Microbiology and Infection Control Final Review
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Questions and Answers

What is the definition of Microbiology?

The study of microorganisms

What is the name of the first antibiotic?

Penicillin

Prions are easily killed by sterilization?

False (B)

Which of the following requirements of cell life is best described by the preferred temperature of 37 deg C.?

<p>Optimum temperature (A)</p> Signup and view all the answers

Transient flora is always found on the body?

<p>False (B)</p> Signup and view all the answers

Which statement regarding the sterile field is FALSE?

<p>The upper back section of the surgical gown is considered sterile. (B)</p> Signup and view all the answers

Remitting symptoms are long-lasting and recurrent.

<p>False (B)</p> Signup and view all the answers

What stage of illness is characterized by a person starting to feel tired and having a sore throat?

<p>Prodromal</p> Signup and view all the answers

An HAI is acquired prior to hospitalization.

<p>False (B)</p> Signup and view all the answers

From the following list, which type of HAI is most influenced by MDR?

<p>Surgical site infections (SSI) (E)</p> Signup and view all the answers

What is the best description of the action of Efflux pumps?

<p>Remove antibiotics from the cell interior</p> Signup and view all the answers

Medical asepsis is also known as the clean technique?

<p>True (A)</p> Signup and view all the answers

Surgical asepsis techniques are only performed in operating rooms.

<p>False (B)</p> Signup and view all the answers

Environmental cleaning is an example of medical asepsis.

<p>True (A)</p> Signup and view all the answers

Masks and caps used in sterile procedures are sterile.

<p>False (B)</p> Signup and view all the answers

Infectious disease may be spread during the incubation period?

<p>True (A)</p> Signup and view all the answers

We are born with adaptive immunity.

<p>False (B)</p> Signup and view all the answers

Macrophages recognize PAMPS because of PRRs (external molecules on the surface of the macrophage.)?

<p>True (A)</p> Signup and view all the answers

A cytokine storm can cause damage to the epithelial tissue of the lung?

<p>True (A)</p> Signup and view all the answers

Provide 2 conditions which increase the susceptibility of a host.

<p>Age and Prematurity</p> Signup and view all the answers

Which mode of transmission is easiest to break?

<p>Direct Contact</p> Signup and view all the answers

Who is considered the "father of modern microbiology"?

<p>Louis Pasteur</p> Signup and view all the answers

Flashcards

What is Microbiology?

Study of microorganisms, typically less than 1 mm in diameter, requiring a microscope for visibility. Includes viruses, bacteria, fungi, algae, and protozoa.

Microbiology Specialties

Specialized fields within microbiology focusing on specific types of organisms.

Microbiology Fields/Work

Areas of work in microbiology with a more applied focus.

What is Cell Theory?

The theory that all living organisms are composed of one or more cells, and all cells arise from pre-existing cells.

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Five Characteristics of All Cells

Five fundamental characteristics common to all cells: self-feeding/nutrition, self-replication/growth, differentiation, chemical signaling/communication, and evolution.

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What is a Prokaryotic Cell?

Cells lacking a nucleus or other membrane-bound organelles, typically unicellular. Examples include bacteria and archaea.

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What is a Eukaryotic Cell?

Cells containing a nucleus and other membrane-bound organelles, often found in multicellular organisms. Examples include animals, plants, and fungi.

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Cell Membrane

The outermost layer of a cell, protecting the cell and regulating the movement of substances in and out.

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Cytoplasm

The gel-like substance inside a cell, containing water and proteins, where essential cell functions occur.

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Nucleus/Nucleoid

The control center of a cell, containing genetic information that directs cell behavior and appearance.

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Organelles

Specialized structures within a cell with specific functions. Examples include mitochondria, Golgi apparatus, and endoplasmic reticulum.

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Cell Wall

A rigid outer layer that provides structural support to many bacteria and plant cells, but NOT present in all bacteria.

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Spore Coat

A protective layer formed by some microorganisms that allows them to survive harsh conditions.

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Proteins

A major component of cytoplasm, essential for many cell functions.

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What is Taxonomy?

The classification of living organisms based on their characteristics, with the highest level being the kingdom.

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Nomenclature

The scientific naming system for organisms, using a two-part name (genus and species).

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What is Morphology?

The study of the form and structure of organisms, including both macroscopic and microscopic features.

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Macroscopic Morphology

The characteristic shape or form of an organism, visible to the naked eye.

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Microscopic Morphology

The characteristic shape or form of an organism, visible only under a microscope.

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Aerobes

Organisms that require oxygen to survive.

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Anaerobes

Organisms that can survive without oxygen.

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Facultative Anaerobes

Organisms that prefer oxygen but can survive without it.

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Gram Stain

A staining technique that differentiates bacteria based on their cell wall structure.

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What are Bacteria?

Unicellular organisms that exist in diverse habitats, with less than 1% harmful (pathogenic) to humans.

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What are Viruses?

Acellular particles that require a host cell to replicate, hijacking the host's machinery to produce more viral particles.

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What are Fungi?

A diverse group of organisms ranging from single-cell yeast to massive multicellular molds. Important in the food industry but can cause diseases and allergies.

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What are Prions?

Infectious protein particles that cause disease by converting other proteins into misfolded forms. Resistant to standard sterilization methods.

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Lipophilic Viruses

Viruses that have an outer layer made of lipids (fats), making them more susceptible to disinfectants.

