The Chain of Infection
As healthcare professionals, it is important to understand two facts about infection: 1.The various ways infection can be transmitted. 2. The ways the infection chain can be broken.
There are six links in the chain of infection: 1. Causative agent 2. Source or reservoir 3. Portal of exit 4. Mode of transmission 5. Portal of entry 6. Susceptible host
1st - The Infectious Agent -Any disease-causing microorganism (pathogen)
Microorganism A small, living plant or animal not visible to the naked eye
Pathogens vs. Nonpathogens Nonpathogens are beneficial microorganisms that are found on and in the human body Pathogens cause disease/infection
Class I - Bacteria Multiply rapidly Classified by shape and arrangement
Cocci Round or spherical in shape If Cocci occur in pairs they are diplococci If Cocci occur in chains they are streptococci If Cocci occur in clusters or groups they are staphylococci
Cocci Cocci are the most common pusproducing microorganisms Diplococci bacteria cause diseases such as Gonorrhea, Meningitis, & Pneumonia. Streptococci bacteria cause diseases such as Strep throat and Rheumatic fever.
Staphylococci Can cause infections such as Boils Wound infections Toxic shock
Bacilli Rod shaped Occur singly, in pairs, or in chains
Bacilli Many bacilli contain flagella, threadlike projections that are similar to tails and allow organisms to move Bacilli have the ability to form spores, thick walled capsules. In the spore form, bacilli are extremely difficult to kill.
Diseases caused by different types of bacilli include: Tuberculosis Tetanus Pertussis Whooping cough Botulism Diphtheria Typhoid
Class II - Protozoa one-celled animals often found in decayed materials and contaminated water.
Class III - Fungi simple, plantlike organisms that live on dead organic matter.
Two common fungi forms: Yeasts Molds
Fungi cause diseases such as: Ringworm Athlete s foot Histoplasmosis Thrush
Class IV - Rickettsiae (ri-ket-se-a) parasitic microorganisms which means they cannot live outside the cells of another living organism. Commonly found in fleas, lice, ticks, mites
Rickettsiae transmitted to humans by the bites of these insects (typhus fever, rocky mountain spotted fever).
Class V - Viruses Difficult to kill because they are resistant to many disinfectants and antibiotics. Smallest microorganism Cause diseases such as Common cold Measles, Mumps Influenza Chicken pox Warts
2nd - The Reservoir Host -The organism in which the infectious microbes reside
What are Carrier Hosts? Hosts that do not show any outward signs or symptoms of a disease, but are still capable of transmitting the disease are known as carriers.
3rd - The Portal of Exit -Route of escape of the pathogen from the reservoir Examples: respiratory secretions, blood exposure, breaks in skin
th - The Route of Transmission Method by which the pathogen gets from the reservoir to the new host direct contact air insects
5th - The Portal of Entry Route through which the pathogen enters its new host Respiratory System (inhalation) Gastrointestinal System (ingestion) Urinary & Reproductive Tracts (sexual contact) Breaks in Skin (Protective Barrier)
6th - The Susceptible Host The organism that accepts the pathogen The support of pathogen life and its reproduction depend on the degree of the host s resistance. Organisms with strong immune systems are better able to fend off pathogens. Organisms with weakened immune systems are more vulnerable to the support and reproduction of pathogens.
How to interrupt the chain of infection: 1. Pathogen Identification: identify infectious - agent and appropriate treatment 2. Asepsis and Hygiene: potential hosts and carriers must practice asepsis and maintain proper personal hygiene 3. Control Portals of Exit: Healthcare personnel must practice standard precautions (Control body secretions and wash hands according to protocol.)
4. Prevent a Route of Transmission Prevent direct or indirect contact by 1.Proper hand washing 2.Disinfection & sterilization techniques 3.Isolation of infected patients 4.Not working when contagious
5. Protect Portal of Entry Healthcare professionals must make sure that ports of entry are not subjected to pathogens. (nose, mouth, eyes, open wounds, etc.)
6. Recognition of Susceptible Host Healthcare professionals must recognize and protect high-risk patients. Cancer Patients AIDS Patients Transplant Patients Infants Elderly Patients
Remember--breaking the chain of infection is the responsibility of each healthcare professional.