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    • #2845
      Sharon
      Member

      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:

      Attachments:
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    • #3155
      Leslie
      Member

      Infectious Agent – Influenza
      Reservoirs – work surface
      Portals of exit – skin
      Modes of Transmission – contact with unclean surface / lack of hand hygiene
      Portal of Entry – lesion in hand
      Susceptible host – elderly diabetic patient

    • #3159
      Makenzie
      Member

      Infectious Agent: c.diff
      Reservoirs: contaminated work surface, contaminated bathroom surfaces
      Portals of Exit: stool
      Modes of Transmission: contact with contaminated surfaces, poor hand hygiene
      Portals of Entry: oral membranes
      Susceptible Host: client post hospital stay and antibiotic use, requiring full care in all ADLs

    • #3160
      Shannon Ruth
      Member

      Infectious Agent: MRSA
      Reservoirs: contaminated linens, dressings, clothing
      Portals of Exit: wounds, discharge, contaminated hands
      Mode of transmission: poor hand hygiene, direct contact person to person
      Portal of Entry: catheter and skin
      Susceptible Host: any one receiving health care ie: wound care, surgery

      • #3330
        Joanna
        Member

        Reply to Shannon Ruth, MRSA, break the chain of transmission
        Hi there.
        I work in a retirement home setting where residents are frequently transferred to and discharged from hospital. Resident exposure to the hospital setting increases risk of potential infection of MRSA. The presence of MRSA in a resident may be unknown or undiagnosed. MRSA can be present in the nose, mucus membranes, on the skin, or in the blood or urine. Consistent use of routine practices with all residents during all care will break the chain of transmission at the portal of entry. A point of care risk assessment will determine actions to be taken. Hand hygiene with an alcohol-based hand rub or with soap and water before and after physical contact with a resident or with a contaminated environment. Determine what PPE to be worn to prevent contact with blood, body fluids, secretions, excretions, non-intact skin, or mucous membranes.
        Glove, as an additional measure to hand hygiene, when there is a risk of hand contact with blood, body fluids, secretions, excretions, non-intact
        Gown if contamination of uniform or skin is anticipated.
        Mask and eye protection or a face shield to protect the mucous membranes of the eyes, nose, and mouth during procedures or activities likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.

    • #3173
      Amber
      Member

      Infectious agent: shingles
      Reservoirs: linen, clothing
      Portals of exit: blisters/ lesions
      Mode of transmission: contact/ airborne until lesions are dry/scabbed
      Portal of exit: skin / fluid in blisters
      Susceptible host: immune compromised (someone who is not immune to chicken pox) varicella zoster virus is the contagion.

    • #3176
      Cheryl
      Member

      Infectious Agent: MRSA

      Reservoirs: Contaminated clothing

      Portals of Exit: Wound Exudate

      Modes of Transmission: Wound cleansing with splash/ spray, improper touching of and disposal of dressings, direct contact and improper hand hygiene post care

      Portals of Entry: open wounds, skin

      Susceptible Host: use of antibiotics, hospital stay

    • #3189
      Prince
      Member

      Infectious Agent: Streptococcus pneumoniae

      Reservoirs: Work surfaces, Nose and throat

      Portal of Exit: coughing, sneezing

      Modes of Transmission: Airbone, poor hand hygiene

      Portal of Entry: upper respiratory tract

      Susceptible Host: Seniors, immunocompromise individuals,

    • #3190
      Barbara
      Member

      Infectious Agent: E-Coli

      Reservoirs: infected people
      infected animals
      contaminated surfaces, foods or liquids

      Portals of Exit: feces, urine, secretions from catheters, cross-contamination when food handling

      Modes of Transmission: Eating, Drinking, cross contamination from improper hand washing or food prep, lack of aseptic technique, improper PPE or not wearing gloves and gowns

      Portals of Entry: GI- eating and drinking,

      Susceptible Host: People who eat contaminated food, drink contaminated water, juice and unpasteurized milk.

    • #3191
      Amanda
      Member

      Infectious Agent – Hepatitis C
      Reservoirs – Patient
      Portals of exit – Blood
      Modes of Transmission – Needle
      Portal of Entry – Needle-stick
      Susceptible host – Health care workers using sharps

    • #3192
      Joanna
      Member

      Infectious Agent: Influenza
      Reservoirs: client/patient/resident lungs and air passages
      Portals of Exit: coughing, sneezing
      Modes of Transmission: droplets, hands, surfaces
      Portals of Entry: eyes, nose, mouth
      Susceptible Host: people who have not received their annual influenza vaccine