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Hydrophilic Viruses

Viruses lacking an outer lipid layer, making them more resistant to disinfectants.

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What is Normal Flora?

The collection of microorganisms (bacteria and fungi) that normally reside on the human body.

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Resident Flora

Microorganisms that are always present at a specific anatomical site on the body.

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Transient Flora

Microorganisms that live on the body for a short period of time, then move on or die off.

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Sterile Body Tissues

Body tissues that are normally sterile and free of microorganisms. Examples include blood, brain, cerebrospinal fluid (CSF).

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Advantages of Normal Flora

The beneficial effects of normal flora, including providing nutrients, stimulating the immune system, inhibiting pathogens, and preventing colonization by harmful organisms.

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Disadvantages of Normal Flora

The negative effects of normal flora, such as causing disease when the immune system is weakened or when they move to different body locations.

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Mutualistic Relationship

A relationship between two organisms where both benefit from the interaction.

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Commensalistic Relationship

A relationship between two organisms where one benefits while the other is unaffected.

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Parasitic Relationship

A relationship between two organisms where one benefits while the other is harmed.

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What is Pathogenesis?

The origin and development of disease.

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Contamination

The mere presence of microbes on or in the body, not necessarily causing disease.

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Infection

The establishment and growth of a pathogen in the body, overcoming the body's defenses.

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Disease

A state where the invading pathogen alters the normal functions of the body, causing illness.

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Portals of Entry

Structures in the body that can be entry points for pathogens, including the skin, mucous membranes, placenta, and parenteral route.

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Symptoms

Subjective characteristics of disease felt only by the patient. Examples include pain, nausea, fatigue.

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Signs

Objective manifestations of disease that can be observed or measured by others. Examples include fever, rash, elevated blood pressure.

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Syndrome

A group of symptoms and signs that characterize a disease or abnormal condition.

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Asymptomatic Infection

An infection that lacks symptoms but may still have signs of infection.

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What is Etiology?

The study of the cause of disease.

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Pathogenicity

The ability of an organism to cause disease.

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Virulence Factors

Molecules expressed and secreted by pathogens that help the pathogen cause disease.

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Adhesion

The process by which a pathogen attaches to host tissues, often a crucial step in causing infection. Requires bacterial adhesins and host cell receptors.

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Biofilm

A community of microorganisms that form a slimy layer on surfaces, often contributing to the persistence of infections. Requires polysaccharide web formation and biosensing.

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Extracellular Pathogens

Pathogens that remain on the surface of cells, causing damage by releasing toxins.

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Intracellular Pathogens

Pathogens that enter and live inside host cells, causing local infection without necessarily entering the bloodstream.

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Systemic Spread

The spread of a pathogen throughout the body via the bloodstream, potentially causing infection in multiple tissues.

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Tissue Injury

Damage to host tissues caused by pathogens, often leading to inflammation and disease.

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Exotoxins

Toxins secreted by bacteria that can directly damage host cell membranes, disrupting their function. Examples include diphtheria toxin, cholera toxin, and tetanus toxin.

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Endotoxins

Toxins released by bacteria when their cell walls break apart. Can trigger a serious inflammatory response that can lead to sepsis.

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Specific Immunity

The body's immune response that specifically targets pathogens through antibodies and other immune cells.

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What is Epidemiology?

The study of the distribution and determinants of disease in human populations, and applying that knowledge to controlling public health problems.

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Determinants

A set of factors that increase the likelihood of developing a disease, often used in epidemiological studies.

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Inclusion/Exclusion Criteria

Criteria used to define a population for study, including both characteristics that must be present (inclusion) and those that exclude individuals (exclusion).

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Prevalence

A measure of the existing disease burden in a population at a specific point in time.

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Incidence

A measure of the rate at which new cases of a disease occur in a population over a specific time period.

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Epidemic

An increase, often sudden, in the number of cases of a disease above what is normally expected in a population.

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Surveillance

A system for collecting and analyzing data on disease occurrences to monitor public health trends, detect outbreaks, and assess the effectiveness of interventions.

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Active Surveillance

A surveillance system where data is collected proactively by actively seeking out cases of disease.

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Passive Surveillance

A surveillance system where data is collected passively by relying on healthcare providers to report cases.

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Notifiable Conditions

Diseases or conditions that must be reported to public health authorities to monitor their occurrence and take appropriate action.

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Pandemic

An epidemic occurring worldwide, or over a very wide area, crossing international boundaries and usually affecting a large number of people.

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Prognostic Signs

Signs that point to the future outcome or prognosis for a patient.

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Anamnestic Signs

Signs that refer to parts of a person's medical history, often providing clues about past conditions.

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Diagnostic Signs

Signs that help healthcare professionals recognize and identify a specific health problem.

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Pathognomonic Signs

Signs that are highly specific to a particular condition, providing near certainty in diagnosis.

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Remitting Symptoms

Symptoms that completely resolve after a period of time, often associated with acute illnesses.

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Chronic Symptoms

Symptoms that are long-lasting or recurring, often associated with chronic conditions.

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Relapsing Symptoms

Symptoms that have previously resolved but then reappear, often associated with recurrent conditions.

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Incubation Period

The period of time between exposure to a pathogen and the onset of symptoms, during which the pathogen is multiplying but not yet causing noticeable illness.

