Sanitation, Disinfection and

Sterilization
 Learning Outcomes
• After this section is completed you should be able
to:
• List the classes of pathogenic organisms in order of
their resistance to destruction
• Differentiate between sanitation, disinfection and
sterilization
• List the different ways that microbial control methods
destroy or inhibit pathogenic organisms
 Learning Outcomes
• After this section is completed you should be able to:
• List the five categories of physical methods of microbial control
• Name and describe the physical methods of microbial control
• Identify the level of microbial control achieved with each of the
physical methods
• State an example of the application of each of the physical
methods of microbial control
 Learning Outcomes
• After this section is completed you should be able
to:
• List the properties of the “ideal chemical agent” for
microbial control
• Name and describe the classes of microbial control
chemicals
• Identify the level of microbial control achieved by the
chemical classes
 Learning Outcomes
• After this section is completed you should be able
to:
• List the advantages and disadvantages of the autoclave
in animal care facilities
• Explain the function of the autoclave
• Compare and contrast the different autoclaves
 Learning Outcomes
• After this section is completed you should be able to:
• Describe the preparation of each of the following for processing
in the autoclave: linen packs, pouch packs, hard goods, liquids
and contaminated objects
• List the guidelines for loading the autoclave chamber
• Compare the three different autoclave cycles
 Learning Outcomes
• After this section is completed you should be able
to:
• List and define the five methods of quality control for
sterilization
• List and define the two methods of quality control for
disinfection
 Section Outline
• Levels of microbial resistance
• Degrees of microbial control
• How microbial control methods work
• Methods of microbial control
• Autoclave
• Quality control for sterilization and disinfection
 Overarching Principle
• The objective in sanitation, sterilization and
disinfection is to control microorganisms, or
pathogens, in the environment, thus protecting
patients and staff from contamination and disease,
and thereby promoting optimal healing and
wellness.
 The Ever Present Danger
• Improper application of the methods of sanitation,
sterilization and disinfection can lead to microbial
resistance and increase the risk of nosocomial
infection
 Levels of Microbial Resistance
• Pathogens
• Microorganisms that cause disease
• Viruses
• Bacteria
• Fungi
• Protozoan
• Prions
• Different classes of pathogens vary in their
resistance to destruction by chemical methods
Most Resistant

Protozoan Cysts
Bacterial Spores
Non-enveloped viruses
TB organisms
Enveloped viruses
Fungi
Vegetative bacteria
Least Resistant
 Levels of Microbial Resistance
• Microbial control
• Is achieved by using methods of sanitation,
disinfection and sterilization
• Microbial control
• Done to a degree that is practical, efficient and cost
effective
 Levels of Microbial Resistance
• Sterility is used only when necessary

• In many situations sanitation and disinfection

create acceptable levels of microbial control
 Degrees of Microbial Control
• Sterilization is the elimination of all life from an
object
• Complete microbial control
• Asepsis is a condition in which no living
organisms are present
• Free of infection or infectious material
 Degrees of Microbial Control
• Sanitation: The state of being clean and conducive
to health.

