SOLUTION AND ANSWER GUIDE
MICROBIOLOGY FOR SURGICAL TECHNOLOGISTS
3RD EDITION
UNDER THE MICROSCOPE
CHAPTER NO. 01: INTRODUCTION TO MICROBIOLOGY
Microbiology research and its application to healthcare have been studied for centuries. The use of traditional tools
of Gram staining and Koch’s Postulates and subsequent advanced tools such as the electron microscope over the
past century have brought the impact of the microbial world on human health into clear focus. The Centers for
Medicare and Medicaid Services (CMS) have initiated revised policies regarding reimbursement to hospitals for
care of patients who suffer health-care-associated infections (HAIs) such as SSIs. Hospitals must bear the costs of
treatment of preventable infections acquired in the course of their interaction with the medical profession which has
the responsibility to utilize the scientific foundation built by the experimental trials and errors of historical, recent,
and current pioneers in the war against disease and human suffering. Healthcare workers, including surgical team
members, are one critical key in preventing patient injury and protecting hospitals.
1. What are examples of a routine procedures performed by surgical technologists and other surgical team
members prior to entering the sterile field that would be part of aseptic technique?
ANSWER: 1.) Creation and maintenance of the sterile field with use of sterile instruments and
supplies only. 2.) Preparation of the patient’s skin with chemical antiseptic agents that remove
transient microbes and reduce the normal microbial populations to reduce the potential for surgical
site infection (SSI). 3.) Proper skin antisepsis used by all surgical team members. 4.) Use of
appropriate personal protective equipment (PPE) that serve as 2-way barriers that protect patients
from contamination from surgical team members and surgical team members from potential diseases
, the patient may have. 5.) Following required vaccination protocols and refraining from exposing
others (patients and personnel) when ill. 6.) Strict adherence to one’s surgical conscience at all times.
2. List components of personal protective equipment (PPE) that serve as barrier protection for patient and
personnel interactions and correlate the various components applicable to the procedures being performed.
ANSWER: 1.) Surgical masks (regular, N-95 respirator, laser) appropriate for the procedure or
transmissible infectious process the patient may have been diagnosed with previously and potential
inhalation by team members or other personnel. Also a dual protection for patients from airborne or
droplet particles from personnel. 2.) Gloves (unsterile or sterile) appropriate to the procedure.
Unsterile used for unsterile tasks and cleaning while sterile gloves are used for sterile procedures.
Often two pairs of sterile gloves are used for additional protection or detection of barrier
compromise (ex. colored under/indicator gloves that make perforations more visible). 3.) Gowns
(sterile for entry into the sterile field and unsterile for contact precautions). Other types of body-
cover PPE not related to disease transmission include x-ray aprons (or wrap-around vests or skirts),
thyroid shields, or radiation glasses/goggles when x-ray, fluoroscopy, or other ionizing radiation is
used; or plastic (impermeable) aprons for high-fluid exposure. 4.) Hats, caps, or hoods contain hair
from the head or sideburns or beards to prevent shedding and contamination of sterile areas. 5.) Eye
protection in the form of goggles or face shields prevent exposure by splash or splatter. 5.) Shoe or
lower leg covers for protection of fluid penetration to team members’ shoes or scrub pants below the
level of the sterile surgical gown.
3. Which vaccinations are required for personnel in the operating room and why?
ANSWER: Typically, students and personnel are required to demonstrate positive blood titers
(indicating active immunity) for measles/mumps/rubella, tuberculosis, tetanus/diphtheria/pertussis,
, hepatitis B, and more recently annual vaccinations for seasonal influenza and current COVID-19
vaccination protocols in many healthcare facilities. Certain exemptions may apply for specific
circumstances.
4. Which historical figures in medicine are credited with recognizing the need for aseptic techniques to reduce
wound infections?
ANSWER: Ignaz Semmelweis and Joseph Lister.
5. Which set of measures are used in addition to Standard Precautions when the disease status of a surgical
patient has been determined in advance?