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Prodromal Period

A short stage of illness, often characterized by mild, nonspecific symptoms, indicating the onset of a disease.

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Period of Illness

The stage of illness where individuals experience the full-blown signs and symptoms of a disease, typically the most infectious period.

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Period of Decline

The stage of illness where the body begins to overcome the pathogen, resulting in a gradual decline in symptoms.

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Period of Convalescence

The final stage of illness where individuals fully recover from the disease and return to a healthy state.

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Physical and Chemical Barriers

The body's first line of defense against pathogens, comprising physical and chemical barriers that prevent entry and minimize invasion.

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Innate Immunity

The body's natural immune response, not specific to particular pathogens, but providing a rapid and general defense. Examples include inflammation, pathogen engulfment, and secretion of immune factors.

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Pathogen Recognition

The process by which immune cells recognize molecular patterns on pathogens, triggering a targeted immune response.

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PAMP's

Molecules found on the surface of pathogens that are recognized by immune cells, triggering an immune response.

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PRRs

Receptors on immune cells that bind to PAMPs, initiating the immune response.

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Macrophages

Large, white blood cells that engulf and destroy pathogens, playing a key role in innate immunity.

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Cytokines

Chemical messengers that regulate various immune functions, including inflammation, cell communication, and pathogen elimination.

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Cytokine Storm

An uncontrolled and excessive release of cytokines, leading to a severe inflammatory response that can cause organ damage and even death.

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Phagocytosis

The process by which immune cells engulf and destroy pathogens, a key mechanism in innate immunity.

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Inflammation

A complex physiological response to tissue injury, characterized by redness, swelling, heat, and pain, which helps to fight infection and repair damage.

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Natural Killer (NK) Cells

A type of white blood cell that kills infected cells and tumor cells, contributing to both innate and adaptive immunity.

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Complement System

A system of proteins that circulate in the blood and work together to destroy extracellular pathogens, enhancing the antibody-mediated response.

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Clean

The removal of visible soil from objects or surfaces, reducing microbial load but not eliminating all microorganisms.

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Disinfected

The process of using chemical agents to kill or inactivate microorganisms on surfaces, reducing their numbers but not eliminating all.

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Sterilization

The process of eliminating all microorganisms, including spores, from an object or surface, ensuring a high level of sterility.

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Asepsis

The absence of living pathogenic organisms, a state achieved through various practices and techniques.

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Medical Asepsis

Practices designed to prevent the spread of infection, often using techniques focused on reducing the number of microbes, but not eliminating all.

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Surgical Asepsis

Practices designed to ensure a completely sterile environment, free from all microorganisms, often used for procedures involving direct contact with the body or introduction of foreign objects.

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Routine Practices

A set of infection control practices that are applied to all patients, regardless of their suspected infection status.

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Additional Precautions

Practices used in addition to routine practices when caring for patients with known or suspected infections, designed to prevent the spread of specific pathogens.

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Contact Precautions

A type of additional precaution used for patients with infections spread through direct contact, such as MRSA.

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Droplet Precautions

A type of additional precaution used for patients with infections spread through respiratory droplets, such as influenza.

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Droplet/Contact Precautions

A type of additional precaution used for patients with infections spread through both direct contact and respiratory droplets, such as some types of pneumonia.

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Airborne Precautions

A type of additional precaution used for patients with infections spread through airborne particles, such as tuberculosis.

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Infection Control Strategies

The process of breaking the chain of infection to prevent the spread of disease.

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Health Care Associated Infections (HAI's)

A type of infection that is acquired in a healthcare setting, often related to procedures or treatments.

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Point of Care Risk Assessment (PCRA)

A point-of-care risk assessment (PCRA) is used to identify patients at risk for infection.

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Environmental/Engineering Controls

Measures taken to control the environment and reduce the risk of transmission of infectious agents, such as proper ventilation, adequate hand hygiene facilities, and waste management

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Administrative Controls

Administrative measures aimed at reducing infection risk, such as staff education, policies for hand hygiene, and isolation procedures

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What is the Public Health Agency of Canada (PHAC)?

The Public Health Agency of Canada (PHAC) is a federal agency responsible for protecting and promoting the health of Canadians. PHAC leads national public health programs, conducts research, and provides guidance on infection prevention and control.

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Vaccination

The use of vaccines, which stimulate the body's immune system to protect against specific diseases.

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Live-Attenuated Vaccines

A type of vaccine that uses a weakened or inactive form of the disease-causing organism to stimulate immunity.

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Inactivated Vaccines

A type of vaccine that uses killed disease-causing organisms to stimulate immunity.

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Subunit Vaccines

A type of vaccine that uses only a specific part of the pathogen, such as a protein, to stimulate immunity.

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Viral Vector Vaccines

A type of vaccine that uses a harmless virus to carry genetic material from a disease-causing organism to stimulate immunity.

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Antibiotic Resistance

The ability of microorganisms to survive and multiply in the presence of antibiotics that were previously effective at killing them.

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Impact of Sanitation, Vaccination, and Antibiotics on Life Expectancy

Sanitation, vaccination, and antibiotics have significantly contributed to increased life expectancy by reducing the incidence of infectious diseases and improving overall public health.

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Strategies for Antibiotic Resistance

Strategies employed by bacteria to resist the effects of antibiotics, including producing enzymes that break down antibiotics, modifying target sites, and reducing antibiotic entry into the cell.

