By: Jesus Mario A. Lopez Jr.

, RN, RTRP

- cide/cidal = when a killing action is implied:

Bactericide- kills/destroys bacteria

Fungicide kills/destroys fungus
Germicidal kills/destroys germs
Sporicidal kills/destroys spores
Tuberculocide- kills/destroys M. Tuberculosis and related
mycobacterium
Virucide kills/destroys viruses
- statis/static = when the organism is only inhibited in

growth or prevented from reproducing:

Bacteriostatic inhibits/retards growth of bacteria

Antiseptic opposes sepsis or putrefaction either

killing microorganism or by preventing their
growth; free from living organism.
Antisepsis preventing the growth of bacteria
/stopping bacterial activity.
Carrier - person who harbors the
specific/infectious agent but DONT MANIFEST
any signs and symptoms of the disease; they
can be the SOURCE and can transmit the agent
to another susceptible host.
Cleaning the removal of all foreign matter such
as sputum, blood, organic matter from an item
that might provide a favorable environment for
bacterial growth; precedes sterilization.

Community-Acquired Pneumonia- occurring within 48

hours before hospital admission in patients with no
criteria for healthcare-associated pneumonia.
Communicable Disease is an illness due to specific
infectious agents or its toxic products transmitted
directly/indirectly; can be transmitted from one
person to another.
Contact person/animal who been presumably
exposed with an infected person/animal.
Contagious Disease- an illness which arises only thru
the DIRECT transmission of an infectious agent and
EASILY transmitted
Decontamination the process of removing a
contaminant by chemical/physical means.
Disinfectant germicidal agent used on inanimate
objects
Disinfection a process that eliminates vegetative,
pathogenic microorganisms on inanimate objects.

Disinfestation physical/chemical procedures that

serves to destroy undesirable animal forms.
Fomites non-living vehicles of transmission of
infectious diseases.
Infectious Disease disease man/animal resulting from
an infectious origin.
Invasiveness (infectivity)- ability of a microbe to invade
tissues.
Incubation Period time from the introduction of the
causative agent up to the appearance of the 1 st signs
and symptoms of the disease.
Isolation separation of an infected person from others
during the period of communicability to prevent the
spread of infection; PATIENTS HAVE SIGNS AND
SYMPTOMS OF THE DISEASE.

Medical Asepsis killing/inhibiting of pathogenic

microorganisms to prevent their transmission
from person to person
Mode of Transmission is the means by which the
infectious agents passes from the portal of exit
in the reservoir to the susceptible host.
Nosocomial Infection - an infection acquired after
hospitalization (>48 hrs ). Also called hospitalacquired infection
Pathogenicity refers to a microbes ability to
cause pathogenic changes or diseases
Portal of Entry way where microorganisms can
enter the susceptible host.

Portal of Exit where infectious microorganism can

exit the reservoir.
Quarantine limitation of movement of an individual/s
or a community EXPOSED to the infectious agent to
prevent the spread of an infection; patient DONT
HAVE ANY MANIFESTATION.
Reservoir place where infectious agents live, multiply
and depend for survival; it can inanimate objects,
human and animals.
Sanitization any process that reduces total bacterial
contamination to a level consistent with safety
handling.
Sanitizer an agent that reduces the no. of bacterial
to a safer level for handling of material.

Sterilization Complete destruction or inactivation

of all forms of microorganisms:
1. the implication of the term is absolute
destruction
2. Sterile- free from all living organisms
Surgical Asepsis sterilization or decontamination
of items used in operating room.
Susceptible Host man/animal who do not have
resistance against the infectious agents and are
liable to infection.
Vector arthropods and other invertebrates that
can be a vehicle of an infection.
Vegetative Organisms organism in active growth.

Virulence refers to the degree of a

microorganisms ability to cause a disease or
pathological change in a host cell; depends on
toxins, ability to evade host defenses, spores,
and genetic variation.

