front 1 Microorganisms | back 1 **invisible to the naked eye, they can be nonpathogenic and parasitic life forms. **converts matter into simple forms through decay converting them to higher forms that can be used as nutrients. |
front 2 Symbiosis or symbiont if referring to both organisms | back 2 relationship between microorganisms (indigenous flora) and humans |
front 3 Mutualism, Commensalism, Parasitism | back 3 categories of symbiosis |
front 4 indigenous microflora (also referred to as opportunistic pathogens) | back 4 microbes that live on the skin an inside the human body. They include bacteria, fungi, viruses, and protozoa *harmless unless given the chance to enter the body through a surgical wound" |
front 5 infection | back 5 multiplication of organisms in the tissues of a host *may affect not only a patient but also any individual who has contact with the health care facility, including health care workers and visitors |
front 6 nosocomial infection | back 6 any infection that develops while a patient is in the health care facility **a broadened categorization - termed HAI (health care-associated infections) 25% not evident until after discharged from hospital |
front 7 Mutualism | back 7 both organisms benefit from and depend on one another to a certain extent. escherichia coli (E coli)- colonizes within the human intestine, obtains nutrients from the food that humans eat. Produces vitamin K for blood-clotting. |
front 8 commensalism | back 8 one organism benefits but second organism neither benefits nor is harmed. indigenous microflora is an example |
front 9 Neutralism | back 9 subcategory of commensalism - two organisms occupy the same area with no effect on each other |
front 10 Antagonism | back 10 subcategory of commensalism - one microorganism inhibits or interferes with the growth of another example: a microbe produces waste products that are toxic to the neighboring microbes |
front 11 competitive exclusion | back 11 in commensalism symbiosis the second organism is usually neither benefited or harmed. To a certain extent the second organism can be benefited if the organism is taking up space and preventing other potentially harmful microbes from colonizing. |
front 12 Parasitism | back 12 one organism benefits and the host is harmed examples: intestinal worms, nosocomial infections (UTI), and airborne viruses (common cold) ** commensal symbiosis can change to parasitism if the microbe becomes opportunistic by entering through a surgical skin incision |
front 13 pathogens | back 13 microorganisms that cause an infection |
front 14 UTI (staphylococcus S. aureus bacteria) | back 14 #1 nosocomial infection (HAI) - 32% |
front 15 Surgical site infections | back 15 22% of HAI |
front 16 pneumonia (lung infections) | back 16 15% of HAI |
front 17 bloodstream infections | back 17 14% of HAI |
front 18 eukaryotes | back 18 a group of how all living cells are classified - cellular structure is complex. includes: protozoa, fungi, green, brown, and red algae, and all plant and animal cells |
front 19 prokaryotes | back 19 a group of how all living cells are classified - cellular structure is less complex organisms whose organelles are not membrane bound. |
front 20 bacteria | back 20 all are prokaryotes and they divide by binary fission (the division of two identical cells) |
front 21 morphology | back 21 characteristics of bacteria size, shape, and arrangement |
front 22 coccoid coccus = singular cocci = plural | back 22 round shaped bacteria |
front 23 diplococci | back 23 paired bacteria |
front 24 streptococci | back 24 chain of bacteria |
front 25 staphylococci | back 25 cluster of bacteria |
front 26 coccobacilli | back 26 a bacterial cell intermediate in morphology between a coccus and a bacillus - rod shaped, but also short and wide that they resemble cocci which is round |
front 27 bacillus | back 27 rod-shaped bacteria |
front 28 spirilla | back 28 spiral-shaped bacteria |
front 29 L-form | back 29 bacteria that lose normal shape due to adverse environmental conditions; once normal conditions are reestablished cells revert to normal shape. |
front 30 characteristics of bacteria | back 30 morphology, growth(varies with type of agar) motility, nutritional requirements, oxygen requirements (and carbon dioxide), pathogenicity, metabolism(secretion of waste products), proteins, genetics, staining, spore forming (sporulation) |
front 31 motility: characteristic of bacteria | back 31 flagella: long thin structures.. whipping motion cilia: fine, short, hairlike extension located on the surface of the cell; rhythmic movement |
