Transcript Micro Webquest Complete Powerpoint

STD’S
Angela, Jeborah, Rosie, Olga
Syphilis
• Species: Treponema pallidum
• Transmission: Sex and contact with
sores
• Why we should be concerned?
• Treponema pallidum has cytoplasmic
and outer membrane.
• Endospore forming:, gram-negative
• Antibiotic-resistant : Penicillin and
anti biotic with cure syphilis within
one year.
• As a surgical tech you need to make
sure you are wearing your PPE’s and
stay sterile, take care
• The helical structure allows the
bacteria to move through mucous then
into lymph, blood, and tissues.
Chlamydia
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Species: Chlamydia Trachomatis
Chlamydia is transmitted during vaginal, anal,
or oral sex. Chlamydia can also be
transmitted through an infected mother to
baby.
Concerns for Surgical Tech: STERILITY !! Like
most bacteria, this likes to grow in warm
areas of the body & it can multiply fairly
quickly so being sterile intraoperative is
VERY important for yourself & the patient.
Chlamydia is classified as a Gram-Negative
bacteria.
There are two antibiotic resistant's, one is
Azithromycin which is given as a single dose.
The second one is Doxycycline that is a week
dose and also the most common.
Chlamydia is the most common STD.
“Silent” disease, majority of infected people
aren’t aware.
Gonorrhea
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Species: Neisseria Gonorrheae
Mode of transmission: anyone who has any type of sex, spread by contact with the Mouth,
Vagina, Penis, Anus, throat & even Eyes!!
Concern for surg tech: STERILITY !! Like most bacteria, this likes to grow in warm areas of the
body & it can multiply fairly quickly so being sterile intraoperative is VERY important for
yourself & the patient.
Its is a BACTERIUM !
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Yes it has a cell wall that is GRAM NEGATIVE
It is not a endospore
It is antibiotic resistant BUT….. Gonorrhea has progressively developed a resistant to the antibiotics prescribed to
treat it
Herpes (HSV-1,HSV-2)
Herpes simplex virus
It ‘s a viral disease
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Cause by both:
- HSV-1 , HSV-2
Common infection of the skin or
mucosa may affect the face and mouth
(orofacial herpes), genitalia (genital
herpes), or hands (herpetic whitlow).
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Transmission :
- sexually transmitted also through
fluids from lesions and skin to skin.
A cure for herpes has not been
developed once infected.
The virus remains in the body for life.
There is no vaccine for the herpes virus.
Protection for the virus, always wear
your PPE’s
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Herpes blisters , Herpes sores
Pelvic Inflammatory Disease
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PID inflammation of Uterus, Fallopian
Tubes, and/or ovaries.
Bacteria infects organs causing
inflammation.
PID most commonly caused from
Gonorrhea, Chlamydia, and
Trichomoniasis.
Trichomoniasis Species: Trichomonas
vaginalis.
Mode of transportation: Sex, caused by
infection with a protozoan parasite.
Trichomoniasis significantly increases
PID.
Team Space Suit
CJD
• Scientific name: Creutzfeld-Jakob Disease.
– CJD is a degenerative neurological disorder (brain disease) that is
incurable and invariably fatal.
• Modes of Transmission:
– The mode of transmission of sporadic CJD is unknown.
– Genetic CJD is caused by an inherited abnormal Gene.
– Iatrogenic CJD is transmitted during medical or surgical procedures
» The defective protein can be transmitted by contaminated
harvested human brain products
– Variant CDJ (vCJD) is linked to to the consumption of food products
from cattle infected with a type of TSE called Bovine Spongiform
Encephalopathy (BSE, commonly known as mad cow disease.)
» Humans can contract the disease by consuming material from
animals infected with the bovine form of the disease.
Concerns for the Surgical Tech:
Since CJD is not transmitted through casual contact,
isolation of patients is not necessary. To prevent the
disease from spreading, tissue or organ transplant from
any CJD patients or re-use of potentially contaminated
surgical instruments should be avoided. Currently there
is no treatment or cure for any forms of CJD.
HIV/AIDS
• Human
• Immunodeficiency
• Virus
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Acquired
Immuno
Deficiency
Syndrome
Modes of Transmission:
• Body fluid
–Ex: Blood. Fluids from an infected person
must come in contact with mucous
membrane or damaged tissue or be
directly injected into the blood stream.
• Ex: Needle or syringe.
Concerns for a Surgical Technician:
Use extreme caution when using blades and hypodermic
needles. Always handle with care and never reuse.
INFECTION
• OSTEOMYELITIS
Definition: An acute or chronic bone
infection.
Mode of Transmission: May spread
throughout the body via the bloodstream.
Spreads to the bone from infected skin,
muscles or tendons. Also, a previous
surgical procedure to the bone can cause
the infection.