    • #3198
      Melissa
      Member

      Infectious Agent – Hepatitis B
      Reservoirs – Patient
      Portals of exit – Blood, bodily fluids (saliva, menstrual, vaginal and seminal fluids) and shared needle
      Modes of Transmission – Needle stick , sexual intercourse, contaminated surfaces
      Portal of Entry – Needle-stick, open wounds, sexual transmission
      Susceptible host – People who have not received Hepatitis B vaccine and who don’t use protection during intercourse or who share needles with an infected individual

    • #3208
      Maria Mercedes
      Member

      – Infectious Agent: Bacteria (Salmonella).
      – Reservoirs: Infected individuals, contaminated food.
      – Portals of Exit: Body excretions (feces), ingestion of contaminated food.
      – Modes of Transmission: Fecal-oral transmission trough contact with contaminated hands, items, or surfaces.
      – Portal of Entry: GI tract (mouth).
      – Susceptible Host: – Anyone, immunocompromised, children, elderly.

      – Infectious Agent: Virus (Hepatitis B).
      – Reservoirs: Blood Donor.
      – Portals of Exit: Blood.
      – Modes of Transmission: Blood transfusion, contact.
      – Portal of Entry: Skin puncture by the needle into the circulatory system.
      – Susceptible Host: Patient receiving the blood transfusion, clinical staff handling blood products and medical equipment during the transfusion.

    • #3215
      Michelle
      Member

      Infectious Agent: common cold (rhinovirus)

      Reservoirs: animate: humans
      inanimate: dry surfaces eg; door handles, exam tables

      Portals of Exit: coughing, sneezing, talking, or singing

      Modes of Transmission: direct contact eg; using the same utensils as a person who is infected with the
      virus
      indirect contact eg; touches contaminated dry surfaces and then touches your
      eyes, nose or mouth with washing them first or not properly.
      droplet: being close ( < 2 meters ) to someone infected by the virus who has just
      sneezed or coughed contaminating your eyes, nose or mouth

      Portals of Entry: mucous membranes of respiratory tract eg; eyes, nose, and mouth

      Susceptible Host: anyone though more susceptible are the elderly, young children 0-5 years and
      immunosuppression

    • #3220
      Jared
      Member

      Infectious Agent: Extended Spectrum Beta-Lactamase (ESLB)

      Reservoirs: Animate – Humans (also known to spread in food + water in places with poor sanitation) | Inanimate: Surfaces

      Portals of Exit: Stool, GI secretions (ESLB producing organisms live in the GI system)

      Modes of Transmission: Contact (Contaminated hands + surfaces)

      Portals of Entry: Mucous Membranes, broken skin

      Susceptible Host: Client’s on Prolonged and extensive treatment of certain antibiotics, transplant recipients, those with catheters (both urinary & central venous lines), extremes in age, Immunosuppressed individuals.

    • #3226
      Tracy
      Member

      Infectious agent- Streptococcus pneumoniae

      Reservoirs-People, food (aspiration pneumonia)

      Portals of exit-sneezing, coughing

      Modes of transmission-droplet, poor hand hygiene

      Portals of entry- Respiratory tract, lungs

      Susceptible hosts-Compromised immune system, elderly

    • #3230
      Judy
      Member

      Infectious Agent – Clostridium difficile
      Reservoir – contaminated surfaces with feces like bed and washroom surfaces
      Portal of exit – feces
      Mode of Transmission – contact of contaminated surfaces with feces and then touching their mouth and poor hand hygiene
      Portal of Entry – oral membrane
      Host- patients who are taking antibiotics in high doses and/or over long period of time

    • #3231
      Judy
      Member

      Infectious Agent – Clostridium difficile
      Reservoir – contaminated surfaces with feces like bed and washroom surfaces
      Portal of exit – feces
      Mode of Transmission – contact of contaminated surfaces with feces and then touching their mouth and poor hand hygiene
      Portal of Entry – oral membrane
      Host- patients who are taking antibiotics in high doses and/or over long period of time

      • #3289
        Cynthia
        Member

        I agree with Judy on how this is transmitted, to break the chain is to protect your yourself.

    • #3234
      Adella
      Member

      Discussion #2 – Knowing that each link in the chain must be present to transmit an infectious agent, review another members post and comment on how would you break the chain of transmission for the infectious agent they have identified.
      E.g., Streptococcus pneumoniae, ESBL, c. diff, Salmonella, Rhinovirus etc.

    • #3237
      Dale
      Member

      Infectious Agent: Influenza A (Flu)

      Reservoirs: Person

      Portals of Exit: Cough or sneeze

      Modes of Transmission: Droplets (cough without covering mouth or not sneezing into elbow, not using PPE)

      Portals of Entry: Contact with mouth, nose or eyes (regular hand washing can prevent from entering body)

      Susceptible Host: Person who lacks immunity (receive flu shot to break chain)

      • #3296
        Jordanna
        Member

        Review of Dale (Influenza)
        I agree the annual flu shot and proper hand hygiene is essential to break the transmission. The addition of wearing a mask when symptomatic would be ideal.

