Infection Control for New York Health Care Professional ‒ 2024 Update ________________________________
b. Mode of transmission: Contact with pathogen: 1. Direct contact with blood, oral fluids, or other patient materials. 2. Indirect contact with contaminated objects (e.g., instruments, equipment, or environmental sur- faces). 3. Droplet-contact of conjunctival, nasal, or oral mucosa (e.g., spatter) containing microorganisms generated from an infected person and propelled a short distance (e.g., by coughing, sneezing, or talking). 4. Airborne-inhalation of microorganisms that can remain suspended in the air for long periods. a. Common vehicle (e.g., food, water, biologic substances, or fomites). b. Vector-borne – Vector-borne diseases are transmitted among their human, animal, or plant hosts by arthropods, usually insects. A broader definition of vector-borne disease recognizes that other animals can serve in the role of infectious disease vector by harboring pathogens that cause disease only in suscep- tible populations. c. Susceptible host: Susceptibility is influenced by genet- ics, level of immunity, constitutional factors, disease, malnutrition, and substance use. d. Factor influencing the outcome of exposures: 1. Host factors: a. Natural barriers (e.g., intact skin, respiratory cilia, gastric acid and motility, flow of urine, tears, normal flora). b. Host immunity (e.g., inflammatory response, humoral immunity, cell-mediated immunity, immune memory). 2. Pathogen or infectious agent factors: a. Infectivity – organism’s ability to infect the host. b. Pathogenicity – ability of the organism to cause disease. c. Virulence – degree of pathology.
2. Safe injection practices (see Element III). 3. Use of masks during spinal/epidural access procedures. b. For patients infected with organisms other than
bloodborne pathogens: 1. Early identification. 2. Prompt isolation. 3. Appropriate treatment. c. Control of routes of transmission: 1. Hand hygiene. 2. Use of appropriate barriers.
a. Appropriate selection, donning, doffing, and disposal of personal protective equipment (PPE and EBP see Element IV). 3. Appropriate isolation/cohorting of patients infected with communicable diseases. a. Standard precautions for all patients. b. Transmission-based precautions for other pathogens. c. Host support and protection. (1) Vaccination. (2) Pre- and post-exposure prophylaxis. (3) Protecting skin and immune system integrity. d. Environmental control measures. (1) Cleaning, disinfection, and sterilization of patient care equipment (see Element V). (2) Environmental cleaning (housekeeping). (3) Appropriate ventilation. (4) Waste management. (5) Linen and laundry management. (6) Food services. e. Engineering and work practice controls (see Element III). f. Training and education of healthcare work- ers. Pathogens or Infectious Agents Pathogens are transmitted through human contact, through surgical procedures, or from devices like catheters or ventila- tors, yet patients may be colonized with pathogens but show no signs of infection. The pathogens may be alive, and multiply- ing, which may lead to infection that can be spread to others. The CDC defines the following two types of infection [5]: 1. Endogenous: Infection caused by a pathogen that is already colonizing a part of their body (e.g., S. aureus in their nose)
d. Size of inoculum. e. Route of exposure. f. Duration of exposure.
3. Environmental factors: a. Contamination of environment, fomites. b. Contamination of equipment. II. Methods to Prevent the Spread of Pathogenic Organisms in Healthcare Settings a. Standard precautions: 1. Respiratory hygiene/cough etiquette.
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