TF COVID-19 Perkantas Webinar Series#3

Infeksi COVID-19 pada tenaga medis, dapatkah dicegah?

https://www.who.int/publications/i/item/cleaning-and-disinfection-of-environmental-surfaces-inthe-
context-of-covid-19
 context of COVID-19: Interim guidance, WHO May 16 2020
Cleaning and disinfection of environmental surfaces in the
Cleaning Disinfection Sterilization

• Removes germs, • Disinfecting kills • Destroys or

dirt, and impurities germs on surfaces eliminates all form of
from surfaces. exclude Bacterial microbial life form an
spores object or environment. This
• soap and water includes highly
• Disinfectan agent
• Lowers the risk of resistant bacterial
• By killing germs on a spores.
spreading infection surface after cleaning,
• Sterilant (physical
it can further lower the
and chemical)
risk of spreading
infection.

After cleaning, the following disinfectants and defined concentrations can be used on environmental
surfaces to achieve a >3 log10 reduction of human coronavirus, and they are also effective
against other clinically relevant pathogens in the health-care setting.
 CDC. Environmental Cleaning in Resource-Limited Settings . April 21, 2020. . Content
source: Centers for Disease Control and Prevention, National Center for Emerging
and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality
Promotion (DHQP)
 Lakukan kunjungan /
MULAI DARI AREA MULAI DARI ATAS KE
visual assessment / Pre
BERSIH KE KOTOR BAWAH
cleaning visite

TANGANI TUMPAHAN
Identifikasi area yang
INFEKSIUS * cairan Lakukan secara
sering disentuh (high
tubuh SEGERA (Jika sistematis
touch areas)
ada)

https://www.cdc.gov/hai/prevent/resource-limited/cleaning-procedures.html
!!!!
https://www.cdc.gov/hai/prevent/resource-limited/high-
touch-surfaces.html
 CDC. Environmental Cleaning in Resource-Limited Settings . April 21, 2020. . Content
source: Centers for Disease Control and Prevention, National Center for Emerging
and Zoonotic Infectious Diseases (NCEZID), Division of Healthcare Quality
Promotion (DHQP)
 Therefore, under normal circumstances they should be cleaned
daily, but the use of a disinfectant is not necessary.

• In special cases : including COVID 19:

Cucunawangsih, Dekontaminasi dan
pembersihan akhir. MEDICINUS Vol. 4
No. 9 Juni 2015 – September 2015
Larutan Pemutih Pengenceran Chlorine (%) Chlorine (ppm)

5.15-6.25% Tanpa pengenceran 52,500-61,500

1:5 1% 10,000

1:10 0.5-0.6% 5,250-6,150

1:100 0.05-0.06% 525-615

1:1000 0.005-0.006% 53-62

not recommended under any circumstances

Cleaning and disinfection of environmental surfaces in the context of COVID-

19: Interim guidance, WHO May 16 2020.
Protein Thermal Irreversible Denaturation.

Native Protein Denaturation Crosslingking

Spores are killed by temperature of
121°C for 15 mnt.
Panjang
Gelombang UV:
• Sinar UV-A (λ
320-400 nm),
• Sinar UV-B (λ
280-320 nm)
• Sinar UV-C (λ
100-280 nm)
 but
do not replace the need for manual
cleaning procedures

Cleaning and disinfection of environmental surfaces in the context of COVID-19:

Interim guidance, WHO May 16 2020.
Damage to vital cell
proteins, including enzymes

DNA damage
Lipid peroxidation and injury
to cell membrane
Optimal concentration 60-90%
 n-Alcohol
Ethyl Alcohol Isopropyl alcohol

Bactericidal, not sporocidal

Formaldehyde inactive microorganism by alkalizing
the amino and sulfhydral groups of proteins
and ring nitrogen atoms of purine base.
Bactericidal but not sporicidal
Mycobacteria generally high resistant to these
compouns
Triclosan and hexachlorophene are
bactericidal and sporostatic.
 Triclosan Mechanism of Action

Tricolans inhibits type II fatty acid biosynthesis

The most important types of chlorine-releasing
agent are sodium hypochlorite, chlorine
dioxide, and sodium dichloroisocyanurate.
oxidizing agents
(Hypochlorous acid) that
destroy the cellular agents that
destroy the cellular activity of
proteins.
Iodine (I2) is rapidly bactericidal
and sporicidal
Iodophors are complexes of iodine and
a solubilizing agent or carrier , which
acts as a reservoir of the active I2

oxidizing agents that destroy the

cellular agents that destroy the cellular
activity of proteins.
Copper ions (Cu2+) are oxidizing agents that
destroy the cellular agents that destroy the cellular
activity of proteins.
Sporicidal activity requires
higher concentration (10-
30%) of H2O2 and longer
contact time.
In general its not sporocidal

All compounds demonstrated lethal properties and

the ability to alter membranes
• Limbah Padat Domestik adalah limbah
yang berasal dari kegiatan
kerumahtanggaan atau sampah sejenis,
seperti sisa makanan, kardus, kertas, dan
sebagainya baik organik maupun
anorganik.
• Sedangkan limbah padat khusus meliputi
masker sekali pakai, sarung tangan
bekas, tisu/kain yang mengandung
cairan/droplet hidung dan mulut),
diperlakukan seperti Limbah B3 infeksius.
• Limbah B3 Medis Padat adalah barang atau bahan
sisa yang berpotensi terkontaminasi oleh zat yang
bersifat infeksius atau kontak dengan pasien
dan/atau petugas di Fasyankes yang menangani
pasien Covid-19, meliputi: masker bekas, sarung
tangan bekas, perban bekas, tisu bekas, plastik
bekas minuman dan makanan, kertas bekas
makanan dan minuman, alat suntik bekas, set
infus bekas, Alat Pelindung Diri bekas, sisa
makanan pasien dan lain-lain, berasal dari
kegiatan pelayanan di UGD, ruang isolasi, ruang
ICU, ruang perawatan, dan ruang pelayanan
lainnya.
APD DISPOSABLE APD REUSEABLE

Plastik kuning
Kumpulkan di 1 tempat
(infeksius)

dimusnahkan Petugas reuse

https://www.who.int/publications/i/item/cleaning-and-disinfection-
of-environmental-surfaces-inthe-context-of-covid-19

CDC. Environmental Cleaning in Resource-Limited Settings

Centers for Disease Control and
Prevention National Center for Emerging and Zoonotic
Infectious Diseases (NCEZID) Division of Healthcare Quality
Promotion (DHQP)