• Disinfection: To cleanse so as to destroy or

prevent the growth of disease-carrying
microorganisms
 Degrees of Microbial Control
• Disinfection, sanitation and cleaning remove most
microorganisms
• Most disinfectants are microbiocidal
• Microbes are killed
• Some disinfectants are bacteriostatic
• Microbial growth is inhibited
 Degrees of Microbial Control
• Disinfectants can be classified according to their
spectrum of activity
• Bacteriocidal
• Bacteriostatic
• Sporocidal
• Virucidal
• Fungicidal
 How Microbial Control Methods Work
• Mode of Action
• Different physical and chemical methods destroy or
inhibit microbes in several ways
• Damage cell walls or membranes
• Interfere with cell enzyme activity or metabolism
• Destroy microbial cell contents through oxidation,
hydrolysis, reduction, coagulation, protein denaturation or
the formation of salts
 Efficacy of Microbial Control
• The effectiveness of all microbial control methods
depends on the following factors:
• Time
• Most methods have minimum effective exposure times
• Temperature
• Most methods are more effective as temperature increases
 Efficacy of Microbial Control
• The effectiveness of all microbial control methods
depends on the following factors:
• Concentration and Preparation
• Chemical methods require appropriate concentrations of
agent
• Disinfectants may be adversely affected by mixing with
other chemicals
• Organisms
• Type, number and stage of growth of target organisms
 Efficacy of Microbial Control
• The effectiveness of all microbial control methods
depends on the following factors:
• Surface
• Physical and chemical properties of the surface to be treated
may interfere with the method’s activity
• Some surfaces are damaged by some methods
 Efficacy of Microbial Control
• The effectiveness of all microbial control methods
depends on the following factors:
• Organic debris or other soils
• Will dilute, render ineffective or interfere with many control
methods
• Method of application
• Items may be sprayed, swabbed or immersed in disinfectants
• Cotton and some synthetic materials may reduce chemical
activity
 Methods of Microbial Control
• Physical Methods
• Chemical Methods
 Physical Methods
• Dry Heat
• Oxidation
• Moist Heat
• Denatures microbial protein
• Radiation
• Damages cell enzyme systems and DNA
• Filtration
• Traps organisms that are too large to pass through the filter
• Ultrasonic Vibration
• Coagulates proteins and damages cell walls
 Dry Heat
• Incineration
• Material or object is exposed to a hot fire
• Object must become red hot as in the inoculation loops
used in microbiology
• Used to dispose of tissue or carcasses
• Efficacy: complete sterilization
 Dry Heat
• Hot Air Oven
• Sterility requires 1 hour of exposure @ 170° C(340° F)
• Powders and non-aqueous liquids like paraffin or
Vaseline
• Used in some animal care facilities and useful in
domestic applications (e.g. the kitchen oven)
• Efficacy: complete sterilization
 Dry Heat
• Drying
• Most organisms require humidity to survive and grow
• More commonly used to prevent spoiling and preserve
foodstuffs (e.g. raisins)
• Efficacy: incomplete sterilization
 Moist Heat
• Hot Water
• Used to clean and sanitize surfaces
• Addition of detergents increases efficacy by
emulsifying oils and suspending soils so they are
rinsed away
• Efficacy: incomplete sterilization
 Moist Heat
• Boiling
• Requires 3 hours of boiling to achieve complete sterilization
• Boiling for 10 minutes will destroy vegetative bacteria and
viruses but not spores
• Addition of 2% calcium carbonate or sodium carbonate will
inhibit rust and increase efficacy
• Useful for field work
• Efficacy: may be complete sterilization
 Moist Heat
• Steam
• Similar to boiling because the temperature is the same
• Exposure to steam for 90 minutes kills vegetative
bacteria but not spores
• Efficacy: incomplete sterilization
 Moist Heat
• Steam under pressure
• Pressure increases the boiling point such that the
temperature of the water becomes much higher that
100° C (212° F)
• The autoclave utilizes steam under pressure to achieve
sterilization
• This is the most efficient and inexpensive method of
sterilization for routine use
• Efficacy: complete sterilization
 Radiation
• Ultraviolet (UV)
• Low energy UV radiation is a sterilant when items are
placed at a close range
• UV radiation has no penetrating ability
• Used to sterilize rooms
• Very irritating to eyes
• Efficacy: may be complete sterilization
 Radiation
• Gamma radiation
• Ionizing radiation produced from a Cobalt 60 source
• Good penetrating ability in solids and liquids
• Used extensively in commercial preparation of
pharmaceuticals, biological products and disposable
plastics
• Efficacy: complete sterilization
 Filtration
• Fluid filtration
• Forced through a filter with either positive or negative pressure
• Filter is most commonly a synthetic screen filter with micropore
openings
• Used to sterilize culture media, buffers and pharmaceuticals
• Pore size of 0.45µm removes most bacteria
• Microplasmas and viruses require 0.01µm to 0.1µm
• May be used in conjunction with a pre-filter
• Efficacy: can be complete sterilization
 Filtration
• Air filtration
• Examples of usage: surgical masks, laboratory animal cages and
air duct filters
• Fibrous filters made of various paper products are effective for
removing particles from air
• Efficacy is influenced by air velocity, relative humidity and
electrostatic charge
• Efficacy: can be complete sterilization
 Filtration
• Air filtration
• HEPA: high efficiency particle absorption filters are
99.97% to 99.997% effective in removing particles
with diameters greater that 0.3µm
 Filtration
• Air filtration
• Surgical masks
• Designed to protect the patient from the surgeon, not the
surgeon from the patient
• Special masks are available that are designed to protect
personnel from animal pathogens
• Masks must fit snugly, stay dry and be changed every
3 to 4 hours to remain effective
 Ultrasonic Vibration
• Cavitation
• High frequency sound waves passed through a solution
create thousands of cavitation “bubbles”
• Bubbles contain a vacuum; as they implode or
collapse, debris is physically removed from objects
• Effective as an instrument cleaner
• Efficacy: incomplete sterility
 Chemical Methods
• Many chemicals are available to sterilize, disinfect or
sanitize
• None is the “ideal” agent
• Chemicals penetrate cell walls and react with cell
components in various ways to destroy or inhibit growth
• Many chemicals are disinfectants with varying levels of
efficacy
• Some are sterilants
 Chemical Methods
Bacteria Viruses
Level Vegetative Acid-fast Spores Lipophilic Hydrophilic

