Disinfection & Sterilization

Dr : Dina Ramadan
Microbiologist In Central Health Laboratory Ministry of Health Cairo-Egypt Quality Manager

Definitions
Disinfection:
It is a procedure intended to reduce microorganisms as far as possible (but not bacterial spores) by physical and chemical means

Sterilization:
the complete removal or destruction of all forms of microbial life including bacterial spores Remember : No absolute assurance that there is 0 microorganism

Other Definitions
Disinfection
The use of a physical or chemical procedure to eliminate pathogenic microorganisms on inanimate objects

Sterilization
The use of a physical or chemical procedure to destroy all microbial life, including large numbers of highly resistant bacterial spores.

Chemical Disinfectant

Alcohols
There are two water-soluble alcohol can be used in lab: ethyl alcohol and isopropyl alcohol. Concentration required : 60-90% in water Mode of its action : it denaturing bacterial proteins its Flammable, Can be removed from disinfected articles by flaming.

Alcohols effect on bacteria

they are bactericidal against for the vegetative forms of bacteria (Gram + and Gram -); also they are tuberculocidal, fungicidal, and virucidal against enveloped viruses (HIV, influenza ,herpes viruses). not effective against bacterial spores and have limited effectiveness against nonenveloped viruses ( adenovirus, rotavirus)

Alcohols

Higher concentrations are less effective as the action of denaturing proteins is inhibited without the presence of water

Hypochlorite's
it has broad spectrum antimicrobial effect inexpensive and fast acting, It is recommended for disinfection of counter tops and work surfaces,

Chlorine

It is very effective against vegetative bacteria and viruses like HBV and HIV viruses, therefore its use is recommended at 1:10 dilution for disinfection of blood spills

not

much useful against spores

Phenol
It effective against bacteria (especially gram +ve bacteria) and enveloped viruses. They are not effective against non enveloped viruses and spores. This compounds is used for decontamination of the hospital environment, including laboratory surfaces.

No Disinfectant is substitute for the following Procedures

Hand washing (hand hygiene); use of personal protective equipment (PPE )in the lab Environmental cleaning Appropriate handling of waste and Taking care of yourself (e.g. immunization)

Yet no substitute for washing hands Do not forget to Wash Your Hands
Immediately

on arrival at work After handling specimens After removing gloves After using the toilet Before leaving work

Sterilization
1.
2. 3.

Heat sterilization Chemical sterilization Radiation sterilization

Heat Sterilization
It is the simplest, most effective and inexpensive method. Types of heat sterilization :
a) b)

Steam sterilization (Autoclaving) Dry heat sterilization

Mechanism of Action

DRY HEAT:

MOIST HEAT:

1. 2.

3.

protein denaturation Oxidative damage Toxic effects of increased levels of electrolytes

1.

2.

3.

Protein denaturation & coagulation Latent heat liberated when steam condenses on cooler surface Hydrolysis & breakdown of bacterial proteins

Steam Sterilization (MOIST HEAT )

Advantages:
good penetration maintains integrity of liquids (e.g. Lubricants) due to the 100% humidity within the chamber.

Disadvantages:
Non stainless steel metal items corrode may damage plastic and rubber items

Dry-Heat Sterilization

Heating at atmospheric pressure and often use a fan to obtain uniform temperature by circulation. Heat at 180 for half hour , 170 for 1 hr., or 160 C for 2 hrs.
Time (minutes)
120 140 150 160 170 180 480 180 150 120 60 30

Temperature (C)

Dry-Heat Sterilization

Advantages:

It is effective and safe for metal instruments because the process does not dull instrument edges or rust/corrode the instruments.

Disadvantages:

Less reliable than autoclaving

Many materials do not tolerate dry heat (as media)

Chemical Sterilization

The chemical compounds used can be: a) Gas Sterilization b) Liquid Sterilization Generally, chemical sterilization procedures have the disadvantages of presenting health hazards to users (e.g. poisonous, flammable, )

Gas Sterilization
The gas used in this procedure is ethylene oxide. Keep objects in constant atmospheric humidity. Heat to temperatures between 30 and 60 C,for a period of 10 hrs. Residual ethylene oxide must be ventilated It is used for sterilizing endoscopes and ansthetic apparatus.

Liquid Sterilization
Can be performed with buffered glutaric aldehyde. Procedure:

Immerse object in liquid for several hours. Rinse with sterile water after end of procedure. It used in hospitals for sterilization of surgical instruments, rubber or plastic equipment which cannot be heat sterilized

Radiation Sterilization

Provides effective way of sterilization when using non ionizing radiation in high doses (Gamma radiation ).
it is clean process dry process the object full exposure from all directions

Non ionizing radiations

UV RAYS (ultra violet) are used to sterilize internal Surfaces of safety cabinets, entry ways, Operation theaters etc.

IR RAYS ( infra red) are used for rapid mass sterilization of pre packed items such as syringes, catheters etc.

Asepsis
Sterilization Disinfection

Heat

Chemical

Radiation

Heat

Chemical

Steam

Gas

Gamma

Boiling water

Phenol

Dry heat

Ethylene oxide

70% Alcohol

Formalin

Hexachlorophene

Liquid

Heat or chloramines solution

Glutaric Aldehyde

In summary
Sterilization and disinfection are costly and time consuming process However, it is an essential in all health care facilities to avoid infection. It depends the material and users of instrument. Staff should keep in mind that contaminated instrument present risk to the sample as well as the user himself.

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