Antisepsis, disinfection and sterilization o No act against spores,viricidal,fungicidal-eff against vegetative

1) Definition bacteria
- Disinfection:Destruction of microorganisms (usually not bacterial o short duration because of its volatility
spores) to a level which is not harmful to health. o organic materials reduce its activity
- Antisepsis :Destruction/inhibition of micro to prevent harmful effects o Isopropanol alcohol : slightly more active than ethyl alcohol
in living tissue. against vegetative cells.
- Sterilisation : removal of all infectious agents form the environment. - Aldehydes
- Bactericidal : kill bacteria o Both disinfection & sterilization,sol/gas
- Bacteriostatic : only prevents multiplication of bacteria. o Formaldehyde (1 to 2 %)and glutaraldehyde:common
2) Disinfectant vs antiseptic use,sterile:8%
- Disinfectants:render material of transmitting infection, not sporicidal, o Alter&inactivates protein&nucleic acid
used on inanimate objects and host toxicity is irrelevant.
o Disadv: toxic to human
- Antiseptic: non-toxic to living tissue
o Noxuthiolon&polynoxylin: release formaldehyde-preparation in
3) Hospital infection: >48 hours or more after admission(UTI,surgical
bladder washes
wound, resp tract, bacteremia
- Exogenous: from another patient or from the environment o Glutaraldehyde : active against G+ / G- bacteria,fungi,virus
- Endogenous : from a site within the patient. and spores (PH 7.5-8.5)
- Causes: - Cationic surfactant:
o Staphylococci- mRSA. o Quartenary ammonium compounds(QAC)
o Coagulase- staphylococci a(S. epidermidis - frequent cause of o Active against G+ , lesser extent:G-
endocarditis) o Denature protein & destroy membrane
o E.coli o Pseudomonas species : resistant
o Enterococci- UTI, septicaemia, endocarditis, wound infection o Not effective: spores/mycobacteria
o Pseudomonas aeruginosa- cause pneumonia in neutropenic - Halogens: Iodine and chlorine
patients. - Phenol: coagulate protein & disrupt cell membrane
o Candida - Peroxygens: H2O2-bacterial,fungicidal,viricidal,weak sporicidal
activity,
o Clostridium difficile
- Biguanides : chlorhexidine (pH5-8),poor activity against
- Viral infections
Pseudomonas aeruginosa,useful disinfectant for skin & mucous
- Respiratory syncytial virus, parainfluenza, Herpes simplex virus, VZV,
membranes,inactivated by
rotaviruses, hepatitis B and C, HIV, HTLV.
>materials(borates,bicarbonates,chlorides), combination with
4) Source & routes:
detergent is highly effective
- Human(people who infected,incubate infection),
9) Efficacy :
- Environmental-fomites, food ,water and air.
- Physical environment (cracked or porous )
5) Consequence: Serious illness,Death,Prolonged hospital stay extends
- Presence of moisture, temp, pH, (agent),hardnesss of H2O,
the patients need for antimicrobial therapy- expensive and lead to
- bioburden on surface,
risks of toxicity.
- type of microbe(fungi/virus/spore producing)
6) Prevention: sterile syringe,dressings,break chain of
- The ability of microbes to inactivate the chemical agent.
infection,enhance hosts ability to resist infection
- basis of their antimicrobial activity, their toxicity and their inactivation
7) Disinfectant:
by organic material.
- Critical devices:contact with blood(catheters)-strilisation
- disinfection policy, which specifys the agent, the contact time and the
- Semi-critical : with mucous membrane(endoscope)
concentrations that are suitable for the different situations
- Non-critical : contact with patient skin,risk of infection minimal,low
10)Degree of suscepbility to disinfectants& sterilization
level disinfecton sufficient
- Most susceptible-Enveloped viruses
8) Example that used
- Gram +bacteria
- Alcohol
- Non enveloped viruses
- Gram-bacteria
- Trophozoite stages of protozoa
- Cysts of protozoa
- Mycobacteria
- Bacterial endospores
11) Sterilisation
- Physical
a. Dry heat ( Denaturation of protein&oxidative damage)-incineration
o Red heat: sterilize metallic object till become red hot
o Hot air oven: sterilization at 160 degree for 2 hrs
o Sterilise glassware,metal equipment,oils,fats,powders
b. Moist heat (autoclave:steam underpressure:sterilise,boiling)-
o denaturation&coagulation of protein
o 121 degree for 15 mins-kill C.botulinum
o Disadv: cannot be overloaded,heat&moisture sensitive obj
may damaged
c. Radiation
o gamma (wavelength <1nm),form free radical in cyto,effective
against spore
o UV: sterilize vaccine,serum,drinking water
o Drawback: not very penetrating&organism protected by
paper,glass,textiles not affected
d. Filteration:passage of fluid through sieve to trap particles(cells,
virus)
o Depends: pores size, pore geometry, size of microorganism
o Used: sterilization of air&heat sensitive,depyrogenation-
adsorption process(+ absorp - pygoren)
*pyrogen: exogenous-derived from microbes,microbial
products/toxins(gram-endotoxin)-bacterial lipopolisaccharides
12) Chemical sterilants
- Aldehydes: with nucleic acid& protein cause denaturation
o formaldehyde(vapour): useful if large area are contaminated
(bactericidal, fungicidal sporicidal, viricidal)
o Glutaraldehyde: endospores, anaesthetic equipment,
disposable instruments
- Ethylene oxide: disposables syringe
o Gas highly flammable, mixed with 90% CO2 to prevent
ignnitation
o Sporcidal
o Sterilize bulky items&delicate instruments catheters,
prosthesis, syringe, delicate rubber articles
o Disadvantage: cost and flammability, carcinogenic