for occupational exposure to tuberculosis (TB). In some cases, where a specific OSHA standard does not apply, the General Duty Clause (Sec. 5(a)(1) of the Occupational Safety and Health Act requires employers to furnish to each employee a place of employment free from recognized hazards that are causing or are likely to cause death or serious physical harm to their employees. Each employer must comply with occupational safety and health standards under this Act. In addition, each employee must comply with occupational safety and health standards and all rules, regulations, and orders issued pursuant to this Act, which are applicable to his own actions and conduct (OSHA, n.d.c). ● Common and uncommon microorganisms with unusual patterns of resistance. ● Difficult to treat because of resistance to multiple classes of antimicrobial agents. ● Association with serious clinical disease, increased morbidity, and mortality. ● A newly discovered or reemerging pathogen.. These epidemiologically important organisms include C. difficile , bioterrorism agents (such as anthrax), prion diseases, SARS-CoV, SARS-CoV-2 (COVID-19), monkeypox, and noroviruses, as well as hemorrhagic fever viruses (including Ebola, Marburg, Lassa, and Crimean-Congo hemorrhagic fever viruses), and multi-drug resistant organisms. The CDC updated its research on modes of transmission and effective preventive measures in 2019, and these updates are included in this course. ● Drug-resistant Campylobacter . ● Fluconazole-resistant Candida . ● Extended spectrum beta-lactamase (ESBL) producing organisms. ● Vancomycin-resistant Enterococci (VRE). ● Multidrug-resistant Pseudomonas aeruginosa . ● Drug-resistant non-typhoidal Salmonella . ● Drug-resistant Salmonella serotype Typhi. ● Drug-resistant Shigella . ● Methicillin-resistant Staphylococcus aureus (MRSA). ● Drug-resistant Streptococcus pneumoniae . ● Drug-resistant tuberculosis. ● Vancomycin-resistant Staphylococcus aureus . ● Erythromycin-resistant Group A Streptococcus . ● Clindamycin-resistant Group B Streptococcus . Category B ● Brucellosis. ● Epsilon toxin of Clostridium perfringens. ● Food safety threats such as Salmonella species, Shigella , and E. coli O157:H7. ● Glanders (primarily a disease of horses but used as a biological weapon in both World Wars; Pal & Gutama, 2022). ● Melioidosis. ● Psittacosis. ● Q fever. ● Typhus fever. ● Various types of viral encephalitis. Category C ● Emerging infectious diseases such as Nipah virus and hantavirus. ● Neisseria gonorrhoeae. ● Multidrug-resistant Acinetobacter .
systems, such as an Airborne Infection Isolation Room (AIIR), to contain and safely remove the infectious agent. OSHA standards and directives for protection against transmission of infectious agents must be included in training for all personnel. These include OSHA’s bloodborne pathogens standard (29 CFR 1910.1030), which provides protection of workers from exposures to blood and body fluids that may contain bloodborne infectious agents; personal protective equipment standard (29 CFR 1910.132) and respiratory protection standard (29 CFR 1910.134), which provide protection for workers when exposed to contact, droplet, and airborne transmissible infectious agents; and TB compliance directive (CPL 02-02-078), which enforces procedures and scheduling Epidemiologically important organisms Infectious agents of particular interest for healthcare settings are called epidemiologically important organisms and are targeted for advanced methods of infection control. An “epidemiologically important organism” is identified by the following characteristics: ● Increased potential for transmission within healthcare facilities based on published reports and the occurrence of temporal or geographic clusters of more than two patients (CDC, 2019a). A single case of healthcare-associated invasive disease caused by certain pathogens is generally considered a trigger for investigation and enhanced control measures because of the risk of additional cases and severity of illness associated with these infections. ● Antimicrobial resistance to first-line therapies. Multidrug-resistant organisms (MDROs) MDROs are microorganisms, mainly bacteria, that are resistant to one or more classes of antimicrobial agents. These pathogens are usually resistant to all but a few commercially available antimicrobial agents, so MDROs are considered to be epidemiologically important and deserve special attention in mortuary facilities. MDROs are transmitted by the same routes as other infectious agents. Preventing the emergence and transmission of these pathogens requires a comprehensive approach that includes administrative involvement, education and training of personnel, comprehensive surveillance for targeted MDROs, application of infection control precautions, and environmental measures such as cleaning and disinfection of the environment and equipment. MDROs include: ● Clostridium difficile (C. diff). ● Carbapenem-resistant Enterobacteriaceae (CRE). Agents of bioterrorism The CDC has designated agents that cause anthrax, smallpox, plague, tularemia, viral hemorrhagic fevers, and botulism as Category A, high priority, because these agents can be easily dispersed environmentally, through food, water, air, and/or transmitted from person to person; can cause high mortality and have the potential for major public health impact; and might cause public panic and social disruption. The federal government categorizes bioterrorism agents into A (the highest priority), B, and C. These agents identified by the CDC (2018) include the following:
Category A ● Anthrax. ● Botulism. ● Plague.
● Smallpox. ● Tularemia. ● Viral hemorrhagic fevers (including Filoviruses such as Ebola and Marburg fever and Arenaviruses such as Lassa and Machupo fever).
Book Code: FTX1624
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