Embed Size (px)
Citation preview
Disinfectants
by
Derar ALJarrah , RN
Jordan
+962790125030
What is DisinfectionWhat is Disinfection
Disinfection may be defined as: Cleaning an article of some or all of the pathogenic organisms which may cause infections.
DEFINITIONS
Antisepsis: the practice of using antiseptics to : the practice of using antiseptics to eliminate the microorganisms that cause diseaseeliminate the microorganisms that cause disease..
Asepsis: the absence of bacteria, viruses, and other microorganisms.
Aseptic technique: is a procedure used by medical staff to prevent the spread of infection. The goal is to reach asepsis, which means an environment that is free of harmful microorganisms.
Antiseptics versus Disinfectants
Antiseptics: • chemicals that kill microorganisms on living skin or
mucous membranes. • Use on skin and mucous membranes to kill
microorganisms• Not for use on inanimate objects
Disinfectants:• Use to kill microorganisms on inanimate objects.
• Not for use on skin or mucous membranes.
Cleaning - Decontamination - DecontaminationCleaning• the physical removal of foreign
material, e.g., dust, soil, organic material such as blood, secretions, excretions and microorganisms.
• Cleaning generally removes rather than kills microorganisms. It is accomplished with water, detergents and mechanical action.
• Cleaning reduces or eliminates the reservoirs of potential pathogenic organisms
Decontamination• the removal of disease producing
microorganisms to leave an item safe for further handling.
Chemical DisinfectionChemical Disinfection
Bactericidal - chemical agents capable of killing bacteria. Similarly agents that are virucidal, fungicidal or sporicidal are agents capable of
killing these organisms.
Bacteriostatic - Chemical agents that inhibit the growth of bacteria but do not necessarily kill
them.
High level disinfection
High level disinfection processes destroy vegetative bacteria, mycobacteria, fungi and enveloped (lipid) and nonenveloped (non lipid) viruses, but not necessarily bacterial spores. High level disinfectant chemicals (also called chemical sterilants) must be capable of sterilization when contact time is extended. Items must be thoroughly cleaned prior to high level disinfection.
Intermediate level disinfection
Intermediate level disinfectants kill vegetative bacteria, most viruses and most fungi but not resistant bacterial spores.
Low level disinfection
Low level disinfectants kill most vegetative bacteria and some fungi as well as enveloped (lipid) viruses (e.g., hepatitis B, C, hantavirus, and HIV). Low level disinfectants do not kill mycobacteria or bacterial spores. Low level disinfectants are typically used to clean
environmental surfaces.
Disinfection
• Alcohols• Chlorine and Chlorine compounds • Formaldehyde • Glutaraldehyde• Ortho-phthalaldehyde, • Hydrogen peroxide • Iodophors• Peracetic acid• Phenolics• Quaternary ammonium compounds.
Many disinfectants are used alone or in combinations in the health-care setting.
Disinfectant effectiveness depends on many factors
• Type of contaminating microorganism. Each disinfectant has unique antimicrobial attributes.
• Degree of contamination. This determines the quality of disinfectant required and time of exposure.
• Amount of proteinaceous material present. High protein based materials absorb and neutralize some chemical disinfectants.
• Presence of organic matter and other compounds such as soaps may neutralize some disinfectants.
• Chemical nature of disinfectant. It is important to understand the mode of action in order to select the appropriate disinfectant.
Disinfectant effectiveness depends on many factors
• It is important to choose the proper concentration and quantity of disinfectant that is best suited to each situation.
• Contact time and temperature. Sufficient time and appropriate temperature must be allowed for action of the disinfectant and may depend on the degree of contamination and organic matter load.
• Residual activity and effects on fabric and metal should be considered for specific situations.
• Application temperature, pH and interactions with other compounds must be considered.
• Toxicity to the environment and relative safety to people that may be exposed.
Alcoholdenaturation of proteins
• Alcohols are commonly used topical antiseptics. Rapid bactericidal, tuberculocidal, fungicidal, and virucidal but do not destroy bacterial spores.
• optimum bactericidal concentration is 60%–90% solutions in water.
• Alcohols are not effective against bacterial spores and have limited effectiveness against nonenveloped viruses.
• They are also used to disinfect the surface of medical equipment. Alcohols require time to work and they may not penetrate organic material.
Chlorine and Chlorine Compounds(Hypochlorits(
•They have a broad spectrum of antimicrobial activity, do not leave toxic residues, are unaffected by water hardness.
•Hypochlorite, the most widely used of the chlorine disinfectants, are available as liquid or solid.
•The most common chlorine products in are aqueous solutions of 4 to 6% sodium hypochlorite, which are readily available as “household bleach”.
•Hypochlorits Most recommended in They are included in most recommendation for decontamination of hepatitis and AIDS viruses .
•Hypochlorits are also the agent of choice in disinfecting surfaces used for food preparation or in bathrooms. Organic material such as feces or blood inactivate chlorine based disinfectants, therefore, surfaces must be clean
before their use.
• Formaldehyde is used as a disinfectant and sterilants in both its liquid and gaseous states.