1. Infectious Agent (e.g. bacteria, fungus, virus,

2.
3.
4.
5.
6.

parasites)
Reservoir (e.g. human, animals, fomites)
Portal of Exit - (e.g. RT, GIT, GUT, Blood, open
skin)
Transmission (e.g. contact, vehicle, airborne,
vector)
Portal of Entry - (e.g. RT, GIT, GUT, Blood, open
skin)
Susceptible Host - (e.g. Immunocompromised,
too old, too young,)
(TO BREAK THIS CYCLE, INTERUPT ONE OF
THESE CHAINS!!!!)

1. Direct transmission:
a. Direct contact person to person thru actual
physical contact (e.g. scabies, STD)
b. Indirect contact usually by contaminated
inanimate objects (e.g. neb kits, syringes)
c. Droplet infection - results from contact with
inanimate objects contaminated with
respiratory secretions (e.g. influenza,
pneumonia)
2. Vehicle transmission is a substance or object
that maintains life/viability of an microbe until
it is ingested /inoculated into a susceptible host
like blood, food, plasma, feces, fomites etc.,

3. Airborne transmission
a. Droplet nuclei microorganisms that can
suspend in the air longer periods of time (e.g.
TB, whooping, MMR)
b. Dust particles
c. Organisms that shed in environment from
skin, hair, wounds, or perineal area
4. Vector transmission (via arthropods) occurs
when an intermediate carrier/vector transfers
a microorganism to another living organism.
(e.g. Dengue, leptospirosis)

A. Standard Precautions (1st Tier)

- designed for the care for all hospital patients
regardless of origin/presumed infection; primary
strategy for reducing of and controlling
nosocomial infections; applied to:
* blood and all body fluids, secretions and
excretions (except sweat)
* open skin lesions
* mucus membrane
- MUST WEAR PPES
- ALWAYS DO HANDWASHING (BEFORE AND AFTER
EACH PROCEDURE AND AFTER EACH PATIENT)!!!
- SHARPS PRECAUTION (DO NOT RECAP)!!!

B. Tranmission-based Precaution (2 nd Tier)

AB AirBorne precaution:
* to reduce air borne transmission;
* e.g. PTB, Measles, SARS, MERSA, etc.,
* isolate the patient!!!
* use particulate mask/HEPA filter/N95
C Contact precaution:
* reduce risk of transmitting infectious agents by
direct and or indirect contact
* e.g. wounds, drains, secretions, MRSA, etc.,
* wear MASK, GOWN, and GLOVES.
* must be 3 ft. away

D Droplet precaution:
* e.g. Pneumonia, MMR, etc.,
* must ISOLATE the patient.
* wear surgical mask.
E Enteric precaution:
* reduce transmission thru Fecal-Oral route.
* e.g. Salmonellosis (egg products and by
products), typhoid fever, hepatitis A, etc.,
* HANDWASHING and proper food handling
and preparation.

F Protective/reverse isolation
* protect the patient under reverse isolation
* neutropenic patients/immunocompromised
host
- burns
- undergoing chemotherapy
- anti-rejection medications
- chronic steroid users
- HIV/or AIDS

Wear ON gear
123456-

Booties
Surgical Cap
Mask
Goggles
Gown
Gloves

Wear OFF gear

123456-

Gloves
Gown
Goggles
Mask
Surgical cap
Booties

1. Chemical Concentration the more

concentrated the chemical is, more rapid the
action.
2. Intensity of the Physical agent the more
intense a physical agent(e.g. heat) the more
rapidly the organism are killed.
3. Time - the longer the organism is exposed to
the agent the greater number killed.
4. Temperature increasing he temperature of an
agent (e.g. autoclave), shortens the exposure
time required to kill the organisms.
5. Type of Organisms vegetative microbes, more
easily killed; spores, more resistant to both
physical and chemical agents

6. Number of organisms the more organisms,

the loner exposure time required to kill them.
7. Medium used for growth of an organism e.g.
sputum, blood, etc.,

