Bacteria Identification and Disinfection Quiz

Microorganisms and Decontamination

• Microbes are too small to be seen with the naked eye, requiring electron microscopes to visualize them
• Figure M2-1 shows a needle tip under high magnification with bacteria attached, demonstrating how difficult it is to ensure complete removal of microbes during decontamination
• Microbes can't be seen by the human eye, so specialists in CSSD (Central Sterile Supply Department) rely on validated procedures and processes to clean and decontaminate reusable medical devices

Types of Microorganisms

• Protozoa: large, complex, single-celled parasites that can cause diseases like malaria and dysentery; can be encysted, making them more difficult to kill
• Fungi: large to medium-sized microorganisms that grow filamentous structures called hyphae; can cause diseases called mycoses; thick cell walls and spores can resist disinfectants
• Yeasts: single-celled organisms with a nucleus; can cause infections in the gut, urogenital tract, respiratory tract, and oral cavity; relatively easy to remove and susceptible to disinfectants and heat
• Bacteria: small microorganisms that come in many shapes and types; can produce toxins and cause infection; can be difficult to remove from uneven surfaces and resist disinfectants
• Viruses: small, non-living infectious objects containing genetic information; can be difficult to remove and inactivate; susceptible to dismantling or disruption of their chemical structure
• Prions: very small proteinaceous units that cause Transmissible Spongiform Encephalopathies (TSEs) when folded abnormally; difficult to remove and inactivate; require a traceability system for medical devices

Importance of Cleanliness and Sterility

• Microbes are ubiquitous and can be found everywhere, including on and in the human body

• Each individual has their own personal microbiome consisting of thousands of different species

• Commensal microbes are helpful, but can be pathogenic if transferred to someone else

• In a hospital or healthcare setting, infection control methods are used to prevent the transfer of pathogens or commensals

• Human skin sheds dead cells and associated microbial biofilm over a period of five or six weeks, which can contaminate clean zones

• Importance of hygiene procedures and appropriate PPE to minimize contamination in CSSD### Clean Rooms and Sterile Areas

• Very high levels of contamination prevention and PPE are used in clean rooms and sterile areas of pharmaceutical and space industries to prevent microbial contamination.

• Despite the highest hygiene standards and rigorous cleaning and decontamination procedures, some microbes can still survive in these areas.

CSSD Workwear and PPE

• The CSSD has three work zones: Contamination, Inspection, Assembly and Packaging, and Sterile Storage, each with its own entry and exit points.
• Staff must change PPE and undergo hygiene procedures when moving between zones.
• The Decontamination zone in the CSSD poses a high risk of exposure to contaminated reusable medical devices and pathogenic microbes.

Decontamination Zone PPE Requirements

• Wear fluid-resistant gowns with long-cuffed sleeves that can be tucked inside gloves during procedures that generate splashes of blood or body fluids.
• Change the gown whenever it becomes visibly soiled or wet and discard after use.
• Wear a plastic bib or apron over the gown for extra protection from splashes during manual cleaning processes.
• Wear fluid-repellent masks with visor eye shields to reduce the risk of microbial transfer to the eyes, nose, and mouth.
• Wear gloves for environmental cleaning activities, handling contaminated reusable medical devices, and waste.

Gloves Usage

• Wash your hands before and after using gloves.
• Wear the correct size and appropriate type of gloves for the task.
• Keep your nails short to avoid puncturing gloves.
• Avoid touching your mask, eyes, or face with your gloves.
• Learn how to remove gloves without contaminating your hands.
• Remove used gloves before touching anything that can be contaminated through contact.

Shoes or Shoe Covers

• Wear dedicated shoes or clogs that are worn only in the decontamination zone, ideally washable.
• Use disposable shoe covers to protect regular shoes from becoming wet and contaminated during cleaning procedures.

Other Workwear Requirements

• In the IAP or sterile storage zones, wear workwear that protects reusable medical devices and their environment.
• Emphasize general hygiene and wash your hands frequently.
• Wear a freshly laundered or new, disposable, low-lint "scrub" uniform that minimizes bacterial shedding.
• Wear a clean, single-use, low-lint surgical hat or hood that fully covers and confines your hair.
• Wear dedicated non-slip enclosed footwear that can protect from injury or contact with accidentally dropped sharp objects.