chapter 11 Flashcards

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1
Q

Terminology and Methods of Control

A
  • Sterilization–aprocessthatdestroysallviable microbes, including viruses and endospores
  • Disinfection–aprocesstodestroyvegetative pathogens, not endospores; inanimate objects
  • Antiseptic–disinfectantsapplieddirectlyto exposed body surfaces
  • Sanitization–anycleansingtechniquethat mechanically removes microbes, wet cloth, public items
  • Degermation–reducesthenumberofmicrobes through mechanical means
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2
Q

Decontamination

A

Physical, chemical, and mechanical methods to destroy or reduce undesirable microbes in a given area

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3
Q

Relative resistance of microbes

A
Highest resistance
--Prions, bacterial endospores
Moderate resistance
--Pseudomonas sp.
--Mycobacterium tuberculosis
--Staphylococcus areus
--Protozoan cysts
Least resistance
--Most bacterial vegetative cells
--Fungal spores and hyphae, yeast
--Envelope viruses
--Protozoan trophozoites
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4
Q

Microbial death

A
  • Hard to detect, Microbes often reveal no conspicuous vital signs to begin with
  • Permanent loss of reproductive capability, even under optimum growth conditions
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5
Q

Methods of control(critical, semi critical, noncritical)

A

Critical-tissue(sterile)
Semi critical-mucosa(disinfectant)
Noncritical-skin(disinfectant)

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6
Q

Selection a method of control depends on circumstances:

A
  • does the application require sterilization
  • Is the item to be reused
  • can the item withstand heat, pressure, radiation, or chemicals
  • Is the method suitable
  • Will the agent penetrate to the necessary extent
  • Is the method cost and labor efficient and is it safe
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7
Q

Cellular targets of chemical and physical agents

A
  1. cell wall–cell wall becomes fragile and cell lyses; some antimicrobial drugs, detergents, and alcohol
  2. cell membrane–loses integrity;detergent surfactants
  3. Protein and nucleic acid synthesis – prevention of replication, transcription, translation, peptide bond formation, protein synthesis; chloramphenicol, ultraviolet radiation, formaldehyde
  4. Proteins – disrupt or denature proteins; alcohols, phenols, acids, heat
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8
Q

Methods of physical control

  1. HEAT–MOIST AND DRY
  2. Coldtemperatures
  3. Desiccation
  4. Radiation
  5. Filtration
A
  1. heat-Moist and dry
    - Moist heat-Lower temperatures and short exposure time, Coagulation and denaturation of proteins
    - Dry heat-moderate to high temperatures, dehydration, alters protein structure, incineration
    - -bacterial endospores most resistant, usually require temperatures above boiling
    - -Thermal death time(TDT)-shortest length of time required to kill all microbes at a specified temp
    - -Thermal death point(TDP)-lowest temp required to kill all microbes in a sample in 10 minutes
    - -steam under pressure- sterilization
    - autoclave(a steam pressure oven)
    - Mode of action- denaturation of proteins, destruction Of membranes and DNA
    - Tyndalization- intermittent sterilization for substances that cannot withstand autoclaving, 3 day repeat cycle, disinfectant used for some canned foods/lab media
    - boiling(not a method of sterilization)-100C for 30min. destroys non endospore forming
    - Pasteurization-kills spoilage/infection without destroying flavor/nutritional value-batch method(63-66c for 30min),flash method(71.6c for 15 sec)
    - dry ovens coagulate protiens
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9
Q

Methods of physical control

  1. Heat–moist and dry
  2. COLDTEMPERATURES
  3. Desiccation
  4. Radiation
  5. Filtration
A
  • Microbiostatic–slows the growth of microbes • Refrigeration- 0–15C and freezing(does not allow microbial growth) <0C
  • Used to preserve food, media, and cultures
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10
Q

Methods of physical control

  1. Heat–moist and dry
  2. Coldtemperatures
  3. DESICCATION
  4. Radiation
  5. Filtration
A
  • gradual removal of water from cells, leads to metabolic inhibition
  • not effective microbial control-Many cells retain ability to grow when water is reintroduced
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11
Q

Methods of physical control

  1. Heat–moist and dry
  2. Coldtemperatures
  3. Desiccation
  4. RADIATION
  5. Filtration
A

Ionizing radiation (low doses mutation, high does fatal)– deep penetrating(preserve food)
power that has sufficient energy to cause electrons to leave their orbit, breaks DNA
– Gamma rays, X- rays, cathode rays
– Used to sterilize medical supplies and food products
Nonionizing radiation – little penetrating power so it must be directly exposed(sterilize water, surfaces)
– UV light creates pyrimidine dimers, which interfere with replication

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12
Q

Methods of physical control

  1. Heat–moist and dry
  2. Coldtemperatures
  3. Desiccation
  4. Radiation
  5. FILTRATION
A

Physical removal of microbes by passing a gas or liquid through filter
Used to sterilize heat sensitive liquids and air in hospital isolation units and industrial clean rooms