Concerns for a ST: This type of infection
can become recurrent. In order to avoid
this, the ST must follow proper sterile
technique.
OSTEOMELITIS
*Nearly 90% of
Osteomyelitis cases are
caused by staphylococcus
aureus
*Affects about two out of
every 10,000 people
*A delay in treatment can
lead to permanent deficit
or in some cases cause
amputation
*A Form of Staphylococcus aureus
*Cell wall: Gram Positive.
*Does not form Endospores
Methicillin Resistant.
Tuberculosis
Tuberculosis (TB) is a bacterial
infection caused by a germ called
Mycobacterium tuberculosis.
• M. tuberculosis has:
- a tough cell wall (prevents passage of
nutrients into and excreted from the cell)
- the cell envelope (contains a polypeptide
layer, a peptidoglycan layer)
Modes of Transmission
• The bacterial infection
that can spread through
the lymph nodes and
bloodstream to any
organ in your body, such
as the kidney, spine, and
brain.
• The bacteria usually
attack the lungs.
Bacterial Infection
• To survive in harsh conditions for a prolonged
period in the host, M. tuberculosis had
learned to adapt to the environment by
allowing or inhibiting transcription according
to its surroundings.
-M. tuberculosis' cell wall
has high acid content, which
makes it hydrophobic,
resistant to oral fluids.
- M. tuberculosis is a rod-shaped,
slow-growing bacterium, and
short for tubercle bacillus
Tuberculosis Prevention
• Hospitals and clinics should take precautions
to prevent the spread of TB, which include:
- special filters
- special respirators and mask
• In hospitals, people with TB should be
isolated in special rooms with controlled
ventilation and airflow
The Meticulous Technique Team
Created by
Aranshi, Annika, Anita, Emily
Endocarditis:
(Inflammation of the Heart)
2 Types:
1. Infective Endocarditis: Caused by a bacteria or (very rarely)
cause by a fungus:
*Streptococcocus viridans (about 50% of the time what the
bacteria is)
*Staphylococcus epidermis (most common in intravenous
drug users)
*Enterococcus
* Pseudomonas
* Serratia
* Candida (Yeast Infection)
2. Non- Infective Endocarditis: Caused more by physical trauma
Transmission
• Mainly through blood and nasal secretions; all have to
enter the bloodstream.
• Higher raters of transmission occur:
1. In those with an acquired or congenital heart condition
2. People who’ve had a dental procedure, tonsillectomy,
Adenoidectomy (removal of the Adenoids), or any Endoscopic
surgery involving the respiratory, urinary, or gastrointestinal tracts.
3. IV’s and Catheters can also be a way of transmission
4. STD’s
5. Intravenous drug users who use contaminated needles
6. Fungal Infections (although rare, and generally occur in
immuno-comprimised individuals)
Why it is Important for the Surgical Tech:
• Because it puts an even greater emphasis on
sterilization as well as having a good surgical
technique for both the patient’s safety and
yours.
If it’s a bacterium…
• The main bacteria found is Staphylococcus
epidermis: it can be brought on by either an
outside or nosocomial infection.
A. Does have a cell wall: Gram +
B. Is not an endospore
C. Typically resistant to penicillin, amoxicillin,
and cefotaxime (there can be more or less resistance
depending on if it is acquired in a nosocomial or outside
environment.)
Meaningful and Memorable Information
about Endocarditis:
1. Treatment is becoming harder than in
previous years because of the resistance to
antibiotics (when it is Infective Endocarditis)
2. One of the main symptoms is when tiny pinpoint hemorrhages start happening of a
person’s chest, fingers and/or toes
Botulism (Clostridium Botulinum)
• Although rare, botulism is a paralytic illness.
• Caused by botulinum toxins which is
metabolic waste produced under anaerobic
conditions by the bacterium clostridium
botulinum.
• There really is no concern for a surgical tech
(unless their an avid home canned-food
consumer) because this type of bacteria can’t
be spread from person to person.
Botulism (Clostridium Botulinum)
Main Types
• Foodbourne Botulism
• Infant Botulism
• Wound Botulism
Transmission
Foodbourne Botulism is contracted by
the ingestion of foods (commonly
home -canned and or with low
acidity) contaminated with
clostridium botulinum bacteria.
Infant Botulism occurs when living
bacteria or spores grow in the
intestines of an infant from ingestion
of substances (such as honey or corn
syrup)and releases toxins.
Wound Botulism occurs when open
wounds are infected with this
bacteria.
Yup, I’m a Bacteria
• Clostridium Botulinum is a gram positive, rod
shaped bacterium.
• It is anaerobic and does produce endospores
• This form of bacteria is not usually treated
with antibiotics. Although there is known
resistant strains to aminoglycoside antibiotics
when used.
Tetanus (Clostridium Tetani)
Why are you so tense?
Transmission
• Infection occurs when
spores enter through a deep
wound or injury.
