Disinfection and Sterilization
 
  • Surgical and other invasive procedures carry a risk of introducing pathogens into the patient’s body
  • Failure to properly clean and disinfect or sterilize medical equipment and items in patient care areas may result in transmission of healthcare-associated pathogens to susceptible patients
  • Disinfectants and sterilants are used to assure that medical equipment and inanimate surfaces do not transmit pathogens to patients
  • Sterilization is defined as a process that destroys all microorganisms, including bacterial spores, by using either physical or chemical methods
  • Disinfection is defined as a process that eliminates most , if not all, pathogenic microorganisms except bacterial spores on inanimate surfaces
  • High-level disinfectants kill all microorganisms except large numbers of bacterial spores
  • Intermediate-level disinfectants kill vegetative bacteria, mycobacteria, most fungi and viruses, but not bacterial spores
  • Low-level disinfectants kill often kill most vegetative bacteria, some fungi, and some viruses in relatively short time periods (< 10 minutes), but not mycobacteria or spores
  • Disinfection/sterilization of patient-care items is usually divided in 3 main categories, described by Spaulding, based on the intended use of the item
    • Critical items, which enter sterile tissue or the vascular system, require sterilization
    • Semicritical items, which come in contact with mucous membranes or non-intact skin, generally require high-level disinfection in order to destroy all microorganisms except small number of bacterial spores
    • Noncritical items, which come in contact with intact skin but not mucous membranes, generally require low-level disinfection
  • Sterilization and disinfection procedures recommended for use in healthcare facilities and indications for their use are summarized in the 2008 CDC Guideline for Disinfection and Sterilization in Healthcare Facilities