ANSWER: Transmission-based precautions including airborne, droplet, and contact (direct and
indirect)
CHAPTER NO. 2: THE SCIENCE OF MICROBIOLOGY
Dev, a student taking the microbiology course pre-requisite to enter the surgical technology program, was intrigued
by a surgery-related article. As neurosurgery was Dev’s favorite surgical specialty, he chose this topic for his
research paper to discuss the connection between microbiology and his future profession. The case in the article
involved a craniotomy for biopsy in which the neurosurgeon advised the staff that the patient was being assessed for
symptoms of ataxia (loss of muscle coordination) and relatively sudden onset of dementia. Tumors and any other
intracranial lesions had been ruled out by radiographic studies. The patient had lived in England approximately 10
years ago when there had been an outbreak of “mad cow” disease.
1. What condition or disease process might the neurosurgeon suspect based on the patient’s history as given?
ANSWER: Most likely Creutzfeldt-Jakob disease (CJD) or variant CJD (vCJD).
, 2. Using binomial nomenclature and taxonomy taught in the microbiology course, how would Dev describe
the other groups of organisms affected by this particular type of pathogen and general category of disease?
ANSWER: Transmissible spongiform encephalopathies affect: Homo sapiens (humans) from “CJD”;
Bos taurus (cows) from “mad cow disease”; Ovis aries (sheep) from “scrapie” ; large hooved animals
(deer, elk, and moose) have other genus and species names and may be affected by “chronic wasting
disease.”
3. What type of infective agent is the cause for this form of transmissible spongiform encephalopathy?
ANSWER: Prions.
4. Which scientific microbial classification system (if any) would contain this type of pathogen?
ANSWER: Prions would be grouped along with viruses, viroids, transposons, and plasmids – all non-
living pathogens included in the Two Empire System of Cellular and Virus.
5. How would Dev describe the characteristics of the infective agents in this case as compared to the other
classes of microbes studied in his course?
ANSWER: He would discuss the unique nature of the prions as proteinaceous infectious particles
that have no nucleic acids and no cellular structure. Their mechanism of infection is an abnormal
folding of normal prior proteins found in the central nervous system (CNS) that cause holes in brain
tissue eventually creating a sponge-like appearance (spongiform encephalopathy). The disease is
slow-progressing, but there is no cure for CJD or vCJD and results are always fatal, unlike bacterial
and viral infections that affect the brain which may be survivable with treatment with antibiotics or
antiviral agents.
MICROBIOLOGY FOR SURGICAL TECHNOLOGISTS
3RD EDITION
UNDER THE MICROSCOPE
CHAPTER NO. 01: INTRODUCTION TO MICROBIOLOGY
Microbiology research and its application to healthcare have been studied for centuries. The use of traditional tools
of Gram staining and Koch’s Postulates and subsequent advanced tools such as the electron microscope over the
past century have brought the impact of the microbial world on human health into clear focus. The Centers for
Medicare and Medicaid Services (CMS) have initiated revised policies regarding reimbursement to hospitals for
care of patients who suffer health-care-associated infections (HAIs) such as SSIs. Hospitals must bear the costs of
treatment of preventable infections acquired in the course of their interaction with the medical profession which has
the responsibility to utilize the scientific foundation built by the experimental trials and errors of historical, recent,
and current pioneers in the war against disease and human suffering. Healthcare workers, including surgical team
members, are one critical key in preventing patient injury and protecting hospitals.
1. What are examples of a routine procedures performed by surgical technologists and other surgical team
members prior to entering the sterile field that would be part of aseptic technique?
ANSWER: 1.) Creation and maintenance of the sterile field with use of sterile instruments and
supplies only. 2.) Preparation of the patient’s skin with chemical antiseptic agents that remove
transient microbes and reduce the normal microbial populations to reduce the potential for surgical
site infection (SSI). 3.) Proper skin antisepsis used by all surgical team members. 4.) Use of
appropriate personal protective equipment (PPE) that serve as 2-way barriers that protect patients
from contamination from surgical team members and surgical team members from potential diseases
, the patient may have. 5.) Following required vaccination protocols and refraining from exposing
others (patients and personnel) when ill. 6.) Strict adherence to one’s surgical conscience at all times.
2. List components of personal protective equipment (PPE) that serve as barrier protection for patient and
personnel interactions and correlate the various components applicable to the procedures being performed.
ANSWER: 1.) Surgical masks (regular, N-95 respirator, laser) appropriate for the procedure or
transmissible infectious process the patient may have been diagnosed with previously and potential
inhalation by team members or other personnel. Also a dual protection for patients from airborne or
droplet particles from personnel. 2.) Gloves (unsterile or sterile) appropriate to the procedure.