1. Equipment must be washed clean from dirt, curds

and all form of organic matter with soap and
water (manual or automatic).
2. Rinsing should be complete
3. Equipment is air dried
4. Then use specified agent depending on the
recommended specifications and manufacturers
instructions of the said equipment.
For equipment to sterilize: package appropriately
for the sterilization process
For equipment to disinfect: follow recommended
use of agent used for disinfection then package
according to product specifications

A. Physical Agents:
1. Autoclave (steam under pressure) most dependable
and practical methods for decontamination. Normal
operating cycle at 121C at 15 psi for 15 mins.
Applicable Equipment: metal instruments, linen
Advantages : inexpensive, non-toxic, fast
Disadvantages: may damage heat/moisture sensitive
equipment.
2. Ionizing radiation (gamma) uses short wavelengths
processing extremely high energy having ability to
ionize a substance .
Applicable Equipment: articles may be prepackaged
Advantages : fast, effective, prewrapping of items
Disadvantages: expensive, may give of toxic agents

3. Dry Heat universally applied method for

sterilization
Applicable Equipment:
metal instruments,
laboratory glass wares
Advantages : inexpensive, simple, non-toxic
Disadvantages: may damage heat sensitive
equipment
4. Boiling another universally applied method for
sterilization uses H2O @ 100C
Applicable Equipment:
metals, heat resistant
plastics
Advantages : inexpensive, simple
Disadvantages: time consuming, may damage
some equipment

5. Incineration/burning only used when the object is

no longer in use or is so contaminated that reused is
prohibited
Applicable Equipment:
Disposables, grossly
contaminated articles
Advantages : surest, simplest method
Disadvantages: limited use, may cause pollution
6. Pasteurization - is the application of moist heat at
temperatures below the boiling point of water.
Applicable Equipment:
heat resistant plastics, metal
Advantages : efficient, cost effective
Disadvantages: recontamination if handled improperly

7. Tyndallization a fractional method of sterilization

that consist of 3 separate heating's or 3 consecutive
days of a liquid/semisolid to be sterilized at 80C
Applicable Equipment:
heat resistant plastics, metal
Advantages : inexpensive
Disadvantages: time consuming
8. Sunlight (UV light) another universally applied
method for disinfection uses natural ultraviolet light
Applicable Equipment:
some medical equipment,
food
Advantages : inexpensive, renewable, simple
Disadvantages: time consuming, availability of
sunlight

B. Chemical Agents
1. Ethylene Oxide (ETO) is a colorless, toxic gas
extensively used for gas sterilization.
Applicable Equipment:
heat sensitive items
Advantages : effective, prewrapping of items
Disadvantages: time consuming, expensive, toxic
residues must be removed by aeration.
2. Acetic acid (e.g. vinegar) kills vegetative
microbes esp. Pseudomonas species but not spores
Applicable Equipment:
some medical equipment
Advantages : inexpensive, simple
Disadvantages: may damage some equipment.

3. Glutaraldehydes (Cidex) most widely used

disinfectant and sterilizing agent for surgical and
RT equipment; also known as COLD
STERILIZATION. (vegetative agents 30 min,
sporicidal 10hrs. In pure form, NOT DILUITED!!!!).
Shelf life, 28 days in pure form.
Applicable Equipment:
all medical and surgical
equipment
Advantages : easy to use, no training need
Disadvantages: may damage carbon based metals

4. Alcohol most common agent used in hospital

settings: it kills all vegetative agents except spores
Applicable Equipment:
most medical equipment
Advantages : simple, easy to use
Disadvantages: corrosive to some metal and plastic
5. Chloride and related compounds (e.g. household
bleach) strong oxidizing disinfectants; effective for
vegetative agents except spores at room temperature
Applicable Equipment:
some medical equipment
Advantages : easy to use, no training required
Disadvantages: may emit toxic fumes when exposed to
polymers or other sensitive equipment

6. Hydrogen Peroxide is a popular wound

antiseptic. Recently it has proven as high level
disinfectant against vegetative agents and
spores.
Applicable Equipment:
most medical and
surgical equipment.
Advantages : require s on activation, safe to use
Disadvantages: may cause corrosion on carbon
based metals