• Prolonged contractions of
skeletal muscle fibers
(locked jaw)
Tetanus is a bacteria
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Gram positive
Rod shaped
Anaerobic bacterium
Endospore producing
• There is no antibiotic
resistant
strain…metrondiazole
and immunoglobulin is
what they treat tetanus
with.
• Surgical techs should be
immunized to prevent
being infected.
Gas Gangrene
• Also known as Clostridial myonecrosis:
• Med Term:
• “Necrosis” cell death
• “myo” muscle
Caused by Clostridium perfringens and has a
gram- positive cell wall and is endospore
forming.
Meticulous Sterile Technique
Clostridium perfringens lives in our intestines
and would be spread during surgery through
cross-contamination. It is a concern for surg
techs for this reason. It will be important to
separate instruments used in “dirty” parts of
the surgery from the “clean.”
Clostridium perfringens is an extremely fast
spreading disease and if left untreated could
result in death.
Why They Call it That?
Gas is produced by the toxins killing off the
tissue. The action of C. perfringens on dead
bodies is known to undertakers as tissue gas.
This is what causes dead bodies (think of road
kill) to bloat up and float as they degrade. The
gases form bubbles causing crepitis (another
cool medical term) Bring Out Your Dead
Hence the name gas gangrene.
Stomach Ulcers
Caused by Helicobacter pylori, a spiral-shaped
bacterium that lives in the acidic environment
of the stomach.
– gram-negative cell wall
– increasing antibiotic resistance
– non-spore forming
Why Do We Care?
• It is significant for the Surg Tech because it is a
resident bacteria in our intestinal flora. Again
separating the “dirty” from the “clean” parts
of the surgery
• Rising antibiotic resistance is scary increases
the importance of preventing contamination.
Of course, to us meticulous Surg Techs, it is
ALL important!
Think Pink
Common treatment
for Peptic (stomach)
ulcures is often
treated with antacids
or H2 antagonists and
bismuth compounds
Hmmmm …….
Pepto Bismol!
MRSA
• Methicillin-resistant Staphylococcus Aureus is
a type of bacteria that is resistant to certain
antibiotics .
– Some of these commonly used antibiotics
include methicillin, oxacillin, penicillin, and
amoxicillin.
• Gram + cell wall
• Non-spore forming
MRSA
• Approximately 30% of the population are
colonized with Staphylococcus Aureus.
• Stapylococcus Aureus live on skin or nasal
passages.
– Harmless in normal circumstances
– Can become pathogenic when it enters body
through open or broken skin (such as a wound,
surgical site, or catheter insertion).
Why it should concern you!
• Mode of transmission:
– Hands may become contaminated with MRSA by
contact with:
• colonized or infected patients
• colonized or infected body sites of the
personnel themselves
• devices, items, or environmental surfaces
contaminated with body fluids containing
MRSA.
Why it should concern you!
• More severe or potentially life-threatening
MRSA infections occur most frequently among
patients in healthcare settings.
• If not treated, it can cause severe
complications, such as: endocarditis, septic
shock, and even death.
“Superbug”
Team WHAT
Necrotizing Fasciitis
aka Flesh Eating bacteria Syndrome
Rare infection of the deep subcutaneous tissue
 Infection spreads across the fascial planes
 Once infection established, debridement required
Caused by many different bacteria
-- Antibiotic resistant (MRSA)
-- Endospores (Clostridium Perfinges)
-- Motile (Vibrio Vulnificus)
-- Common (Bacteroides Fragilis)
-- Group 'A' Streptococcal...
Necrotizing Fasciitis
aka Flesh Eating bacteria Syndrome
Streptococcus Pyogenes (GAS)
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"Pyo" = Pus ; "gen" = producing
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Infrequent (but usually pathogenic) skin flora
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Causes many invasive systemic infections
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Some strains produce exotoxins and other problems
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Prevention?
 Antibiotic RESISTANCE is common
 Penecillin TOLERANT (1985)
 Cell wall and embedded M-proteins
 Capsule resists neutrophils
 Binds with Fibrinogen = immune system evasion
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Bacillus Anthracis
89 Known stands
A gram-positive bacterium
Can form endospores
Is naturally found in soil, but can be produced in vitro
Anthrax
• Produced and used as a
biological weapon
• Acute disease- Transmitted
by Direct Contact with
broken skin, Inhalation, or
Ingestion
• Antibiotics must be
administered quickly after
exposure or you will most
likely DIE!!!
Anthrax- Major concern for Us!!
• Most commonly infects wild
and domesticated mammals
that ingest or inhale the
spore while grazing
• Don’t bring muddy shoes to
work!!!