    • #3238
      Dale
      Member

      Review of member Judy regarding Infectious Agent – Clostridium difficile
      In order to prevent the spread of an infectious disease one of the 6 links in the chain of infection must be broken. With the use of proper hand hygiene and use of PPE (gloves) you can break the chain of infection.

    • #3239
      Dale
      Member

      Review of member Judy regarding Infectious Agent – Clostridium difficile
      To prevent the spread of an infectious disease use proper hand hygiene and use PPE (gloves). y

    • #3257
      Tanya
      Member

      Infectious Agent: Clostridioides difficile (C. diff)
      Reservoirs: Intestines of infected individual/carrier, wheelchairs, commodes, bedrails that are contaminated with infected feces
      Portals of Exit: Feces, mainly diarrhea, via the gastrointestinal tract
      Modes of Transmission: Commonly by a fecal-oral route, contaminated hands, during client transfers when there is failure of notification of a positive case
      Portals of Entry: Oral
      Susceptible Host: Clients who had GI tract surgeries, clients on antibiotics, multiple hospital admissions, clients with weakened immune systems, older adults

    • #3258
      Heather
      Member

      Infectious Agent: Staphylococcus
      Reservoirs: stethoscope
      Portals of Exit: skin
      Modes of Transmission: stethoscope (diaphragm part ) touching the patient’s arm
      Portals of Entry: broken skin
      Susceptible Host: the patient who is at risk of infection, for example, immunocompromised

    • #3259
      Tanya
      Member

      In review of member Amber’s Infectious agent Shingles, clients who have disseminated shingles should be in airborne isolation to prevent the spread of infection.

    • #3261
      Jared
      Member

      In review of Dale’s post on Influenza Type A – the chain can be broken at the portal of exit (client masking), interrupting the mode of transmission (placing client’s on droplet precautions), portal of entry (ensuring staff wear proper PPE and perform hand hygiene), and protecting susceptible hosts (Ensuring all who have direct contact with the client have a flu shot… and keeping compromised persons away from the infected).

      All of this sounds very familiar…

    • #3263
      Maria Mercedes
      Member

      Discussion # 2: Breaking the chain of transmission:

      – Review of Lesly and Dalle: Virus Influenza (flu) – Immunization will break the link of susceptible hosts. Appropriated Hand hygiene to break the links of Portals of Entry, Exit and Mode of Transmission

      – Review of Prince and Tracy: Bacteria Streptococcus pneumoniae – Proper barriers (nose and mouth covering) to block portals of exit when coughing, sneezing. Spatial separation and hand hygiene will break the link of mode of transmission.

      – Review of Michelle: Virus Common cold Rhinovirus – Spatial separation, hand hygiene, and environmental sanitation will break the link of mode of transmission. Treatments for high risk individuals could be effective to promote prevention in Susceptible Hosts.

      – Review of Makency, Judy and Tania: Bacteria: Clostridium Difficile (c.dif) – Hand hygiene and environmental disinfection break the link of Reservoirs and Modes of transmission.

      – Review of Sharon Ruth and Cheryl: Bacteria: MRSA – Hand hygiene and environmental disinfection break the link of Reservoirs and Modes of transmission. Appropriated disposal of waste and contaminated linen can break the link of Portal of Exit as well.

      – Review of Barbara: Bacteria E-Coli – Hand hygiene, PPE, and environmental disinfection break the link of Modes of transmission. Controlling body excretions could block the Portal of Exit.

      – Review of Maria Mercedes: Bacteria Salmonella – Proper food storage and environmental cleaning break the link of the Reservoir. Hand hygiene, PPE and disinfection of surfaces to prevent transmission.

      – Review of Melissa and Maria Mercedes: Virus Hepatitis B – Control of blood and body fluids with adequate PPE, hand hygiene and disposal of contaminate waste and utensils will break the link of Portal of Exit. Maintaining the Skin intact and adequate sex protection are effective barriers at Portals of entry links. Susceptible hosts can be immunized with the Hepatitis B vaccine.

      – Review of Amanda: Virus Hepatitis C – Control of blood and body fluids with adequate PPE, hand hygiene and disposal of contaminate waste and utensils will break the link of Portal of Exit. It is important to maintain skin integrity and reframe from wearing tattoos and piercings to break the chain of transmission at the skin Portal of Entry link. There is not vaccine for this viral infection

      – Review of Jared: Enzyme found in Bacteria Extended Spectrum Beta-Lactamase (ESBL) – Sterile Techniques inserting Foley catheters and IV lines will prevent from contamination in Susceptible Hosts who require these clinical supplies.