High + + + + +

Medium + + 0 + +/-

Low + 0 0 +/- 0

Examples:
High: Aldehydes, VPHP, Chlorine-dioxide
Medium: Alcohols, Phenols, 7th generation Quats
Low: Quats
High-cidal
Activity

Ethylene oxide
Aldehydes
Vapor phase H2O2
Halogens
Phenols
7th generation quaternary
Alcohols
Chlorhexidine
Old generation quaternary
Low-cidal
Activity
 Chemical Methods
• Ideal chemical agent
• Broad spectrum of activity
• Does not stain or damage surfaces
• Stable after application
• Effective in a short time
• Nonirritating and nontoxic to surfaces and tissues
• Inexpensive and easy to store and use
• Not affected by organic debris or other soil
• Effective at any temperature
• Nontoxic, nonpyrogenic and nonantigenic
• Possesses residual and cumulative action
 Chemical Methods
• Soaps
• Detergents
• Quaternary ammonium compounds
• Phenols
• Aldehydes
• Halogens
• Chlorine and chlorine releasing compounds
• Alcohols
• Peroxygen compounds
• Ethylene Oxide
 Chemical Methods
• Soaps
• Anionic cleaning agent made from natural oils
• Ineffective in hard water
• Does not mix well with quats and decreases the
effectiveness of halogens
• Is not antimicrobial
• Minimal disinfectant activity
 Chemical Methods
• Detergents
• Synthetic soaps
• Anionic, cationic or nonionic; anionic combined with
cationic will lead to neutralization of both
• Most are basic; a few are acidic
• Emulsify grease and suspend particles in solution
• May contain wetting agents
 Chemical Methods
• Quaternary Ammonium Compounds
• Quats: Centrimide, benzalkonium chloride, Zephiran, Quatsyl-
D, Germiphene
• Effective against gm+ and gm- microorganisms and enveloped
viruses
• Low toxicity and generally nonirritating
• Prolonged contact irritates epithelial tissues
 Chemical Methods
• Quaternary Ammonium Compounds
• Inactivated by organic material, soap, hard water and cellulose
fibers
• Reduced efficacy in presence of organic debris, soap, detergents
and hard water
• Ineffective sporocide and fungicide
• Bacteria not destroyed may clump together; those inside the
clump are protected
• Dissolves lipids in cell walls and cell membranes
 Chemical Methods
• Quaternary Ammonium Compounds
• Organically substituted ammonium compounds
• More effective in basic pH
• Cationic detergent
• Deodorizes
 Chemical Methods
• Phenols
• Active against gm+ bacteria and enveloped viruses
• Developed from phenol or carbolic acid
• Synthetic phenols are prepared in soap solutions that
are nontoxic and nonirritating
• Prolonged contact may lead to skin lesions
 Chemical Methods
• Phenols
• Toxic to cats because cats lack the inherent enzymes
needed to detoxify the compound
• May be toxic to rodents and rabbits
• Not inactivated by organic matter, soap or hard water
• Activity decreased by quats
 Chemical Methods
• Aldehydes
• Active against gm+ and gm-, most acid fast bacteria,
bacterial spores, most viruses and fungi
• Considered to be a sterilant but may require prolonged
contact
 Chemical Methods
• Aldehydes
• Gluteraldehyde (Cidex)
• Noncorrosive
• Supplied as an acid, activated by adding sodium bicarbonate
• Good for plastics, rubber, lenses in “cold sterilization”
• Not inactivated by organic material or hard water
• Irritating to respiratory tract and skin
 Chemical Methods
• Aldehydes
• Formaldehyde (Formicide)
• Aqueous solution 37% to 40% (w/v) formaldehyde
• May be diluted with water or alcohol
• Irritating to tissues and respiratory tract
• A vapor phase surface disinfectant that slowly yields
formaldehyde
 Chemical Methods
• Aldehydes
• Biguanide (e.g. chlorhexidine gluconate [Hibitane, Precyde])
• Active against gm+, most gm-, some lipophilic viruses and fungi
• Efficient disinfectant, used mostly as an antiseptic
• Some reduction of activity in presence of hard water and organic
material
• Immediate, cumulative and residual activity
• Precipitates to an inactive form when mixed with a saline solution
• Used as a surgical scrub and hand wash
• Low toxicity
 Chemical Methods
• Halogens
• Chlorine, iodine, fluorine and bromine
• Active against gm+ and gm-, acid fast, all viruses and
fungi
• Iodine most common
• Chlorine and chlorine releasing compounds
 Chemical Methods
• Halogens
• Iodine
• Used in solution with water or alcohol
• Iodophors: iodine plus carrier molecule that acts to release iodine over time
• Surgical scrub (Betadine): iodophor plus detergent