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Cleaning

A process of cleaning using water and detergent to remove visible soil and organic matter.

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Autoclaving

A type of sterilization using high-pressure steam to kill microorganisms.

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Radiation Sterilization

A type of sterilization using a high-energy radiation source to kill microorganisms.

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Chemical Sterilization

A type of sterilization using a chemical process to kill microorganisms.

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Study Notes

RRC Polytech

  • RRC Polytech is an institution, likely a college or vocational school.

Recording Alert

  • This session is being recorded.
  • Recordings will be available for future RRC Polytech members.

Land Acknowledgment

  • A slide with images of natural scenes.

Microbiology and Infection Control

  • This is a final review of the microbiology and infection control course.

Learning Outcomes

  • Students should be able to identify important events in the History of Microbiology.
  • Students should be able to define microorganisms and list three classifications.
  • Students should be able to tell the difference between normal flora and pathogens.
  • Students should be able to identify the ideal environment for the growth of microorganisms.
  • Students should be able to recognize and describe the body's natural defense mechanisms.
  • Students should be able to describe the chain of infection.
  • Students should be able to identify portals of entry to the human body and those of exit.
  • Students should be able to recognize and describe modes of transmission.
  • Students should be able to identify factors that increase individual susceptibility to infection.
  • Students should be able to list signs and symptoms of infection.
  • Students should be able to define healthcare-associated infection (HAI).
  • Students should be able to distinguish between clean, dirty, and sterile objects.
  • Students should be able to define medical asepsis.
  • Students should be able to describe the major Infection Control Strategies.

Module 1: Objectives

  • Define Microbiology
  • List techniques used to isolate and culture microorganisms
  • Identify and define different types of microbiological specialties.
  • Identify areas of interest for microbiological fields/work
  • Name and describe the contributions of major historical figures in microbiology, and their modern-day impacts.

What is Microbiology?

  • The study of microorganisms typically smaller than 1mm in diameter.
  • Examples include viruses, bacteria, fungi, algae, and protozoa.

What is Microbiology? Specialties

  • Microbiology can focus on specific types of organisms:
  • Virology - viruses
  • Bacteriology - bacteria
  • Phycology - algae
  • Mycology - fungi
  • Protozoology - protozoa

What is Microbiology? Fields/Work

  • Microbiological work can focus more on applied sciences:
  • Medical microbiology, including immunology
  • Food and Dairy microbiology
  • Public Health microbiology (Epidemiology)
  • Industrial microbiology

Historical Timeline 1665-1995: Study Example

  • A timeline showcasing key developments in microbiology from 1665-1995.

Module 2: Cell Structure of Microorganisms

  • Taxonomy/Morphology
  • Types of Microorganisms

Module 2 Objectives

  • Define cell theory
  • List 5 characteristics of all cells
  • Identify cell structure basic components: the cell membrane, cytoplasm, nucleus/nucleoid, organelles, cell wall, and spore coat.
  • Distinguish between eukaryotic and prokaryotic cells
  • Define protein impact on MDR
  • Describe the characteristics of proteins
  • Define taxonomy and the nomenclature method for bacteria- genus and species
  • Define morphology and macroscopic and microscopic morphology implications
  • Define anaerobic, aerobic, and facultative anaerobe
  • Describe bacterial shapes and give examples
  • Outline structural differences between Gram+ and Gram- bacteria & human impact
  • Describe the significance and procedure for Gram staining

Cell Theory

  • All organisms are formed of one or more cells and all cells are derived from pre-existing cells.
  • Cells are the basic units of life and common to all living things.

5 Characteristics of All Cells

  • Self Feeding/Nutrition
  • Self Replication/Growth
  • Differentiation of forming new cell structures
  • Chemical Signalling/Communication
  • Evolution/Changes to show new biological properties

Types of Cells

  • Prokaryotic Cells
  • No nucleus or other membrane-bound organelles
  • Usually unicellular
  • Eukaryotic Cells
  • Has a nucleus and multiple complex membrane-bound organelles
  • Can be unicellular or multicellular

Differences Between Prokaryotic and Eukaryotic Cells

  • Genetic Information
  • Organelles
  • Size
  • Organisms
  • Cell Structure

Cell Membrane

  • The "skin" of the cell, providing protection by regulating the movement of water, nutrients and waste into and out of the cell.

Cytoplasm

  • The largest part of the cell, made up of water and proteins in a gel-like consistency.
  • All cell activities, function, growth and replication happen here, though the nucleus coordinates the actions.

Nucleus/Nucleoid

  • The cell's "brain".
  • Contains the genetic information to direct cell behavior and appearance function.

Organelles

  • Includes the nucleus and several other structures that perform specific functions within the cell.

Cell Wall

  • Most, but not all bacteria, have a rigid cell wall.
  • In plants, it helps the cell maintain its shape.
  • It does not replace the cell membrane

Spore Coat

  • A protective layer for some microorganisms.
  • Allows for bacterial rest and protection in unfavorable conditions.

Proteins

  • Proteins are a major component of cytoplasm and form the human body and its waste matter.
  • Common elements within the waste sent to the MDRD laboratory.

Characteristics of Protein

  • Not soluble in water
  • Can be coagulated by heat, drying, or specific chemicals
  • Coagulated protein can trap and protect pathogens.
  • Must be removed prior to disinfection or sterilization.

