective equipment in accordance
with OSHA’s standards, and facility recommendations:
Gloves, Goggles, Mask, Fluid Resistant Gown.
NOTE: GLOVES ARE A MINIMUM DURING
CLEANING AND DISINFECTION
Cleaning and Disinfection
of
Equipment & Environmental Surfaces
Choosing the Correct
Chemical Germicide
Definitions
 A "disinfectant" is a substance that destroys or
eliminates a specific species of infectious or other public
health microorganism, but not necessarily bacterial
spores, in the inanimate environment. *
 A "sanitizer" is a substance that significantly
reduces the bacterial population in the inanimate
environment, but does not destroy or eliminate all
bacteria or other microorganisms. *
(* EPA March 2002)
Two Levels of Disinfection for
Environmental Services
Intermediate Disinfection (ILD) – Inactivate
Mycobacterium Tuberculosis var. Bovis in
addition to all other organisms below it.
ex. 3% Hydrogen Peroxide, 70% Isopropyl,
Phenolics, Iodophors, and the other ready to use
tuberculocidal solutions
Low-Level Disinfection (LLD) – Inactivate most
forms of bacteria, some fungi, some viruses.
ex. Quaternary Ammonium Solutions
DESCENDING ORDER OF RESISTANCE TO GERMICIDAL CHEMICALS
Sterilization
BACTERIAL SPORES
Bacillus Subtilis
Clostridium Sporogenes
MYCOBACTERIA
Mycobacterium Tuberculosis Var. Bovis
‘TB’
HLD High Level Disinfection
ILD Intermediate Level
NONLIPID OR SMALL VIRUSES
Poliovirus
Coxsackie Virus
Hepatitis A Virus
Rhinovirus ‘Common Cold’
FUNGI
Trichophyton Spp. ‘Nail Fungus’
Cryptococcus Spp.
Candida Spp. ‘Yeast’
LLD Low Level
VEGETATIVE BACTERIA
Pseudomonas Aeruginosa
Staphylococcus Aureus ‘Staph’
Salmonella Choleraesuis ‘Gastroenteritis’
LIPID OR MEDIUM-SIZED VIRUSES
Herpes Simplex Virus ‘Cold Sores’
Cytomegalovirus ‘CMV’
Respiratory Syncytial Virus ‘RSV’
Hepatitis B Virus ‘HBV’
Human Immunodeficiency Virus ‘HIV’
(Adapted From Bond & Favaro, 1991)
Recommending
Chemical Germicides