      – Review of Header: Bacteria: Staphylococcus – Equipment disinfection and hand hygiene will block the Mode of transmission and Portals of Entry.

      – Review of Amber: Virus: Herpes Zoster (shingles) – Vaccination will immunize Susceptible Hosts who have not been exposed to Chicken Pox (Varicella) by primary infection or previous vaccination. This immunization will break the chain of transmission. Spatial separation, preventing contact with clothing and contaminated linen with vesicular fluid of a Zoster individual, and hand hygiene could interfere transmission at Portals of Exit.

    • #3264
      Jieun
      Member

      Infectious Agent: Meningitis

      Reservoirs: Human

      Portals of Exit: secretions ( saliva, mucus), and feces

      Modes of Transmission: Transmitted to person to person; Spreads by close/direct contract with nasal secretions, mucus or feces

      Portals of Entry: ear, nose, and throat

      Susceptible Host: Most susceptible host is children younger than 1 year and also elderly within weakened immune systems

    • #3265
      Jieun
      Member

      Infectious Agent: Meningitis (Bacteria)

      Reservoirs: Human

      Portals of Exit: secretions ( saliva, mucus), and feces

      Modes of Transmission: Transmitted to person to person; Spreads by close/direct contract with nasal secretions, mucus or feces

      Portals of Entry: ear, nose, and throat

      Susceptible Host: Most susceptible host is children younger than 1 year and also elderly within weakened immune systems

      • #3333
        Alice
        Member

        Reply to Heather re: staphylococcus transmission. Stop spread with equipment disinfection and hand hygiene.

    • #3270
      Francine
      Member

      I am pleased to see so many responses to this discussion. I am pleased to see that you are referencing each other in your posts. At the present moment we will need to continue to refer to each other in our posts by name.

      Good discussion arising out of the posts. Many things to consider. I want you all to consider how the chain of transmission directly affects your practice when looking at the infectious agents you have noted.

    • #3277
      Michelle
      Member

      review of Amber infection agent Shingles: ways of breaking the chain
      1. handling the clothing and bedding of the infected person with proper PPE (gloves and gown) and wash them frequent to minimize infecting other household members or residents.
      2. best practice is prevention by effective immunization in childhood.

    • #3288
      Cynthia
      Member

      Infectious agent -Influenza transmission
      Reservoir-Human
      Reservoir- lungs and air passages
      Portal of Exit- coughing and sneezing
      Mode of Transmission-hands/surfaces and droplets
      Gains entry-eye, nose, mouth
      Susceptible Host-people who have not gotten vaccine and immune deficient, young children older adults

    • #3294
      Cheryl
      Member

      In reply to Heather re Staph

      Proper hand hygiene before and after care
      Disinfection of stethoscope post use with a DIN certified disinfectant and allowed to dry for recommended time
      Where possible if immunocompromised not using same equipment on multiple patients
      Having open skin covered with a sterile dressing and avoiding that area with hands and equipment

    • #3295
      Jordanna
      Member

      Infectious Agent: Varicella Zoster Virus

      Reservoirs: People
      Portals of Exit: Mucus, excretions, broken skin ie: open blisters
      Modes of Transmission:Contact, airborne
      Portals of Entry: Contact, respiratory (breathing virus particles until blisters dry/scab over)
      Susceptible Host: Infants, children, pregnant women, immunocompromised, unvaccinated persons

      • #3324
        Amanda
        Member

        Regarding infectious agent: Varicella Zoster Virus

        We can help break this chain at various stages.
        The vaccine helps us break the link of a susceptible host, creating an inhospitable reservoir for the virus.
        When caring for a person who is already infected we can break the link of the portal of entry by protecting ourselves with proper PPE. Things like 95 masks, eye protection, gowns, and gloves. Ensuring we doff the equipment properly to avoid contamination.
        We can help break the link of mode of transmission by placing the person in a negative air pressure room, limiting the virus’ ability to transmit through the air.

    • #3300
      Shannon Ruth
      Member

      reply to Michelle common cold (rhinovirus)- wearing mask, environmental cleaning-high touch areas and hand hygiene can break the transmission

    • #3332
      Alice
      Member

      Infectious agent: Pertussis

      Reservoirs: Upper respiratory system
      Portal of exit:coughing or sneezing
      Mode of transmission: Person to person Close contact for long period of time with infected person .
      Portal of entry :respiratory
      Susceptible host: Infants, children and unvaccinated even though this is not fully protective

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