Blood: Source of Protein on Instruments

  • Blood sample types and images of instruments commonly used in medical/surgical contexts.

Taxonomy: Genus/Species

  • A table listing genus and related species.

Macroscopic Morphology

  • Image of bacterial growth on a plate.
  • The visual appearance of the bacteria can be observed.

Microscopic Morphology

  • Requirements for oxygen for bacteria growth
  • Gram Stain procedure.
  • Bacterial shape and groupings.

Gram Stain: Method

  • Gram + vs. Gram – bacteria stained using a four step procedure involving crystal violet, gram's iodine, an alcohol decolorizer and a safranin counterstain.

Microscopic Morphology

  • Bacterial morphology in forms of cocci, bacilli, helical form.

Classification of Microorganisms

  • List of microorganisms that are broadly categorized from bacteria to prions.

Bacteria

  • Unicellular organisms
  • Present in every habitat
  • Outnumber human cells.
  • Less than 1% are harmful (pathogenic)

Viruses

  • Smaller than bacteria
  • Cannot replicate independently of host cells.

Fungi

  • Molds and Yeasts:
  • Microscopic/Large organisms
  • Crucial in food production (bread)
  • Can cause disease and allergic reactions.

Prions

  • Infectious proteinaceous particles.
  • Misfolded proteins that cause similar body proteins to deform.

Viruses: Types

  • Lipophilic viruses have an envelope, are more easily killed by hospital disinfectants, and can be very pathogenic.
  • Hydrophilic viruses have no envelope.

Bacteria: Interventions

  • May be susceptible to antibiotics and immunization.
  • Disinfectants/sterilization may also be effective (with spore forming bacteria requiring sterilization).

Viruses: Interventions

  • Viruses are not susceptible to antibiotics.
  • Prevention via vaccines are paramount
  • Disinfectants can reduce the amount and type of viruses.

Fungi: Interventions

  • Fungal infections becoming more prevalent in modern medicine.
  • Treatment via antifungals (topical, oral or IV)

Prions: Interventions

  • Prions can remain infectious for years; no cure; cannot be destroyed by standard sterilization methods, radiation, boiling or alcohol.

Module 3: Normal and Pathogenic Organisms

  • Symbiotic Relationships
  • Pathogenesis - the Origin of Disease

Module 3: Objectives

  • Define the human microbiome
  • Define normal flora and describe its benefits
  • Define resident and transient flora
  • List sterile body tissues
  • List locations where normal flora are found
  • List factors influencing resident flora
  • List disadvantages of normal flora
  • Define and give examples of symbiotic relationships (mutualistic, commensalistic, opportunistic)
  • Define pathogenesis.
  • Define contamination vs. infection.
  • List the main portals of entry.
  • Define infection vs. disease
  • Define asymptomatic/subclinical infections
  • Define etiology
  • Define pathogenesis vs. pathogenicity
  • List and define the factors affecting pathogenicity (virulence, virulence factors)
  • Describe mechanism of pathogenicity (adhesion, biofilm, extra/intracellular, systemic, tissue injury)
  • List and define three causes of tissue injury (exotoxin, endotoxin, specific immunity)

Human Microbiome: Definition

  • The collection of microorganisms residing on the surface/deep layers of skin, oral mucosa, conjunctiva, and the gastrointestinal tract.

Normal Flora: Definition

  • A mixed population of microorganisms (bacteria and fungi) regularly found at various anatomical sites within the human body.

Normal Flora: Advantages

  • Provide some essential nutrients (e.g., vitamin K).
  • Stimulate the immune system.
  • Prevent colonization by potential pathogens.
  • Inhibit some pathogens.

Normal Microbial Flora: Types

  • Resident Flora
  • Microbes constantly present.
  • Transient Flora
  • Microbes reside temporarily (hours to months).

Normal Flora

  • Expected/Normal (Skin, Eyes, Nose, Mouth, EARS, Urogenital Tract/Digestive Tract).
  • Not Expected/Abnormal (Blood, Brain, Muscle, Cerebrospinal Fluid)

Importance of Normal Flora (Advantages)

  • Constitute a protective host defense mechanism by occupying ecological niches.
  • Produce vitamin B and K in the intestines.
  • Contribute to immunity by inducing low levels of circulating and secretory antibodies.

Importance of Normal Flora (Disadvantages)

  • Can cause disease when individuals become immunocompromised or their usual anatomic location shifts.

Normal Flora: Influencing Factors

  • Age (changes continuously throughout life)
  • Nutrition
  • Environment
  • Sex

The Three Types of Symbiotic Relationships

  • Mutualism (both organisms benefit)
  • Commensalism ( one organism benefits, the other isn't harmed or benefited)
  • Parasitism (one organism benefits, the other is harmed.)

Module 3. Pathogenesis

  • The origin and development of disease (contamination, infection, disease).

Contamination vs. Infection

  • Contamination - the mere presence of microbes.
  • Infection - microbes evade defenses, multiply, and establish in the body.

Infection vs. Disease

  • Infection - invasion and establishment of a pathogen.
  • Disease - infection alters normal body functions.