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13
Q

Microbial Control(agents, qualities)

A
• Disinfectants,antiseptics,sterilants, degermers, and preservatives
• Some desirable qualities of chemicals: 
– Rapid action in low concentration
– Solubility in water or alcohol, stable
– Broad spectrum, low toxicity
– Penetrating
– Noncorrosive and nonstaining 
– Affordable and readily available
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14
Q

Levels of Chemical Decontamination

A

• High-level germicides(cavicide)
–kill endospores;maybe sterilants
– Devices that are not heat sterilizable and intended to be used in sterile environments (body tissue)
• Intermediate-level
–kill fungals pores(not endospores), tubercle bacillus, and viruses
– Used to disinfect devices that will come in contact with mucous membranes but are not invasive
• Low-level
–eliminate only vegetative bacteria, vegetative fungal cells, and some viruses

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15
Q

Factors that affect germicidal activity of chemicals

A
  • Nature of the material being treated(metal, plastic)
  • Degree of contamination(blood or vomit on item, presence of organic matter)
  • Time of exposure and temp.
  • Strength and chemical action of the germicide
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16
Q

Chemical agents used in healthcare(p.338 table)

A



17
Q

3 most common halogens(bromine, chlorine, iodine) main two chlorine and iodine

A

bromine- not volatile, carcinogenic, can’t smell, small amounts in H20
• Chlorine–Cl2,hypochlorites(chlorinebleach), chloramines
– Denaturate proteins by disrupting disulfide bonds – Intermediate level
– Unstable in sunlight, inactivated by organic matter – Water, sewage, wastewater, inanimate objects
• Iodine-I2,iodophors(betadine)
– Interferes with disulfide bonds of proteins
– Intermediate level
– Milder medical and dental degerming agents, disinfectants/ointments

18
Q

Phenolics(chemical agent, germicide)

A

• Disrupt cell walls and membranes and precipitate proteins
• Low to intermediate level – bactericidal, fungicidal, virucidal,notsporicidal
– Lysol
– Triclosan – (can cause stunted brain development, for chronic exposure, in makeup/sunscreens) antibacterial additive to soaps

19
Q

Phenolics(chemical agent, germicide)

A

• Disrupt cell walls and membranes and precipitate proteins
• Low to intermediate level – bactericidal, fungicidal, virucidal,notsporicidal
– Lysol
– Triclosan – (can cause stunted brain development, for chronic exposure, in makeup/sunscreens) antibacterial additive to soaps
-Used as skin degerming agents for preoperative scrubs, skin cleaning, and burns

20
Q

alcohols

A

-optimal dilution 70%
• Ethyl, isopropyl in solutions of 50-95%
• Act as surfactants dissolving membrane lipids and coagulating proteins of vegetative bacterial cells and fungi, no resistance bacteria dies or doesn’t
• Intermediate level

21
Q

Hydrogen Peroxide

A

-no residue, not stable, only lasts up to 2 months
• Produce highly reactive hydroxyl-free radicals that damage protein and DNA while also decomposing to O2 gas – toxic to anaerobes
• Antiseptic at low concentrations; strong solutions are sporicidal

22
Q

Aldehydes(power disinfectants)

A

• KillbyalkylatingproteinandDNA
– Glutaraldehyde in 2% solution (Cidex) used as sterilant for heat sensitive instruments
• High level
– Formaldehyde – disinfectant, preservative, toxicity
limitsuse
• Formalin – 37% aqueous solution • Intermediate to high level

23
Q

Gases and Aerosols

A
  • Ethylene oxide, propyleneoxide(residue is highly toxic)
  • Strong alkylating Air filter agents
  • High level
  • Sterilize and disinfect plastics and prepackaged devices, foods
24
Q

Detergents and Soaps

A

Quaternary ammonia compounds(quats)

  • act as surfactants that alter membrane permeability of some bacteria and fungi
  • very low level
  • soaps- mechanically remove soil/grease containing microbes
25
Q

heavy metals

A
  • Solutions of silver and mercury kill vegetative cells in low concentrations by inactivating proteins
  • Oligodynamic action Low level
  • Merthiolate(alcohol and mercury, old 1st aid kits),silver nitrate(smear in infants eyes to prevent microbes), silver(can kill free nerve endings(smell))
26
Q

Dyes as Antimicrobial Agents

A
  • Aniline dyes are very active against gram- positive species of bacteria and various fungi(bind to cell wall, crystal violet, can treat thrush, binds/prevents growth of bacteria)
  • Sometimes used for antisepsis and wound treatment
  • Lowlevel,narrow spectrum of activity
27
Q

Acids and Alkalis

A

• Low level of activity
– Organic acids prevent spore germination and bacterial and fungal growth
– Acetic acid inhibits bacterial growth
– Propionic acid retards molds
– Lactic acid prevents anaerobic bacterial growth
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– Benzoic(most common food preservative) and sorbic acid inhibit yeast