Germs: Not Just Surviving, But Thriving


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Knowing where germs live and thrive is important for infection control in healthcare.

When you understand where germs live and how they can spread from place to place and make people sick, the infection control actions you take to keep them from spreading become second nature.

How Do Germs Spread?

Germs must be moved from person to person, place to place, or between places and people for them to potentially get someone sick.

When you’re thinking about the risk for germs to spread in healthcare, the first step is to think through where germs live.

A “reservoir” is a place where germs live and thrive. Like a habitat.

Reservoirs can be in the human body – the skin, the gastrointestinal system, the respiratory system, including the nose, throat, and lungs, and the blood.

Reservoirs can also be things in the environment, like water and surfaces that have water on them, dry surfaces like countertops and bedrails, dirt and dust, and devices.

How Do Germs Spread in Healthcare Settings?

Healthcare settings are home to other unique reservoirs for germs.

For example, germs can live and thrive on specific medical equipment and devices and spread to people and other places in the environment.

In healthcare, we also think about the reservoirs of the body differently because we have patients who are vulnerable – their bodies can’t defend themselves against germs as well as healthy people.

“A lot of patients have things going on that you can’t really see, like if their immune system is weak because of the medication for their cancer treatment,” said Dr. Abigail Carlson, an infectious diseases physician with the CDC, as part of CDC Project Firstline’s Inside Infection Control video series.

We also have patients whose bodies may have germs in or on them that can spread and cause harm.Germs spreading by cough

Depending on the germ, people who are sick could spread germs more easily.

For instance, someone with a respiratory infection who’s coughing can spread germs through their respiratory droplets.

“Like many other respiratory viruses, SARS-CoV-2 is able to get into a lot of cells in our nose, our throat, our eyes, and our lungs, and when that happens, the virus can then hijack the cells,” Dr. Carlson said. “And that’s how we get sick with COVID-19.”

How Do Germs Cause Infection?

For germs to spread and cause an infection, a few things must happen.

The germs need a pathway to leave their reservoir. To do that, they usually have help.

Germs typically travel on hands, devices, in air currents, or in water.

For example, when someone has diarrhea, the germs in their stool can spread onto their hands or onto surfaces in the environment.

To cause an infection, germs must survive traveling outside their reservoir and find a new place where they can survive.

Germs must enter the body of a new person, such as through their eyes, nose, mouth, or a break in the skin, and get around the body’s natural defenses.

When the germs get around the body’s natural defenses, they can multiply and cause damage – resulting in an infection.

Infection Control Actions Against Germs

germs surviving

Infection control uses key actions to stop germs from spreading, such as wearing personal protective equipment (PPE) when needed, cleaning and disinfecting surfaces and objects, and practicing hand hygiene.

Different situations require different infection control actions.

To make decisions about infection control, it’s important to think about where the germs are – which reservoir or reservoirs are you dealing with – and how the germs might get somewhere else.

What Can You Do to Promote Infection Control in Your Healthcare Setting?

It is important to protect yourself, patients, and colleagues from germs that can spread and cause infection.

You can determine the best infection control actions when you think about where germs are, and how they might spread.

How else can you stay up to date on infection control actions?

Pledge to take a training module or activity from the CDC Project Firstline!

Access more information about infection prevention and control in healthcare by visiting resources from CDC Project Firstline.

Project Firstline creates resources, including videos and shareable images, web buttons, posters, and print materials. They also have facilitator toolkits to help workers lead trainings even if they are not an infection control expert.

Salud America! at UT Health San Antonio is working with the National Hispanic Medical Association to bring Project Firstline infection control educational content to healthcare workers, so they are equipped with the knowledge they need to protect themselves, their facilities, and their patients (Latinos and all communities) from infectious disease threats in healthcare settings.

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“Healthcare teams in hospitals, nursing homes, and other care settings are the front lines against the spread of infection,” said Dr. Amelie G. Ramirez, director of Salud America! at UT Health San Antonio. “CDC’s Project Firstline is bolstering those efforts by developing evidence-based tools that can be delivered in a variety of ways to make infection control learning convenient and accessible for busy healthcare staff.”

Learn More about Project Firstline!

 Editor’s Notes:

This article is part of a collaboration between Salud America!, the National Hispanic Medical Association, and the CDC’s Project Firstline. To find resources training materials, and other tools to bolster knowledge and practice of infection control, visit Project Firstline and view Salud America!’s infection control content.


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