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Infection Control Lecture

KFHU Healthcare Infection Control 2004

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The Infection Control Team

Infection Control Committee Chairman: Dr. Huda Bukhari Infection Control Associate Director: Mrs. Basmah Al Marzooq Infection Control Nurse: Mrs. Juanita S. Changco

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How Else Can HCWs Reduce Risks to Patients?

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DEFINITION OF TERMS
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Antiseptic – A chemical germicide formulated for use on living tissue. Disinfectant – A chemical germicide formulated for use on nonliving items. Sterile – Completely free of all micro-organisms. Cleaning – Removal of foreign material from an item. This usually involves friction and washing with a detergent or disinfectant to remove contamination, followed by rinsing and thorough drying. Sterilization – A procedure that kills all bacteria (including large numbers of endospores), fungi and viruses. Operationally, sterilization is a process that results in a probability of a microorganism surviving on an item of less than 1 in 1 million (1x10-6). Decontamination – A process that renders a contaminated item 13 safe 10/22/08 to handle (reasonably free from the likelihood of

CHARACTERISTICS OF ANTISEPTIC AGENTS
Group and subgroup Grampositive bacteria Gramnegativ e bacteri a Excellent Mycobacterium tuberculosi s Excellent Fungi Virus Speed of killing sensitive bacteria Fast Inactivated by mucus or protein Moderat e Comments

Alcohols

Optimum strength 70% to 90% with added emolients (glycerine or cetyl alcohol is less drying), not recommended for physical cleaning of skin; good for hand antisepsis and for surgical site preparation. Optimum concentration 60%95%; no persistent activity Chlorhexidine Excellent Good Fair Fair Excelle IntermeMinimal Has persistent effect; good for 2% and 4% nt diate both hand washing and aqueous surgical site or preoperative patietn skin preparation; do not use near mucous membranes; toxic effects on ears and eyes reported; activity neutralized by noniomic surfactants. Persistent activity; rare allergic reactions Note: +++ Excellent; ++ Good but nodes not include the entire spectrum; + Fair; - no activity or not sufficient. Hexachlorophene is not
included because it is no longer an accepted ingredient of hand disinfectants. * Activity improved by addition of chelating agent such as EDTA. Some of these agents, such as iodine or chlorhexidine are combined with alcohol to form tinctures and are available in the combined formulation.

Excellent

Excelle nt

Excelle nt

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CHARACTERISTICS OF ANTISEPTIC AGENTS (cont’d)
Group and subgroup Grampositive bacteria Gramnegativ e bacteri a Poor Mycobacterium tuberculosi s Poor Speed of killing sensitive bacteria Slow Inactivated by mucus or protein Minimal

Fungi

Virus

Comments

HexachloroPhene 3% aqueous

Good

Poor

Poor

Iodine compounds, iodine in alcohol

Excellent

Excellent

Excellent

Good

Excelle nt

Intermediate

Marked

Provides persistent, cumulative activity after repeated use (washing with alcohol reduces persistent action), can be toxic when absorbed from skin especially in premature infants; good for hand washing but not for surgical site preparation; limited spectrum of Causes skin”burns,” but this is antimicrobial activity. unusual with 1% tincture, especially if it is removed after several minutes; too irritating for hand washing but excellent for surgical site preparation.` Less irritating to the skin than iodine; good for both hand washing and surgical site preparation; rapidly neutralized in presence of organic materials such as blood or sputum

Iodophors

Excellent

Excellent

Fair

Good

Good

Intermediate

Moderat e

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CHARACTERISTICS OF ANTISEPTIC AGENTS (cont’d)
Group and subgroup Grampositive bacteria Gramnegativ e bacteri a Fair* Mycobacterium tuberculosi s Fair Speed of killing sensitive bacteria Intermediate Intermediate Intermediate Slow Minimal Inactivated by mucus or protein Minimal

Fungi

Virus

Comments

Para-chlorometa-xylenol (PCMX) Phenol derivatives Triclosan Quaternary ammonium compounts

Good

Fair

Fair

Activity neutralized by nonionic surfactants. ِActivity neutralized by nonionic surfactants Acceptability on hands varies Used only in combination with alcohols; ecologic concerns

Excellent

Fair

Fair

Fair

Fair

Excellent Fair

Good Good

Fair -

-

Excelle nt Fair

Note: Excellent; Good but nodes not include the entire spectrum; Fair; - no activity or not sufficient. Hexachlorophene is not included because it is no longer an accepted ingredient of hand disinfectants. * Activity improved by addition of chelating agent such as EDTA. Some of these agents, such as iodine or chlorhexidine are combined with alcohol to form tinctures and are available in the combined formulation.

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Any Questions???

Thank you for not asking!!!

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