Portals of Entry

  • Skin
  • Mucous membranes
  • Placenta
  • Parenteral route

Manifestations of Disease

  • Symptoms (subjective)
  • Signs (objective)
  • Syndrome (group of symptoms)

Asymptomatic Infection

  • Lacking symptoms but with signs of infection.

Etiology: Definition

  • Study of the cause of disease.
  • Germ theory of disease: disease is caused by infections/pathogens.

Pathogenesis vs. Pathogenicity

  • Pathogenesis - origin and development of disease.
  • Pathogenicity - the ability of an organism to cause disease.

Definitions

  • Pathogenesis - the origin and development of disease
  • Virulence - the ability of a microorganism to cause disease
  • Virulence Factors – the molecules expressed and secreted that aid in pathogenesis.

Pathogenicity: Mechanism

  • Adhesion, how bacteria attach to tissues
  • Biofilm, formation of a collective of one or more types of microorganisms, comprising polysaccaride web (slime) and biosensing.

After Infection: Penetration & Spread/Tissue Injury

  • Exotoxin - Secreted by certain bacteria
  • Endotoxin vs Specific Immune Response - Microbial Toxins, when bacterial cells lyse and specific immune system response

Exotoxins

  • Proteins
  • Secreted by bacteria
  • Destroy cell membranes
  • Examples: Diphtheria Toxin, Cholera Toxin, Tetanus Toxin

Endotoxins

  • Can lead to endotoxic shock, a severe reaction associated with hypotension, fever, and intravascular coagulation
  • Potentially leading to organ failure or death (SEPSIS)

Specific Immunity

  • Continuous secretion of antigens stimulates the immune system
  • Example: Rheumatic Fever
  • Muscle damage caused by hypersensitivity reaction

Module 4: The Chain of Infection

  • Introduction to Epidemiology

Module 4: Objectives

  • Identify and define each link of the chain of infection
  • Define epidemiology
  • Describe the role of public health in disease assessment, intervention, and reassessment
  • Define and describe disease distribution (person, place, time), determinants (risk factors).
  • Define inclusion/exclusion criteria.
  • Define and describe disease frequency- counts, incidence, prevalence
  • Describe the purpose of surveillance and its relationship to epidemiology (early warning, intervention impact)
  • Define active vs passive surveillance
  • Define and describe notifiable conditions and methods for their reporting.
  • Define Pandemic

Chain of Infection

  • Infectious Agent
  • Reservoir (where the agent can survive and thrive - human, animal, or equipment)
  • Portal of Exit (source from which pathogen emerges - blood, respiratory tract, or contaminated equipment/supplies).
  • Mode of Transmission (method of transfer from portal of exit to portal of entry).
  • Portal of Entry (pathway into a susceptible host - e.g., airway, wound, body insertion
  • Susceptible Host (factors influencing the host's susceptibility to infection - e.g., age, chronic disease, or immunosuppression)

Module 5: Pathology - the Disease Process

  • Signs and Symptoms of Disease
  • Stages of Illness
  • The Immune Response – Health Care Associated/Acquired Infection (HAI)

Module 5: Objectives

  • Define and provide examples of sign classifications (prognostic, anamnestic, diagnostic, and pathognomonic)
  • Describe examples of symptom classifications (remitting, chronic, and relapsing)
  • Recognize the stages of illness (incubation, prodromal, illness, decline, convalescence)
  • Describe the physical and chemical immune barriers (skin, tears/mucous, pH/blood proteins, flushing)
  • Explain immediate and induced innate immune responses (inflammation, pathogen engulfment, secretion)
  • Describe innate immunity
  • Describe pathogen recognition (PAMPs/PRRs, macrophages, cytokines/cytokine storm)
  • Describe phagocytosis and inflammation.
  • Define and describe natural killer cells
  • Define and describe the complement system

Signs & Symptoms - Review

  • Signs/Objective Observations: use of senses, measurable
  • Symptoms/Subjective Perceptions: patient experience, descriptive, not measurable.

Signs- Examples

  • Fever, Rash, High/Low Blood Pressure, Vomiting, Diarrhea, Hemoptysis, Hematuria

Signs - Classifications

  • Prognostic: predicts future outcomes
  • Anamnestic: points to past medical history - Example- skin scars from past acne
  • Diagnostic: aids in identifying current health problems - High PSA levels in males as a diagnostic sign of prostate cancer
  • Pathognomonic: unambiguously links the sign to a condition - Presence of specific bacteria in samples

Symptoms - Classifications

  • Remitting: completely resolve - e.g., common cold
  • Chronic: long lasting or recurrent - e.g., asthma
  • Relapsing: previously resolved but recur - e.g., depression

Symptoms

  • Feeling hot/cold
  • Pain
  • Fatigue
  • Muscle aches
  • Nausea

Signs & Symptoms

  • Foundation of pathology - study of disease

Stages of Illness

  • Incubation Period
  • Prodromal Period
  • Period of Illness (acme point)
  • Period of Decline
  • Period of Convalescence

Stages: Incubation

  • Microbes infect, multiply, individual doesn’t feel sick, microbes may be easily spread.
  • Length depends on the microbe and individual’s immune system

Stages: Prodromal

  • Short stage where individual starts to feel sick
  • Brain aware of a problem, not sure what exactly

Stages: Period of Illness

  • Individual feels typical signs and symptoms of disease.
  • Acme point is the peak intensity of the illness – most spread is during this stage, if communicable

Stages: Period of Decline

  • Immune system controls microbes, clinical signs/symptoms lessen.

