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Disinfectant Use in Hospital: Dr. Yogita Mistry GMC, Surat
Disinfectant Use in Hospital: Dr. Yogita Mistry GMC, Surat
Disinfectant Use in Hospital: Dr. Yogita Mistry GMC, Surat
In Hospital
Bedpans
Blood pressure cuff
Computers
Bedside table, furniture,floor
Gn=Gp
prions
Concentration and potency of disinfectant
Duration of exposure
Biofilms
Residual proteins and salt
Microbial Contamination Of
Disinfectant
Leads to HAI
Not reported with high level disinfectant/ sterilient
They are usually not contaminated at point of
manufacture, but contaminated during use, storage,
dilution
Property Of Ideal Disinfectant
Broad spectrum: should have a wide
antimicrobial spectrum
Fast acting: should produce a rapid kill
Not affected by environmental factors: should
be active in the presence of organic matter (e.g.,
blood, sputum, feces) and compatible with soaps,
detergents, and other chemicals encountered in
use
Nontoxic: should not be harmful to the user or
patient
Surface compatibility: should not corrode
instruments and metallic surfaces and should not
cause the deterioration of cloth, rubber, plastics,
and other materials
Residual effect on treated surfaces: should leave
an antimicrobial film on the treated surface
Easy to use with clear label directions
Odorless: should have a pleasant odor or no odor to
facilitate its routine use
Economical: should not be prohibitively high in cost
Solubility: should be soluble in water
Stability: should be stable in concentrate and use-
dilution
Cleaner: should have good cleaning properties
Environmentally friendly: should not damage the
environment on disposal
High Level Disinfectant
Formaldehyde
Gluteraldehyde
Orthophtahdehyde
Hydrogen peroxide
Peracitic acid
Formaldehyde
Formaldehyde is used as
a disinfectant and sterilant
both in the liquid and
gaseous states.
Formaldehyde is sold and
used principally as a
water-based solution
called formalin, which is
37% formaldehyde by
weight. The aqueous
solution is bactericidal,
tuberculocidal, fungicidal,
virucidal and sporicidal
Formaldehyde
Formaldehyde should be
handled in the workplace as a
potential carcinogen with an
employee exposure standard
that limits an 8 hour time-
weighted average exposure to a
concentration of 0.75 ppm. For
this reason, employees
should have limited
direct contact with
formaldehyde and these
considerations limit its
role in sterilization and
disinfection processes
Formaldehyde
MOA: Alkylating amino and sulfhydral groups of
proteins and ring nitrogen atoms of purine base
Microbicidal action:
2%=Most virus
8%=Poliovirus
4%=Tuberculocidal in 2 minutes for 104 bacilli
2.5% =Salmonella typhi
4%=Sporicidal with 2 hour exposure
Hypochlorite available as :
Liquid(sodium hypochlorite)
Solid (calcium hypochlorite)
Advantage:
They retain chlorine longer
More prolonged bactericidal effects
It is acidic from so HOCL remain for longer time
Microbicidal activity
Bleach Dilution Chlorine level in
ppm
5.25-6.25% None 52500-61500 (5 liter)
1:10 5250-6150 (4500-
500)
1:100 525-615 (4900-
100)
5000ppm=10 1:1000
6 Cl.difficle spore in less than
53-62 (4950-
10
minutes 50)
1000 ppm=M.tb
500 ppm=Candida in 30 seconds
100 ppm=B.atropheaus in lesstthan 5 minutes,
106-107 S.aureus, Salmonella, Proteus,
pseudomonas
Use:
Tonometer head,
For decontamination of blood spill
Disinfection of water supply
Legionella contaminated hospital water
Iodine And Iodophor
Disinfectants
Iodine tinctures:
2% iodine + 2.4% sodium
iodide (NaI) in 50% ethanol; It
is used as a skin disinfectant,
as a nonirritant antiseptic on
wounds and abrasions.
95%= Tuberculocidal
Alcohols
Alcohols are commonly
used topical antiseptics.
They can be used as a
reasonable substitute
for handwashing as
long as hands are not
visibly soiled.
They are also used to
disinfect the surface of
medical equipment.
Alcohols require time to
work and they may not
penetrate organic
material.
Alcohols
They also evaporate
rapidly which makes
extended exposure time
difficult to achieve unless
the items are immersed.
Alcohol irritates tissues.
They are generally too
expensive for general use
as a surface disinfectant
Not recommonded for sterilizing medical and
surgical material due to lack of sporicidal action
and they can not penetrate protein rich material
Reprocessing of Endoscope
HAI
Heat sensitive endoscopes-GI , Bronchoscope, nasopharyngeoscope
All must be properly cleaned first .
Should minimally subjected to high level disinfectant
Most common in use : 2% gluteraldehyde for 20 minutes
Other imp: Orthophthaldehyde 0.55% (is now replacing gluteraldehyde due
to its less irritant property on eye and nasal mucosa,12 minutes)
Other:
7.35% hydrogen peroxide + 0.23% peracitic acid
1 % hydrogen peroxide+ 0.08% peracitic acid
7.5 % hydrogen peroxide
But all 3 are more corrosive and causing functional damage on endoscope
Dry: Rinse with alcohol and dry with forced air after
disinfectant and before storage
VIKRON: Contain
Pottasium peroxymonosulphate,
Sodium dodecyl benzenesulphate, sulphanic acid,
inorganic buffer.
Can be used for managing spill in OT.
Surface cleaning/
disinfection
Non critical items
Divided as Housekeeping and medical
equipments surface