Lecture 9

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University of Otago
Medical Laboratory Science
Jenny Rhodes

MELS223 Lecture 9 8/08/13 Transmission and prevention – The chain of infection Lecture objectives: The ways microbes may be transmitted  With attention to transmission in a hospital setting The chain of infection  Infectious agents  Reservoirs  Portal of exit  Modes of transmission  Portal of entry  Susceptible host How transmission of microbes can be prevented in a hospital  How to break the chain of infection Aim is to protect BOTH the patient and healthcare provider Infectious agents:  Viruses o Hepatitis B, C, influenza, ‘cold’ viruses, norovirus, HIV Bacteria  Gram positives – Staphylococcus aureus, Enterococcus, Streptococcus pneumoniae  Gram negatives- E.coli, Klebsiella, Enterobacter, Psudomonas, Acinetobacter, Legionella  Fungi – Candida  Parasites – uncommon in hospital setting Disease producing characteristics of infectious organisms  Virulence – measure of an organism’s ability to cause disease  Adhesion, Invasiveness, toxins, infectious dose o Immune evasion – capsules, biofilms, antigenic variation, resistance to phagocytosis,  Antimicrobial resistance  Host susceptibility important Prevention  Diagnosis, treatment Reservoir  Place in which an infectious agent may survive but not multiply o Humans, Animals (zoonoses) o Environment – air, water, soil, fomites  Human reservoirs: people with acute or subclinical infection o Pathogen infected but no signs of clinical disease= early infection / resolving infection / chronic carriers  Prevention : screening/ diagnosis – treat carriers (MRSA) / infections  No contact if infected Portal of exit  Respiratory tract (mucosal secretions) o Cold, influenza, respiratory bacteria, Neisseria meningitides  Genitourinary tract o STI, UTI  Gastrointestinal tract o Salmonella, Shigella, Campylobacter, Giardia,
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