• Aseptic Technique- spore
easily attaches to clothing
Nosocomial Pneumonia
• The second-common nosocomial
infection
• Cause: by a spectrum of bacterial
pathogens such as Pseudomonas
aeruginosa
• Pseudomonas aeruginosa;
• Gram negative bacilli
• It doesn’t form endospore
• It is found in soil, water, skin, flora and
most man-made environments
• Is naturally resistant to a large range of
antibiotics and may demonstrate
additional resistance after
unsuccessful treatment
• Pseudomonas is one of the most
vigorous, fast-swimming bacteria seen
in hay infusions and pond water
samples.
Mode of Transmission
• Through ventilation machines
• Aspiration of bacteria in the oropharynx
• Through intubation
Surge tech concerns:
• Use of Aseptic techniques
• Prevent cross-contamination
Tonsillitis
• Tonsillitis is an infection of the
tonsils.
• Tonsillitis can be caused by either
a bacterium or virus.
• The bacterium often responsible
for tonsillitis is Streptococcus
Group A.
• The virus often responsible for
tonsillitis is the Epstein-Barr virus
(EBV).
Epstein-Barr Virus (EBV)
Also Known as the Kissing Disease
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EBV is found in the saliva of the host
and is transmitted
through saliva or swapping spit. EBV
is also transmitted
by sharing utensils or drinking
containers.
Sterile Surgical Techniques is
extremely important in the OR suite
since contact in with the nose,
mouth, and throats of infected
patients could potentially transmit
the EBV Virus to the surgical team.
Several links have been found
between EBV and the occurrence of
cancer, rheumatoid arthritis and
neurological problems in humans.
TEAM
VACCINE
• Whooping cough
• Smallpox
• Shingles
• HPV
Kelly, Liz, Glenda, Becky
Whooping Cough
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Bordetella Pertussis
Gram neg, Coccobacillus bacteria
Non-endospore forming
No antibiotic resistant varieties, usually treated with
erythromycin
• Bordetella bacteria prefer
ciliated cells of the respiratory
tract vs. non-ciliated
2 Stages
• Catarrhal stage: 1-2 weeks, symptoms of URI with mild
cough
• Paroxysmal stage: 4-6 weeks, bursts of rapid coughs with
increased breathing difficulty
Whooping Cough
• Transmission: Airborne – coughing
• Affects mostly infants and children
• DTaP vaccine boostered at 2 mo., 4 mo., 6 mo., 15-18 mo.,
and 4-6 yrs.
• Important to Surg tech due to ease of transmission
Smallpox
• Orthopoxvirus
• Variola virus(Major)
• Vaccinia virus (Minor)
• Ellipsoid particles. Outer lipoprotein
envelope encloses core of double stranded
DNA
• Replicates in the cytoplasm, not the nucleus
Smallpox
• Transmission: Airborne – droplets expressed
from oral, nasal orpharyngeal mucosa of an
infected person. Also, body fluids,
contaminated fomites and can cross the
placenta
• Symptoms: red lesions appearing on mucous
membranes of oral cavity as well as rash and
pustules on skin.
• No prophylactic vaccine due to eradication.
Vaccination 4-7 days after exposure can
offer some protection.
• Treatment: primarily supportive care.
No drug is currently approved but studies
suggest antiviral drug Cidofovir may be
useful as a therapeutic agent.
Shingles
• Varicellovirus
• Human herpesvirus 3 - dsDNA
• Varicella, or chickenpox, is the primary infection. Clinically
apparent and common during childhood. Zoster(shingles) is
the clinical manifestation due to reactivation of VZV and
usually occurs in adults.
• Symptoms: burning and painful skin lesions
• Transmission: not transmitted from person to person.
However, a person who hasn’t had chicken pox can develop
it when exposed to shingles. Later, they may have a
reactivation and develop shingles.
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Shingles
• Treatment: symptomatically (pain and
discomfort). Antivirals (Acyclovir) may help
shorten duration.
• Varicella vaccine given at 12-15 months and 4yrs
• Important: A surg tech who hasn’t had chicken
pox exposed to a patient’s shingles rash may
contract chicken pox. Although varicella is a
minor childhood disease it can be serious in
adults.
HPV
• Papillomavirus
• Human papillomavirus - dsDNA
• There are 200 known types; 40 types of HPV are known to
infect the genital area in both sexes. HPV is the most
common of sexually transmitted diseases.
• Transmission: Sexual ororal contact, mother to child during
birth (rare), and shared objects (rare). Transmission can
occur even when symptoms are not present.
• Symptoms: Most types cause no symptoms, some cause
genital, skin, or respiratory tract (rare) warts and even
cancer (cervical).
• Important to surgical tech due to ease of transmission and
prevalency.
HPV
• Prevention: Gardasil and Cervarix vaccines are available to
girls/women. Boys/men have just Gardasil.
• Treatment: Body clears 90% of all HPV infections within two
years. Symptomatically treat lesions with topical
medications, cryosurgery or laser to remove warts.