Infection Control

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How Infections Spread

Germs are a part of everyday life and are found in our air, soil, water, and in and on our bodies. Some germs are helpful, others are harmful. Many germs live in and on our bodies without causing harm and some even help us to stay healthy. Only a small portion of germs are known to cause infection.

How Do Infections Occur?

An infection occurs when germs enter the body, increase in number, and cause a reaction of the body.

Three things are necessary for an infection to occur:

  • Source: Places where infectious agents (germs) live (e.g., sinks, surfaces, human skin)
  • Susceptible Person with a way for germs to enter the body
  • Transmission: a way germs are moved to the susceptible person

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  • Source
  • Susceptible Person
  • Transmission

Source

A Source is an infectious agent or germ and refers to a virus, bacteria, or other microbe.

In healthcare settings, germs are found in many places. People are one source of germs including:

  • Patients
  • Healthcare workers
  • Visitors and household members

People can be sick with symptoms of an infection or colonized with germs (not have symptoms of an infection but able to pass the germs to others).
Germs are also found in the healthcare environment. Examples of environmental sources of germs include:

  • Dry surfaces in patient care areas (e.g., bed rails, medical equipment, countertops, and tables)
  • Wet surfaces, moist environments, and biofilms (e.g., cooling towers, faucets and sinks, and equipment such as ventilators)
  • Indwelling medical devices (e.g., catheters and IV lines)
  • Dust or decaying debris (e.g., construction dust or wet materials from water leaks)

Susceptible Person

A susceptible person is someone who is not vaccinated or otherwise immune, or a person with a weakened immune system who has a way for the germs to enter the body. For an infection to occur, germs must enter a susceptible person’s body and invade tissues, multiply, and cause a reaction.

Devices like IV catheters and surgical incisions can provide an entryway, whereas a healthy immune system helps fight infection.

When patients are sick and receive medical treatment in healthcare facilities, the following factors can increase their susceptibility to infection.

  • Patients in healthcare who have underlying medical conditions such as diabetes, cancer, and organ transplantation are at increased risk for infection because often these illnesses decrease the immune system’s ability to fight infection.
  • Certain medications used to treat medical conditions, such as antibiotics, steroids, and certain cancer fighting medications increase the risk of some types of infections.
  • Lifesaving medical treatments and procedures used in healthcare such as urinary catheters, tubes, and surgery increase the risk of infection by providing additional ways that germs can enter the body.

Recognizing the factors that increase patients’ susceptibility to infection allows providers to recognize risks and perform basic infection prevention measures to prevent infection from occurring.

Transmission

Transmission refers to the way germs are moved to the susceptible person.

Germs don’t move themselves. Germs depend on people, the environment, and/or medical equipment to move in healthcare settings.

There are a few general ways that germs travel in healthcare settings – through contact (i.e., touching), sprays and splashes, inhalation, and sharps injuries (i.e., when someone is accidentally stuck with a used needle or sharp instrument).

  • Contact moves germs by touch (example: MRSA or VRE). For example, healthcare provider hands become contaminated by touching germs present on medical equipment or high touch surfaces and then carry the germs on their hands and spread to a susceptible person when proper hand hygiene is not performed before touching the susceptible person.
  • Sprays and splashes occur when an infected person coughs or sneezes, creating droplets which carry germs short distances (within approximately 6 feet). These germs can land on a susceptible person’s eyes, nose, or mouth and can cause infection (example: pertussis or meningitis).
    • Close range inhalation occurs when a droplet containing germs is small enough to breathe in but not durable over distance.
  • Inhalation occurs when germs are aerosolized in tiny particles that survive on air currents over great distances and time and reach a susceptible person. Airborne transmission can occur when infected patients cough, talk, or sneeze germs into the air (example: TB or measles), or when germs are aerosolized by medical equipment or by dust from a construction zone (example: Nontuberculous mycobacteria or aspergillus).
  • Sharps injuries can lead to infections (example: HIV, HBV, HCV) when bloodborne pathogens enter a person through a skin puncture by a used needle or sharp instrument.

What is breast Cancer?

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Breast Cancer Awareness

Wondering when to start or how often to get screening mammograms? 

Ask your doctor when you should get a mammogram.

Other than skin cancer, breast cancer is the most common cancer among American women. Mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms.

Kinds of Breast Cancer

The most common kinds of breast cancer are—

  • Invasive ductal carcinoma. The cancer cells begin in the ducts and then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread, or metastasize, to other parts of the body.
  • Invasive lobular carcinoma. Cancer cells begin in the lobules and then spread from the lobules to the breast tissues that are close by. These invasive cancer cells can also spread to other parts of the body.

What Are the Symptoms?

There are different symptoms of breast cancer, and some people have no symptoms at all. Symptoms can include—

  • Any change in the size or the shape of the breast.
  • Pain in any area of the breast.
  • Nipple discharge other than breast milk (including blood).
  • A new lump in the breast or underarm.

If you have any signs that worry you, see your doctor right away.

How Can I Lower My Risk?

You can do things to help lower your breast cancer risk.

  • Keep a healthy weight and exercise regularly.
  • Choose not to drink alcohol, or drink alcohol in moderation.
  • If you are taking hormone replacement therapy or birth control pills, ask your doctor about the risks.
  • Breastfeed your children, if possible.

Fast Facts About Breast Cancer

  • Each year in the United States, about 240,000 women get breast cancer and 42,000 women die from the disease.
  • Men also get breast cancer, but it is not very common. About 1 out of every 100 breast cancers diagnosed in the United States is found in a man.
  • Most breast cancers are found in women who are 50 years old or older, but breast cancer also affects younger women.

How is a mammogram done?

You will stand in front of a special X-ray machine. A technologist will place your breast on a plastic plate. Another plate will firmly press your breast from above. The plates will flatten the breast, holding it still while the X-ray is being taken. You will feel some pressure. The steps are repeated to make a side view of the breast. The other breast will be X-rayed in the same way. You will then wait while the technologist checks the X-rays to make sure the pictures do not need to be redone. Keep in mind that the technologist cannot tell you the results of your mammogram. Each woman’s mammogram may look a little different because all breasts are a little different.