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QUESTION: Define disinfection, sterilization, antiseptic, deodorants and detergents, highlighting the difference between them. Give short description of disinfection and sterilization procedures which we practice in hospitals.

Disinfection is the process of killing pathogenic organisms or rendering them inert. Disinfection is the killing of infectious agents outside the body by direct exposure to chemical or physical agents. Disinfectants are substances that are applied to non-living objects to destroy microorganisms that are living on the objects. Disinfection does not necessarily kill all microorganisms, especially nonresistant bacterial spores; it is less effective than sterilisation, which is an extreme physical and/or chemical process that kills all types of life. Bacterial endospores are most resistant to disinfectants, but some viruses and bacteria also possess some tolerance. Disinfectants are frequently used in hospitals, dental surgeries, kitchens, and bathrooms to kill infectious organisms.

Sterilaization is the process of complete elimination or destruction of all living microorganisms. Sterilization refers to any procedure by which an individual is made incapable of reproduction. Sterilization refers to any process that eliminates (removes) or kills all forms of life, including transmissible agents (such as fungi, bacteria, viruses, spore forms, etc.) present on a surface, contained in a fluid, in medication, or in a compound such as biological culture media. Sterilization can be achieved by applying the proper combinations of heat, chemicals, irradiation, high pressure, and filtration.

An antiseptic is a substance which inhibits the growth and development of microorganisms. Antiseptics are antimicrobial substances that are applied to living tissue/skin to reduce the possibility of infection, sepsis, or putrefaction. Some antiseptics are true germicides, capable of destroying microbes (bacteriocidal), whilst others are bacteriostatic and only prevent or inhibit their growth. Antibacterials are antiseptics that have the proven ability to act against bacteria. Microbicides which kill virus particles are called viricides or antivirals. A disinfectant in low concentration can act as an antiseptic.

A deodorant is a substance which suppresses or neutralizes bad odours. For example: lime or bleaching powder

Detergent :
A cleansing substance that acts similarly to soap but is made from chemical compounds rather than fats and lye. Detergents are cleaning agent that increases the ability of water to penetrate fabric and break down greases and dirt. Detergents act like soap but, unlike soaps, they are derived from organic acids rather than fatty acids. Their molecules surround particles of grease and dirt, allowing them to be carried away. A cleaning agent that increases the ability of water to penetrate fabric and break down greases and dirt. Detergents are surfactant or a mixture of surfactants having "cleaning properties in dilute solutions."

Sterilization and disinfection procedures practiced in hospitals

Various methods of sterilization are:

1. Natural agents: a. Sunlight: Direct and continuous exposure to sunlight causes destruction to bacteria due to penetration of ultraviolet rays. Articles such as furniture, bedding, linen can be disinfected by sunlight. b. Air: Exposure to air acts by drying or evaporation of moisture which is lethal to most bacteria. 2. Physical agents: a. Burning: Burning or incineration is an excellent method of disinfection of inexpensive articles such as contaminated dressings, rags and swabs. Faeces can be disposed of by burning. b. Hot air: Hot air is used for sterilization of glassware, syringes, swabs, dressings, French chalk, oils, Vaseline and sharp instruments. The temperature in the oven should be maintained at 160-1800c for at least an hour to kill spores. c. Boiling: Boiling is used for disinfection of linen, utensils, bedpans. It is used for the disinfection of small instruments, tools which is not be used for subcutaneous insertion, also for rubber goods like gloves. Boilers provide temperature of above 900c in an atmosphere of steam, which is exposed to open air. d. Autoclaving: Autoclaves are sterilizers which work at high temperature at a pressure, usually its 1220c at 15 lbs/sq. Autoclaving is the most effective method of sterilization of linen, dressings, gloves, syringes, certain instruments and culture media. e. Radiation: Ionizing radiation is being increasingly used for sterilization of bandages, dressings, catgut and surgical instruments. It is usually carried out with gamma radiation.

3. Chemical Agents: Articles which cannot be boiled or autoclaved may be immersed in chemical disinfectants. a.Phenol and related compounds: Phenolic agents used in disinfection are crude phenol, cresol, chlorhexidine, hexachlorphane, Dettol etc. Pure phenol is used as a standard to compare the germicide activity of disinfectants. Crude phenol is used for mopping the floors and cleaning drains. Cresol is an allpurpose disinfectant. Creams and lotions containing 1% chlorhexidine are recommended for burns and hand disinfection. Dettol (5%) is suitable for disinfection of instruments and plastic equipments; a contact of at least 15 minutes will be required for the disinfection. b.Quaternary ammonia compounds: Agents used are cetrimide, savlon etc. Plastic appliances like Lippes loop are disinfected by keeping them in a normal strength savlon for 20 minutes. Clinical thermometers are best disinfected in savlon 1 in 6 in spirit in 3 minutes. c. Halogens and their compounds: Commonly used agents are bleaching agents, sodium hypochlorite, halazone tablets, iodine, iodophors etc. Bleaching powder is widely used for the disinfection of water, faeces and urine and as a deodorant. Halogens are actively bactericidal agents and are the only useful antiseptics with a sporocidal action. d. Alcohols: Ethyl and isopropyl alcohols are commonly used as disinfectants and antiseptics. Ethyl alcohol is used for skin disinfection and hand washing. e. Formaldehyde: Most commonly used in form of formalin. It may be used as a 2-3% solution for spaying rooms, walls and furniture. Formaldehyde gas is most commonly used for disinfection of rooms especially for operation theatres. The gas can also be used for disinfection of blankets, beds, books and other valuble articles which cannot be boiled.