front 32 oxygen requirements - characteristic of bacteria | back 32 obligate aerobes; require level of oxygen found in a typical room microaerophiles; require oxygen but at a lower level than room air 5% obligate anaerobes; will not grow if there is any amount of oxygen present in the environment facultative anaerobes; able to survive in an environment that contains oxygen or no oxygen aerotolerant anaerobes; grow best in environment without oxygen - can survive up to 15% oxygen capnophiles; grow best in high concentrations of carbon dioxide |
front 33 staining - characteristic of bacteria | back 33 simple stain; used to determine basic shape and structures of cell; single dye such as methylene blue is used and the cell is rinsed with water. Gram stain; cells are stained with crystal violet; washed with ethanol that removes purple stain from bacteria that don't retain the stain; red dye safranin is applied; specimen is rinsed with water. *Gram positive bacteria retain the crystal violet and therefore are purple color. *Gram negative bacteria do not retain the crystal violet an are red from the safranin stain. **Gram-variable bacteria, Mycobacterium tuberculosis do not consistently stain red or purple **Acid-fast stain; used to identify bacteria classified in the genus Mycobacterium. Red dye (carbolfuchsin) is retained by acid-fast bacteria |
front 34 Staphylococcus - S. aureus | back 34 ******Most common post-op bacterial infection (pathogen) - SSI gram-positive coccus - common in the flora of the skin, hair and nares of nose toxic shock syndrome osteomyelitis endocarditis |
front 35 Staphylococcus - S. epidermis | back 35 IV catheter infections, UTIs, prosthetic device infections, subacute bacterial infections, endocarditis |
front 36 Streptococcus - S. pneumoniae | back 36 bacterial pneumonia |
front 37 Streptococcus - S. pyogenes | back 37 rheumatic fever, necrotizing fasciitis, strep throat, tonsillitis, scarlet fever |
front 38 Aerobic gram-negative cocci, coccobacilli | back 38 Neisseria gonorrhoeae - pelvic inflammatory disease deading to salpingitis Moraxella catarrhalis - otitis media in children |
front 39 spore forming - characteristic of bacteria | back 39 clostridium is an example *when conditions are unfavorable(extreme temps, dry, lack of food) the genetic material of the cell is enclosed in a protein capsule *can survive for a long time until favorable conditions are reestablished, bacteria returns to vegetative state and able to grow *not to be confused with reproduction, it is a method of bacterial survival *are difficult to destroy; sterilization processes must be able to kill it |
front 40 Aerobic gram-positive bacilli, coccobacilli, coryneform bacilli (B. anthracis, Listeria, monocytogenes, lactobacillus species, corynebacterium diphtheriae) | back 40 anthrax, meningitis, bacteremia, endocarditis, respiratory and cutaneous diptheria |
front 41 Aerobic, microaerophile gram-negative bacilli spirochetes Legionella pneumophila | back 41 Pontiac fever (influenza-like illness) Legionnaires' disease (severe form of pneumonia) |
front 42 Aerobic, microaerophile gram-negative bacilli spirochetes pseudomonas aeruginosa | back 42 deep-tissue health care-associated infections in patients with burns, deep puncture wounds, and open bone fractures |
front 43 Aerobic, microaerophile gram-negative bacilli, spirochetes Helicobacter pylori | back 43 chronic gastritis, stomach ulcers, peptic ulcers |
front 44 Facultative anerobic gram-negative bacilli Haemophilus influenzae | back 44 Bacterial meningitis (primary cause in infants and children), respiratory tract infections, bacterial pneumonia (elderly), septic arthritis, cellulitis, eye infections |
front 45 Facultative anaerobic gram-negative bacilli Escherichia coli | back 45 UTIs, sepsis, neonatal meningitis |
front 46 Mycobacteria Mycobacterium tuberculosis | back 46 Tuberculosis |
front 47 Chlamydia C. trachomatis | back 47 Conjunctivitis, ocular lymphogranuloma venereum, lymphogranuloma venereum, nongonococcal urethritis, postgonococcal urethritis, infant pneumonia |
front 48 Tuberculosis - mycobacterium tuberculosis | back 48 transmitted through airborne droplet nuclei, usually infect the lungs but may also infect the kidneys, bone, joints, or skin. annual testing fit test for mask require isolation precautions when surgical procedures are performed - PPE plus a NIOSH approved respirator patient advised how he/she can prevent cross-contamination |
front 49 Viruses | back 49 nonliving particles that are completely reliant on the host cell for survival *obligate intracellular parasites *replication is directed by the nucleic acid within the host cell *contain either DNA or RNA and a protein coat that encases the nucleic acid *depend on the protein production of the host cell; does not contain the enzymes required for the production of energy *no antibiotics are given |
front 50 Capsid | back 50 A protein covering that surrounds and protects the virus's DNA or RNA and aids in the attachment of the viral cell to the host cell *composed of protein molecules called capsomeres |