• The aqueous solution is a bactericide, tuberculocide, fungicide, virucidal and sporicidal.
• Mode of Action. Formaldehyde inactivates microorganisms by
alkalizing the amino and sulfhydral groups of proteins and ring nitrogen atoms of purine bases.
• Be careful in handling Formaldehyde, wear mask (irritant and
potential carcinogenic )
Formaldehydeformalin
Glutaraldehydehigh-level disinfectant and chemical sterilant
• Aldehydes have a wide germicidal spectrum. Gluteraldehydes are bactericidal, virucidal, fungicidal, sporicidal and parasiticidal.
• They are used as a disinfectant or sterilant in both liquid and gaseous forms.
• Glutaraldehyde is used most commonly as a high-level disinfectant for medical equipment such as endoscopes.
• Glutaraldehyde should not be used for cleaning Noncritical surfaces because it is too toxic and expensive.
Hydrogen Peroxide3% hydrogen peroxide is a stable and effective
disinfectant when used on inanimate surfaces. • Peroxides such as hydrogen peroxide are often used as
antiseptics to clean wounds.
• The activity of peroxides is greatest against anaerobic bacteria. Hydrogen peroxide at high concentrations is in some cases is damaging to tissues, resulting in a prolonged healing time.
• It is useful for cleaning surgical sites after closure, but use sparingly to avoid penetrating suture lines, which would inhibit healing.
Iodophors Iodine solutions
• The best-known and most widely used iodophor is povidone-iodine.
• Mode of Action. Iodine can penetrate the cell wall of microorganisms quickly, and the lethal effects are believed to result from disruption of protein and nucleic acid structure and synthesis.
Ortho-phthalaldehyde (OPA(
• Ortho-phthalaldehyde is a high-level disinfectant
• OPA solution is a clear, pale-blue liquid with a pH of 7.5.
• advantages :excellent stability over a wide pH range (pH 3–9(
• not a known irritant to the eyes and nasal passages, does not
require exposure monitoring, has a barely perceptible odor
Peracetic Acid• rapid action against all microorganisms. • Special advantages of peracetic acid are that it lacks
harmful decomposition products • It remains effective in the presence of organic matter and is
sporicidal even at low temperatures• Uses. An automated machine using peracetic acid to chemically
sterilize medical (e.g., endoscopes, arthroscopes(, surgical, and dental instruments.
• Peracetic Acid and Hydrogen Peroxide• combination of peracetic acid and hydrogen peroxide
inactivated all microorganisms except bacterial spores within 20 minutes.
• The 0.08% peracetic acid plus 1.0% hydrogen peroxide product effectively inactivated glutaraldehyde-resistant mycobacteria.
Phenolics• In high concentrations, phenol acts as a gross protoplasmic poison,
penetrating and disrupting the cell wall and precipitating the cell proteins.• Phenolics are bactericidal, fungicidal, virucidal, and tuberculocidal (low
level disinfectant(
• disinfectants for use on environmental surfaces (e.g., bedside tables, bedrails, and laboratory surfaces( and noncritical medical devices.
• hyperbilirubinemia in infants placed in bassinets where phonetic detergents were used , bilirubin levels were reported to increase in phenolic-exposed infants.
should not be used to clean infant bassinets and incubators while occupied.
Quaternary Ammonium Compounds• The quaternary ammonium compounds are widely used as disinfectants. • quaternaries are good cleaning agents. • Mode of Action. The bactericidal action of the quaternaries has been
attributed to the inactivation of energy-producing enzymes, denaturation of essential cell proteins, and disruption of the cell membrane.
• Uses. The quaternaries commonly are used in ordinary environmental
sanitation of Noncritical surfaces, such as floors, furniture, and walls.
Chlorhexidine
Chlorhexidine products are often used as disinfectants for inanimate objects or antiseptics for cleaning skin wounds.
• Skin Antisepsis: 0.5% Chlorhexidine Skin Preparation with Alcohol.
• Low toxicity
• Used in disinfection of the skin and hands and mucous membranes
No Disinfectant is substitute for No Disinfectant is substitute for the following Proceduresthe following Procedures
• Hand washing (hand hygiene)• The use of personal protective equipment (e.g.
gloves) when handling blood, body substances excretions and secretions.• Appropriate handling of patient care equipment
and soiled linen;• The prevention of needle stick/sharp injuries.• Environmental cleaning• Appropriate handling of waste and• Taking care of yourself (e.g. immunization)
Hand WashingYet no substitute for washing hands
Do not forget to Wash Your HandsDo not forget to Wash Your Hands
Immediately on arrival at workImmediately on arrival at work Before and after examining each clientBefore and after examining each client After touching anything that might be contaminatedAfter touching anything that might be contaminated After handling specimensAfter handling specimens Before putting on gloves for clinical proceduresBefore putting on gloves for clinical procedures After removing glovesAfter removing gloves After using the toilet or latrineAfter using the toilet or latrine Before leaving workBefore leaving work
Make your contributions for safe Make your contributions for safe HospitalsHospitals