Stages: Period of Convalescence

  • Microbial replication fully stops.
  • Individual returns to pre-illness state.
  • Still possible to transmit the disease in some cases.

The Immune Response ("Fighting Back")

  • Physical and Chemical Barriers
  • Innate immunity
  • Pathogen Recognition

Conditions that May Overcome Physical/Chemical Barriers

  • Skin abrasions/puncture
  • Large numbers of pathogen that can overcome mucus/cilia
  • Evolution of specific mechanisms of the pathogen

Innate Immunity

  • Inflammation initiates when pathogens enter the body
  • Pathogen engulfment
  • Secretion of immune factors and proteins

Innate Immunity - Characteristics

  • Natural
  • Developed/evolved early
  • Not induced by infection/vaccination
  • Limited number of targets

Pathogen Recognition

  • Blood/lymph cells recognize specific PAMPS (pathogen associated molecular patterns) on pathogen surfaces
  • Macrophages engulf foreign particles/pathogens
  • Macrophages recognize PAMPS via PRRS (pathogen recognition receptors)
  • Binding of PAMPS/PRRs releases cytokines

Cytokines

  • Chemical messengers
  • Regulate cell differentiation/proliferation/gene expression for immune response.
  • Signs of feeling sick (e.g., lethargy, muscle pain, nausea)
  • Encourage rest/prevent spreading

Cytokine "Storm"

  • Normally part of the body’s immune response to infection.
  • Sudden release in large quantities potentially leading to multisystem organ failure/death.

Macrophages and Natural Killer Cells

  • Macrophages engulf pathogens, stimulate immune responses in other cells.
  • Natural Killer cells kill infected cells or cancer cells, constantly patrolling the body

Summary: Phagocytosis/Inflammation

  • Response to injury/cuts
  • Histamine secretion, causing dilation of capillaries.
  • Neutrophils/monocytes leave capillaries, monocytes become macrophages
  • Release chemicals to trigger inflammatory response.
  • Phagocytosis by neutrophils/macrophages

Natural Killer (NK) Cells

  • Always functioning/active
  • Patrol the body to control potential infections and stop cancer progression

Review: Innate Immune System

  • First responders
  • Employ inflammation, phagocytosis, cytokine release, destruction by NK cells, and/or complement system.
  • Adaptive system is informed when innate mechanisms are insufficient to handle an infection.

Review: Innate Immune System (Functions/Characteristics)

  • Functions: inflammation, pathogen engulfment, secretion of immune factors and proteins
  • Characteristics: natural immunity - developed/evolved early, not induced by infection/vaccination, limited # of targets

Review: Pathogen Recognition

  • Viruses: intracellular
  • Bacteria: intracellular/extracellular
  • PAMPS – present on pathogen surfaces
  • PRRS – receptors on macrophages

Review: Cytokines

  • Cytokine release effect = PAMPS + PRRS
  • Chemical messengers: cell differentiation (form/function), proliferation (production), gene expression.
  • Causes illness symptoms – fever, etc
  • Cytokine Storm: uncontrolled, excessive cytokine release leads to multiorgan failure/death.

Review: Phagocytosis/Inflammation

  • WBCs release chemicals to gather at infection site (necessary for all cells)
  • Can develop hypersensitivity/allergic response

Review: NK's and Complement System

  • Natural Killer cells - lymphocytes patrolling the body to destroy infected and tumor cells
  • Complement proteins – assist in destroying extracellular pathogens/compliment antibody response
  • Adaptive Immune System

Module 6: Clinical Applications of MDR

  • Clinical applications of multi-drug resistant organisms (MDR).
  • MDR Basics: Clean vs. Disinfected vs. Sterile
  • Medical, Surgical Asepsis
  • Routine Practices
  • Additional Precautions/Disease Transmission
  • Infection Control Strategies
  • Antibiotic Resistance
  • HAI's

Module 6: Objectives

  • Define cleaning, disinfection, and sterilization
  • Define asepsis
  • Listing 3 examples of medical asepsis (respiratory, environmental cleaning, PPE)
  • Define surgical asepsis
  • Components of surgical asepsis (equipment sterilization, sterile fields, sterile workers, sterile techniques)
  • Examples of breaches in sterile technique
  • Define routine practices
  • Define PHAC

MDR Basics

  • Clean: no visible soil; reduces microbial load.
  • Disinfected: reduces microbes to 99%.
  • Sterility: one in a million chance of a viable organism.

Asepsis

  • Freedom from living pathogenic organisms.
  • Techniques don’t discriminate between pathogens and non-pathogens (they kill or avoid)

Basics of Medical Asepsis

  • Practices designed to prevent infection spread.
  • Also called 'clean technique’ - Example- Hand Hygiene

Examples of Medical Asepsis

  • Respiratory Etiquette/Hygiene
  • Environmental Cleaning
  • Personal Protective Equipment (PPE)

What is Surgical Asepsis?

  • Ensuring a completely microbe-free environment.
  • Used with surgical/brief invasive procedures that breech skin or mucous membranes, or normally sterile parts of the body

Components of Surgical Asepsis

  • Equipment Sterilization
  • Sterile Field
  • Sterile Workers
  • Sterile Technique

Breaches in Sterile Technique

  • Sterile field exposure to air.
  • Coughing/sneezing over sterile field.
  • Talking excessively over sterile field
  • Unsterile object below waistline of worker
  • Unsterile objects contacting sterile objects
  • Sterile objects contacting the edge of a surgical tray.
  • Healthcare worker leaning over the sterile field.