front 51 Viruses enter the body through the following methods | back 51 inhalation of respiratory droplets, exchange of body fluids, ingestion of food or water, bites by arthropod vectors |
front 52 the capsid and the nucleic acid together are referred to as | back 52 nucleocapsid |
front 53 Common pathogens in the OR | back 53 Hepatitis B (HBV) - blood, body fluids - liver cancer Hepatitis C - blood-borne (silent killer - prior to 1980 no testing of blood) - liver cancer Hepatitis D (Delta) Human immunodeficiency Virus (HIV) - blood or other bodily fluids Herpes simplex virus (HSV) - contact with fluid from lesions Papillomavirus - direct contact with another person Cytomegalovirus (CMV) - direct contact with body fluids Cruetzfeldt-Jakob Disease (CJD) - exact mode of transmission unknown - prions (20hr) sterilization or properly dispose of instrumentation |
front 54 Prion | back 54 "proteinaceous infectious particle" do not contain DNA or RNA changes normal PrP (a protein) from noninfectious spiral shape, alpha-helical, to the infectious folded shape called the beta-sheet attack the brain (neurons) and cause diseases called subacute spongiform encephalopathies **more common in animals, and include the two common forms of scrapie(disease that infects sheep and goats) and bovine spongiforms encephalopathy (commonly called mad cow disease) in rare cases can be inherited as a mutant gene or sporadic case |
front 55 CJD | back 55 20 year incubation time, mimics Alzheimer's disease, no vaccine or cure, definitive diagnosis is through histologic examination of affected brain and lymphoid tissue WHO - recommends use of single-use, disposable instruments and the destruction of all reusable instruments |
front 56 vCJD or nvCJD | back 56 a new variant strain has a younger median age of onset at 28 years of age and longer duration of symptoms of 13 -14 months more chemical indicators of prion accumulation in the neural and lymphoid tissues |
front 57 two categories of parasitic human pathogens | back 57 Unicellular protozoans and Multicellular protozoans |
front 58 Parasitology | back 58 the study of invertebrates that cause disease |
front 59 Helminths | back 59 metazoans category - endoparasites properly known as worms most common worms are tapeworms, flukes, and roundworms primary route of transmission = food or water contained eggs also transfers by skin penetration, fecal-oral contamination, or arthropod bite cause intestinal blockage and may rupture intestinal wall |
front 60 increase in helminth infection | back 60 human mobility, immigration from Third World countries |
front 61 damage of body tissues and organs to the point of surgery example: cysticeri (Taenia solium) pork tapeworms that can migrate out of the intestinal tract and travel to muscle and brain tissue, and the eyes. | back 61 worms |
front 62 Protozoa | back 62 unicellular eukaryotes causes malaria and chronic sleeping sickness the intestinal form of these are transmitted by fecal-oral route and are often responsible for infections in crowded environments such as day care centers and underdeveloped countries. |
front 63 Entamoeba histolytica | back 63 a protozoa that causes amebic dysentery patients who are scheduled to undergo a sigmoidoscopy or colonoscopy |
front 64 Trichomonas vaginalis (T. vaginalis) | back 64 a unicellular anaerobic protozoan that is part of the normal flora of the vagina and urethra If acidity of vagina is upset, protozoan population will grow causing trichomoniasis (usually a sexually transmitted disease) |
front 65 The study of fungi | back 65 Mycology |
front 66 unicellular yeast or multicellular molds and mushrooms reproduce sexually or asexually by producing spores | back 66 Fungi |
front 67 fungal diseases | back 67 called mycoses (mycosis=plural) |
front 68 opportunistic pathogens that cause disease when the host is immunocompromised common in AIDS patients | back 68 The majority of fungal diseases |
front 69 Bread mold | back 69 zygomycosis |
front 70 rapidly progressive and destructive disease which causes extensive damage to the bone and tissues of the face. If the organism enters the bloodstream and destroys the cranial bones, the brain tissue will be invaded. | back 70 rhinocerebral zygomycosis |
front 71 candida albicans | back 71 vaginal yeast infection trench mouth (thrush) immunocompromised patients should be monitored for infection |
front 72 intraoperative guidelines for suspected CJD patients | back 72 use disposable equipment avoid use of power instruments use neutral zone for passing sharps sterile attire-gloves, face shields, knee-high impervious shoe covers clean body fluid spills with sodium hydroxide (household bleach) specimens into specimen container, then place biohazard bag labeled properly with this disease per surgeon's order: clean patient's head with 1 molar sodium hydroxide at the end of procedure |