• Tinctures and solutions: iodines and iodophors w/o detergent
• Nonstaining and nonirritating
• Inactivated by organic material
• Aqueous forms are staining, irritating and corrosive to metals, especially if
used undiluted
 Chemical Methods
• Halogens
• Chlorine and chlorine releasing compounds (e.g. chlorine gas,
chlorine dioxide)
• Commonly available as sodium hypochlorite
• Least expensive and most effective chemical disinfectant
• Available chlorine equals oxidizing ability
• Damages fabrics, corrosive to metals
• Inactivated by organic debris
• May require several minutes of contact to be effective
• Skin and mucous membrane irritant if not diluted properly or rinsed well
 Chemical Methods
• Alcohols
• Ethyl alcohol, isopropyl alcohol, methyl alcohol
• Active against gm+ and gm- bacteria and enveloped viruses
• Most effective when diluted to 60% to 70% (isopropyl), 705
to 80% (ethyl)
 Chemical Methods
• Alcohols
• Used as a solvent for other disinfectants and antiseptics
• Most commonly used skin antiseptic
• Low cost and low toxicity
 Chemical Methods
• Alcohols
• Irritating to tissues and painful on open wounds
• Repeated use dries skin
• Forms coagulum in presence of tissue fluid
• Consists of a layer of tissue fluid whose proteins have been denatured by
alcohol
• Facilitates survival of bacteria under the coagulum
• Fogs lenses, hardens plastics and dissolves some cements
 Chemical Methods
• Alcohols
• Inactivated by organic debris
• Ineffective after evaporation
• Defatting agent
 Chemical Methods
• Peroxygen compounds (e.g. Peracetic acid)
• Active against gm+ and gm-, acid-fast, fungi.
• No virucidal activity
• Classified as a sterilant but may not kill pinworm eggs
 Chemical Methods
• Peroxygen compounds (e.g. Peracetic acid)
• Oxidizing agent
• Reacts with cellular debris to release oxygen
• Kills anaerobes
• Applied as a 2% solution for 30 minutes at 80% humidity
• Explosive and can damage iron, steel and rubber
• Irritating to healthy tissues
 Chemical Methods
• Ethylene Oxide
• Active against gm+ and gm-, lipophilic and
hydrophilic viruses, fungi and bacterial spores
• Classified as a sterilant
• Effective sterilant for heat labile objects
 Chemical Methods
• Ethylene Oxide
• EO is a colorless nearly odorless gas that diffuses and
penetrates rapidly
• Flammable and explosive
• Toxic, carcinogenic and irritating to tissue
 Chemical Methods
• Ethylene Oxide
• Used in a chamber with a vacuum
• May be mixed with CO2, ether or freon
• Used at temperatures of 21° to 60° C (70° to 140° F)
• Works quicker at higher temperatures
• Exposure times of 1 to 18 hours
• Requires minimum relative humidity of 30% (40% is optimum
• Items must be clean and dry and can be wrapped muslin, polyethylene,
polypropylene or polyvinyl
• Sterilized items must be ventilated in a designated area for 24 to 48 hours to
dissipate residual EO
 Autoclave
• Advantages
• Consistently achieves complete sterility
• Inexpensive and easy to operate
• Safe for most surgical instruments and equipment, drapes and
gowns, suture materials, sponges and some plastics and rubbers
• Safe for patients and personnel
• Established protocols and quality control indicators are easy to
access
 Autoclave
• Disadvantages
• Staff may overestimate the ability of the autoclave
• Sterility depends on saturated steam of the appropriate
temperature having contact with all objects within the unit
for a sufficient length of time
• Requires a thorough understanding of techniques to
ensure that the above occurs
 Autoclave
• Function
• Heat is the killing agent
• Steam is the vector that supplies the heat and promotes
penetration of the heat
• Pressure is the means to create adequately heated
steam
 Autoclave
• Function
• Complete sterilization of most items is achieved after 9 to 15
minutes exposure to 121° C (250° F)
• Steam at sea level is 100° C (212° F) as pressure is increased
the temperature of the steam increases
• The minimum effective pressure of the autoclave is 15 pounds
per square inch which provides steam at 121° C (250° F)
• Many autoclaves attain 35 psi which creates steam temperature
of 135° C (275° F)
 Autoclave
• Function
• Exposure times must allow penetration and exposure
of all surfaces to 121°C (250° F) steam
• Exposure time is decreased by increasing pressure,
which increases steam temperature
 Steam Sterilization Temperature/
Pressure Chart

