DISINFECTION & STERILIZATION Jana Dáňová Dept. of epidemiology Third Faculty of Medicine

INTRODUCTION disinfection and sterilization are essential for ensuring that medical and surgical instruments do not transmit infectious pathogens to patients. because sterilization of all patient-care items is not necessary, health-care policies must identify, primarily on the basis of the items' intended use, whether cleaning, disinfection, or sterilization is indicated.

STERILIZATION Sterilization describes a process that destroys or eliminates all forms of microbial life and is carried out in health-care facilities by physical or chemical methods

EPIDEMIOLOGIC APPROACH FOCUSED TO PREVENTION OF TRANSMISSION OF DISEASES main task decontamination → process focused to killing or removing of microorganisms from subjects and environment degree of efficiency sanitation (mechanical cleaning) and higher degree disinfection and sterilization

DISINFECTION, DISINSECTION, DERATISATION (DDD) main steps leading to protection of human health working conditions → protection against infectious agents (bacterial, viral), vectors, rodents etc.

DISINFECTION Regular protective disinfection → part of basic technological and occupational methods as a protection against infectious diseases Special protective disinfection → specific type of protection focused to elimination of infectious diseases, vectors, animal reservoir etc.

PERSONS RESPONSIBLE FOR PROTECTIVE DISINFECTION They can use only licenced substances by public health authorities List of these agents are published in special register

STERILIZATION Process leading to killing all microorganisms (bacterial, viral, including spors, worms and their eggs) Sterilisation is realized in special instruments = sterilizing box (sterilizer) As a sterile are labeled all objects without alive microorganisms

PREPARATION BEFORE STERILIZATION methods used before sterilization cleaning of all objects used in health care package of these objects before sterilization to sterilizational envelope

PREPARATION BEFORE STERILIZATION disinfection → heat 90 oC /10 min. or termochemical 60 oC/ 20 min. cleaning → important before sterilization

TYPES OF STERILIZATION Physical: steam hot- air plasma radiational Chemical: formaldehyde ethylenoxide

INSTRUMENTS BEFORE STERILIZATION

CENTRAL STERILIZATION

CONTROL OF STERILIZATION Monitoring of cycle of sterilization Effectivness of sterile boxes Sterile control of materials

DISINFECTION methods leading to destroy microorganisms by physical, chemical or combined techniques to interrupt mode of transmission to susceptible person

METHODS OF DISINFECTION Physical disinfection Physical – chemical disinfection Chemical disinfection

Physical disinfection Physical-chemical disinfection Boiling for 30 min. Washing and cleaning machines by 60 oC Alkalies Boiling in pressure containers 20 min. Steamformaldehyde box Acids Boiling by temerature 90 o C /10 min. Oxidants UV radiation Halogens Compounds of methals Alcohols and ethers Aldehyds Combined

CONTROL OF DISINFECTION chemical methods: quantitative a qualitative measurements microbiological methods: control of effectivness of disinfectious materials

FREQUENCY OF DISINFECTION according type of helath care facility character of disinfection is part of operating rules of the healt care facility usage of disinfectious methods control Ministry of Health

CLEANING OF HANDS mechanical washing hands as a part of personal hygiene→ removing of microorganisms from the skin of hands mechanical washing hands before surgical disinfection of hands→removing of microorganisms from the skin of hands before surgical disifection surgical disinfection of hands → reduction of amound of microorganisms on the skin of hands and forearms hygienic disifection of hans → reduction of amound of microorganisms on the skin of hands, interruption of mode of transmission hygienic washing of hands → usage of washing tools with disinfectious additive

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