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Introduction to Microbiology Objectives • Define terms related to asepsis. • Discuss the relationship between the principles of asepsis and practice of sterile technique and surgical patient care. • Discuss the history and development of disinfectant techniques. • Identify characteristics of pathogens associated with surgical site infections. History of Sterilization • Even in ancient times, forms of disinfection were practiced. • Understanding of how these practices worked to prevent disease, was not known. • Many used the burning of sulfur to “cleanse” an area. History of Sterilization • Early bible passages suggest purification by fire. • Aristotle, Hippocrates, and Galen used boiling of water, to sanitize drinking water and instruments used in surgery. History of Sterilization • In the middle ages, advances were made linking the spread of disease by direct contact, fomites, and airborne. History of Sterilization • 1775 – Spallanzani demonstrated that boiling for 1 hour killed microbes. • 1832 – Henry demonstrated that dry heat could sterilize infected clothing. • 1847 – Semmelweis advocated hand washing between patient contact to prevent spread of puerperal fever. History of Sterilization • 1862 – Pasteur developed early principles of sterile technique. – Father of bacteriology • 1867 – Lister applied Pasteur’s principles of asepsis to surgery. – Father of antiseptic surgery • 1876 – Tyndall discovered a heat resistant stage of bacteria the spore. History of Sterilization • 1880 – Chamberland developed the first pressure steam sterilizer. – Chamberland’s Autoclave • 1885 – Schimmelbusch used steam sterilization for surgical dressings. • 1888 – Esmarch recommended use of bacteriological testing to prove sterilization. History of Sterilization • 1888 – Kinyoun recommended use of a vacuum to increase steam penetration. • 1915 – Gravity sterilizer introduced. • 1933 – Development of the modern autoclave. • 1963 – Glutaraldehyde was approved for sterilization of heat sensitive items. Terminology • Pathogen – Organism capable of causing disease. • Fomite – Inanimate object that transmits disease. • Vector – Living carrier that transmits disease. • Resident flora – Normal microbes that live in the skin. • Transient flora – Microbes that live on the skin surface that are easily removed. Terminology • Infection – Invasion of pathogens into the body that causes disease. – Nosocomial Infections Terminology • Antiseptic – Used on living tissue to inhibit growth of microbes. • Disinfectant – Used on inanimate objects to kill most microbes. Terminology • Bacteriostatic – Substance that inhibits the growth of bacteria. • Bacteriocidal – Substance that destroys bacteria. – Fungicide – Virucide – Sporicidal Terminology • Sterile – Rendered free of all microbes. – Sterilization – Sterile Field • Sterile Technique – Methods used to prevent contamination of the sterile field. • Contamination – Presence of pathogenic materials. – Cross-contamination Terminology • Decontamination – To reduce to a minimum the presence of pathogens. • Terminal Disinfection – Render items safe to handle using high level disinfection. • Terminal Sterilization – Render items safe to handle using sterilization. Pathogens • Microorganisms are a natural part of the world we live in. • Some microbes are useful: – Decomposition of organic matter – Take inorganic matter and convert them to nutrients for plants and animals. • Yogurt • Cheese • Antibiotics Pathogens • Certain microorganisms use a parasitic relationship with plants and animals causing harm. – Disease – SSI (Surgical Site Infections) Bacteria • Classified according to the environment that sustains its life. • Aerobic – Must have Oxygen to survive. • Anaerobic – Live without Oxygen. – Obligate Anaerobes – Faculatative Anaerobes • Microaerophilic – Prefer low oxygen environments. Bacteria • May also be classified by a specialized lab test called a Gram’s Stain. • Gram Positive stain blue • Gram Negative stain pink Bacteria • Bacteria is also identified by shape. • Cocci - Spherical • Bacilli – Rod shaped • Spirilla – Spiral shaped Cocci • Round spherical shaped bacteria. • Found in chains or groups. • Example: – Staphylococcus Aureus • Methicillin Resistant Staphylococcus Aureus (MRSA) – Neisseria Gonorrhoeae – Streptococci • Nectrotizing Fascitis Bacilli • Rod shaped bacteria. • Have the ability to form heat and drought resistant spores. • Examples: – – – – Escherichea Coli Pseudomonas Aeruginosa Salmonella Mycobacterium Tuberculosis Spirilla • Spiral shaped bacteria. • Posses the ability to move itself. • Examples: – Borreclia Burgdorferi (Lyme Disease) – Rickettsiae – Treponema Pallidum (Syphilis) Yeasts • Single Celled, type of parasite. • Found on skins of fruits and vegetables. • Grow well in warm temperatures. • Examples: • Candida Albicans • Invade mucous membranes of the mouth, throat, and vagina. Molds • Multicellular, filamentous fungi. • Responsible for most crop and food spoilage. • Examples: – Aspergillus – Histoplasmosis Virus • Nonliving small particles that rely on a host cell for survival. • Invades a cell host, combines with the DNA/RNA and replicates. • Not affected by antibiotics. • Transmission varies: – Blood – Body Fluids – Airborne Virus • Examples: – – – – – – Hepatitis (A,B,C,D,E,F,G) HIV (AIDS) Influenza Varicella (Chickenpox) Rabies HSV (Herpes Simplex Virus) Prions • Proeinaceous Infectious Particles • Fatal disease referred to as spongiform encephalopathies. • Example: – Creutzfeld-Jakob Disease (CJD) (Mad cow disease) Parasites • Organisms that nourish themselves at the expense of other living things, causing them damage. • Examples: – Giardia Lamblia – Malaria – Helminths (worms) Microbiology in the O.R. • Most common transmitted pathogen in the O.R. is Staphylococcus aureus. • Source: – Skin or nares of the patient and surgical team. • Other contaminations occur with the type of procedure being performed. – Gastrointestinal tract – Respiratory tract What are some ways to limit these contaminations from happening? Review • • • • • • • History Terminology Bacteria Yeasts Molds Viruses Parasites Introduction to Microbiology • QUESTIONS