Infection Control Strategies

  • Overview of infection control strategies

Routine Practices & Hand Hygiene

  • Overview of routine practices & hand hygiene

Routine Practices History

  • Evolution of precautions from Universal Precautions to Standard Precautions to Routine Practices & Additional Precautions.

Universal Precautions

  • Avoid contact with patients' bodily fluids (1985-1988).
  • Associated with HIV/AIDS epidemic
  • 1987 saw addition of body substance precautions.

Standard Precautions

  • Use of PPE recommended in all settings (1996)

Routine Practices & Additional Precautions

  • Overview and implementation, as it relates to infection control (1999).

Additional Precautions

  • Requirements to deal with difficult/dangerous pathogens (ex. Clostridium difficile or MRSA).
  • Indicated with signage.

Routine Practices

  • Point of Care Risk Assessment (PCRA)
  • Environmental Controls
  • Administrative Controls

PHAC (Public Health Agency of Canada)

  • Created in 2004 in response to growing public health concerns.
  • Created in response to recommendations from leading public health experts (e.g., Dr. David Naylor's report, Learning from SARS).

Additional Precautions

  • Contact
  • Droplet ( >5 microns, within 2 meters)
  • Droplet/Contact
  • Airborne ( <5 microns, greater than 2 meters)

At Risk Populations-Contracting Flu

  • Individuals over 65
  • LTC facilities/congregate living
  • Those with pre-existing/chronic diseases
  • Caregivers/those living with high risk individuals

At Risk Populations/Complications of Flu

  • Over 65 (older adults)
  • Chronic health conditions (adults & children)
  • Pregnant women
  • Indigenous populations
  • Young Children

Is it Cold or Flu?

  • Symptoms-cold vs. flu comparison table

Breaking the Chain of Infection

  • An overview of the different aspects of breaking the chain of infection

Chain of Infection

  • Infectious Agent
  • Reservoir
  • Portal of Exit
  • Mode of Transmission
  • Portal of Entry
  • Susceptible Host

Infectious Agent: Antimicrobial Therapy: Disinfection; Sterilization

  • Overview of various infection control strategies.

Reservoir: Engineering Controls: Environmental Cleaning; Disinfection; Proper Food Storage; Water Treatment

  • Overview of strategies to prevent/control reservoirs for the spread of infection.

Portal of Exit: Hand Hygiene; Disposal of contaminated linens; Control of Excretions/Secretions

  • Overview of methods and approaches to limit/manage portals of exit.

Means/Mode of Transmission: Spatial separation; Engineering Controls; Hand Hygiene; Environmental cleaning/disinfection; Device disinfection/sterilization; PPE

  • Overview of strategies to reduce the methods of transmission including spatial separation/engineering controls/hand hygiene, environmental cleaning/disinfection, device disinfection/sterilization and PPE

Portal of Entry: Hand Hygiene; Aseptic Technique; Wound Care; Catheter Care; PPE

  • Overview and examples of strategies for limiting portals of entry.

Susceptible Host: Immunization; Nutrition; Recognition of high risk patients; Treatments

  • Overview and examples of strategies to limit/manage susceptible factors.

Antimicrobial Therapy

  • An overview of antimicrobial therapy.

Rise in Life Expectancy

  • The impact of sanitation, antibiotics, and vaccines on increased life expectancy.

Types of Vaccines

  • Live-attenuated
  • Inactivated
  • Subunit
  • Toxoid
  • mRNA
  • Viral Vector

Antibiotics

  • Alexander Fleming, and Penicillin

Antibiotic Resistance

  • When an organism becomes resistant to an antibiotic
  • Strategies used by microorganisms to develop resistance: access restriction of antibiotics, antibiotic destruction via enzyme secretion, efflux pumps (removal of antibiotics from cell), metabolic pathways modification, overproduction of target molecules, structural changes/mutation.
  • Mechanisms of resistance acquisition (random mutation, horizontal/lateral gene transfer).

Antibiotic Resistance: Increasing

  • Resistance is developing faster than new antibiotics are being developed.
  • Misuse of antibiotics increases selective pressure on bacteria, accelerating resistance development.

Summary: Methods to Control Pathogens

  • Host defense mechanisms
  • Public health measures
  • Vaccines
  • Antibiotics

Define Health Care Associated Infection (HAI)

  • Hospital-acquired infections (HAIs) - infections resulting from hospital stays or other healthcare settings; usually not present or incubating at the time of admission.

Monitoring HAI's

  • CNISP (Canadian Nosocomial Infection Surveillance Program), maintained by PHAC to track/monitor HAIs in healthcare settings.

Types of HAI's

  • Antimicrobial-resistant organisms (AROs)
  • Bloodstream infections (BSIs)
  • Urinary tract infections (UTIs)
  • Surgical site infections (SSIs)
  • Pneumonia
  • Infectious Diseases

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Description

This quiz serves as a final review for the Microbiology and Infection Control course at RRC Polytech. It covers essential topics such as the history of microbiology, classifications of microorganisms, and the body's natural defense mechanisms against infections.

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