[Grace]

Thinking of your current or a past practice area provide an example of the train of transmission specific to that area. Fill in all ‘links’ in the chain with an example for each link:

Infectious Agent:

Reservoirs:

Portals of Exit:

Modes of Transmission:

Portals of Entry:

Susceptible Host:

[Mildred]

Chain of Transmission – Medical–Surgical Unit

Infectious Agent:
Clostridioides difficile (C. difficile)

Reservoirs:

Gastrointestinal tract of infected or colonized patients

Contaminated surfaces (bed rails, call bells, toilets, commodes)

Contaminated healthcare workers’ hands

Portals of Exit:

Feces from an infected or colonized patient (during bowel movements or incontinence episodes)

Modes of Transmission:

Indirect contact transmission via the contaminated hands of healthcare workers

Contact with contaminated equipment or environmental surfaces (e.g., shared commodes, improperly cleaned rooms)

[Arlene]

Hi Mildred

C-Diff must be one of my most feared infections as it is so difficult to remove/treat increasing the chance of transmission.

Lack of education – Not all health care providers are aware that alcohol-based hand rub (ABHR) is not an effective way to remove C-Diff from hands therefore soap and water must be used.

Accessible facilities – Many times, the inconvenient placement of sinks within facilities prevent the accessibility of soap and water hand washing as frequently as needed.

Your document seems to have cut off “Portals of Entry” (fecal-oral) and “Susceptible Host” (immunocompromised, previous antibiotic use).

[Carla-Jane]

Chain of Transmission; Long Term Care Facility

Infectious Agent : Norovirus

Reservoirs: Infected residents, Contaminated surfaces, Contaminated food or water

Portals of exit: Vomit, Feces, Respiratory droplets. The virus exits the body primarily through gastrointestinal secretions.

Mode of Transmission: Direct contact – hands of healthcare workers or residents after toileting.
Indirect contact – touching contaminated surfaces or shared equipment.
Fecal-oral transmission – Ingestion of virus particles due to poor hand hygiene

Portal of Entry: Mucous membranes (mouth or nose), Ingestion of contaminated food or hands

Susceptible Host: Older adults with weakened immune systems, residents with chronic illness

[Arlene]

Chain of Transmission – Psychiatric ICU

Infectious Agent: MRSA

Reservoirs-
High touch surfaces (shared bathrooms, door handles), Nasal passages, medical equipment, linens, skin of infected or colonized individuals, contaminated hands of healthcare workers.

Portals of Exit-
Respiratory secretions, wound drainage, Skin of colonized or infected individuals

Modes of Transmission-
Direct: Healthcare workers hands; contact with skin or respiratory secretions of an infected or colonized individual;
Indirect: Medical equipment (Vitals machines); door handles; linens; healthcare workers clothing

Portal of Entry –
Break in skin (open wounds), invasive devices (Peripheral/central lines), mucous membranes (nasal passages, mouth)

Susceptible Host-
Immunocompromised individuals; Patients with invasive medical devices; open wounds

[Author]

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