front 73 postoperative guidelines for suspected CJD patients | back 73 place reusable instruments in impervious container, biohazard bacs, and labels with this disease according to hospital policy (policy may be disposal) bodily fluids in biohazard bags labeled with this disease and kept separate from other red bags; notify environmental services to collect bags. sharps in a separate container labeled with this disease; notify environmental services to collect and incinerate container |
front 74 CJD environmental cleaning protocols | back 74 decontaminate all OR surfaces with 1 molar sodium hypochlorite for 60 min.. rinse with water then give routine cleaning visible bioburden decontaminated with 1:10 dilution of 5.25% sodium hypochlorite...followed by routine cleaning with disinfectant |
front 75 most hospital infections are transmitted by bacteria (UTI), viruses, and occasionally fungi and parasites | back 75 Frequent handwashing helps to eliminate these primary agents |
front 76 transmission based precautions help prevent cross-contamination of patients when the disease process has been diagnosed may even be required to change scrubs in the event of MRSA or VRE | back 76 Direct contact - Indirect contact - Droplet particle size(>5um) - Airborne spread particle size (<5 um) |
front 77 SSI (surgical site infection) sources at the time of surgery, rather than at some point after surgery | back 77 divided into two groups: environmental: (1) personnel, (2)the environment, and (3)contaminated instrumentation endogenous: patient's endogenous flora |
front 78 SSI sources - environmental - (1)personnel | back 78 personnel hair, skin, and nares are reservoirs of bacteria, which may be discharged in particle form into the air and therefore pose a risk of these to the patient. gowns and drapes cover the skin on areas of the body other than the hands. The primary purpose of wearing PPE around the OR table is to provide a barrier to contamination, both from personnel to patient and from patient to personnel. This is termed surgical conscience |
front 79 SSI sources - environmental - (2)environment FOMITES | back 79 A second source of microbial transmission is through the air and through these inanimate objects that may contain infectious microorganisms including walls, floors, cabinets, furniture and equipment |
front 80 SSI sources - environmental - (3)contaminated surgical instrumentation | back 80 contaminated antiseptic solutions, contaminated wound dressings, and contaminated or improperly sterilized surgical instruments |
front 81 SSI sources - endogenous - patient's endogenous flora cannot sterilize your skin | back 81 two primary sources of SSI risk to the patient: 1. encountered in contaminated procedures 2. resident (the normal) flora of the skin |
front 82 Preoperative prophylaxis with antibiotics | back 82 shown to reduce SSIs carriers of S. aureus are at particular risk for SSI |
front 83 Factors that increase SSI | back 83 age: pediatric or geriatric lower immunological defenses obesity: diminished blood flow general health: poor health=predisposed to infection carriers of S. aureus or MRSA: greater risk from their own flora remote infections: other body site infections; will travel preoperative hospitalization: duration of operative stay preexisting illness and related treatment: rates are higher in patients with compromised immune systems from preexisting illness, patients on meds., etc. |
front 84 preoperative preparations for suspected CJD patients | back 84 notify all units remove all unnecessary equipment and supplies from the OR as possible and everything else as far from the OR table as possible cover all OR surfaces; electrical cords with sterile plastic sleeves |
front 85 Other factors that may contribute to an increased likelihood of SSI | back 85 malnutrition, tobacco use, diabetes, malignancy, immunosuppression, high staph carriers, ruptured appendix (fecal matter in the colon) |
front 86 Procedure-related risk factors that increase the danger of SSI | back 86 Preoperative hair removal: use of razors carries a greater risk than the use of clippers. Blades leave many small cuts on the skin, allowing bacteria easier access for colonization. Depilatory cream is a safer alternative Type of procedure: clean-contaminated (class II), contaminated (class III), and dirty (class IV), cases carry a higher risk of infection Duration of procedure: longer anesthetic and operative times have an accompanying increase in time for bacterial contamination to occur, increased tissue damage, and greater immunosuppression, fatigued team members which may break sterile technique |
front 87 AST recommended standards of practice | back 87 use of eye protection, laundering of scrub attire, wearing jewelry, wearing the lab coat/cover gown, hand hygiene and fingernails, head covers, shoe covers (during operation) |