Unsterile used for unsterile tasks and cleaning while sterile gloves are used for sterile procedures.
Often two pairs of sterile gloves are used for additional protection or detection of barrier
compromise (ex. colored under/indicator gloves that make perforations more visible). 3.) Gowns
(sterile for entry into the sterile field and unsterile for contact precautions). Other types of body-
cover PPE not related to disease transmission include x-ray aprons (or wrap-around vests or skirts),
thyroid shields, or radiation glasses/goggles when x-ray, fluoroscopy, or other ionizing radiation is
used; or plastic (impermeable) aprons for high-fluid exposure. 4.) Hats, caps, or hoods contain hair
from the head or sideburns or beards to prevent shedding and contamination of sterile areas. 5.) Eye
protection in the form of goggles or face shields prevent exposure by splash or splatter. 5.) Shoe or
lower leg covers for protection of fluid penetration to team members’ shoes or scrub pants below the
level of the sterile surgical gown.
3. Which vaccinations are required for personnel in the operating room and why?
ANSWER: Typically, students and personnel are required to demonstrate positive blood titers
(indicating active immunity) for measles/mumps/rubella, tuberculosis, tetanus/diphtheria/pertussis,
, hepatitis B, and more recently annual vaccinations for seasonal influenza and current COVID-19
vaccination protocols in many healthcare facilities. Certain exemptions may apply for specific
circumstances.
4. Which historical figures in medicine are credited with recognizing the need for aseptic techniques to reduce
wound infections?
ANSWER: Ignaz Semmelweis and Joseph Lister.
5. Which set of measures are used in addition to Standard Precautions when the disease status of a surgical
patient has been determined in advance?
ANSWER: Transmission-based precautions including airborne, droplet, and contact (direct and
indirect)
CHAPTER NO. 2: THE SCIENCE OF MICROBIOLOGY
Dev, a student taking the microbiology course pre-requisite to enter the surgical technology program, was intrigued
by a surgery-related article. As neurosurgery was Dev’s favorite surgical specialty, he chose this topic for his
research paper to discuss the connection between microbiology and his future profession. The case in the article
involved a craniotomy for biopsy in which the neurosurgeon advised the staff that the patient was being assessed for
symptoms of ataxia (loss of muscle coordination) and relatively sudden onset of dementia. Tumors and any other
intracranial lesions had been ruled out by radiographic studies. The patient had lived in England approximately 10
years ago when there had been an outbreak of “mad cow” disease.
1. What condition or disease process might the neurosurgeon suspect based on the patient’s history as given?
ANSWER: Most likely Creutzfeldt-Jakob disease (CJD) or variant CJD (vCJD).
, 2. Using binomial nomenclature and taxonomy taught in the microbiology course, how would Dev describe
the other groups of organisms affected by this particular type of pathogen and general category of disease?
ANSWER: Transmissible spongiform encephalopathies affect: Homo sapiens (humans) from “CJD”;
Bos taurus (cows) from “mad cow disease”; Ovis aries (sheep) from “scrapie” ; large hooved animals
(deer, elk, and moose) have other genus and species names and may be affected by “chronic wasting
disease.”
3. What type of infective agent is the cause for this form of transmissible spongiform encephalopathy?
ANSWER: Prions.
4. Which scientific microbial classification system (if any) would contain this type of pathogen?
ANSWER: Prions would be grouped along with viruses, viroids, transposons, and plasmids – all non-
living pathogens included in the Two Empire System of Cellular and Virus.
5. How would Dev describe the characteristics of the infective agents in this case as compared to the other
classes of microbes studied in his course?
ANSWER: He would discuss the unique nature of the prions as proteinaceous infectious particles
that have no nucleic acids and no cellular structure. Their mechanism of infection is an abnormal
folding of normal prior proteins found in the central nervous system (CNS) that cause holes in brain
tissue eventually creating a sponge-like appearance (spongiform encephalopathy). The disease is
slow-progressing, but there is no cure for CJD or vCJD and results are always fatal, unlike bacterial
and viral infections that affect the brain which may be survivable with treatment with antibiotics or
antiviral agents.