Temperature

Pressure(psi) °C °F Time(mins)
0 100 212 360
15 121 250 9-15
20 125 257 6.5
25 130 266 2.5
35 133 272 1
 Autoclave
• Types
• Gravity displacement autoclave
• Prevacuum autoclave
 Autoclave
• Types
• Gravity displacement
• Water is heated in a chamber
• Continued heating creates pressure
• Steam displaces air within the chamber forcing it out
through a vent
• Cycle timing begins when the temperature reaches at least
121°C
 Autoclave
• Types
• Gravity displacement
• After sufficient exposure time, steam is exhausted through a vent back
into a reservoir
• Air that has been sterilized within the jacket and then filtered is admitted
back into the chamber to replace the exhausting steam
• If the chamber is loaded improperly or there is insufficient steam, there
will be air pockets remaining in the chamber that will interfere with
steam penetration and result in non-sterile areas
• The load must be dried within the autoclave
 Autoclave
• Types
• Prevacuum
• Usually a much larger and more costly machine
• Equipped with a boiler to generate steam and a vacuum system
• Air is taken out of the loaded chamber by means of the vacuum system
• Steam at 121°C or more is introduced into the chamber
• The steam immediately fills the chamber to eliminate the vacuum
• Exposure time begins immediately
• At completion of the cycle steam is vacuumed and replaced by hot, dry sterile air
• Air pockets are eliminated and processing times are reduced due to the vacuum
 Autoclave
• Operation
• Preparation of the load
• Loading the chamber
• Autoclave cycles
 Autoclave
• Operation
• Preparation of the load
• Linen packs
• Pouch packs
• Hard goods
• Liquids
• Contaminated objects
 Autoclave
• Linen packs
• All instruments in packs are scrupulously cleaned and
rinsed in de-ionized water
• Instruments are disassembled and ratchets are left
closed and unlocked
• Appropriate lines are in good repair and freshly
laundered
• Disposable linens are not reused
 Autoclave
• Linen packs
• A chemical sterilization indicator is included in every
pack
• Chemical sterilization indicators provide verification that the
inside of the pack was exposed to appropriate sterilization
temperatures for the appropriate length of time
 Autoclave
• Linen packs
• The pack is wrapped using at least two layers of
material
• The shelf life of the sterilized pack varies with the type of
the outer wrapping
• Pack is sealed with autoclave tape and labeled with the
date, contents and operator
• Autoclave tape provides verification that the outside of the
pack was exposed to appropriate sterilization temperatures
 Autoclave
SHELF LIFE
Wrapper Shelf-life
Dbl wrapped two layer muslin 4 wk
Dbl wrapped two layer muslin 6 mo
heat sealed in dust covers
after sterilization
Dbl wrapped two layer muslin 2 mo
tape sealed in dust covers
after sterilization
Dbl wrapped non-woven barrier 6 mo
materials (paper)
Paper/plastic peel pouches, heat sealed 1 year
Plastic-peel pouches, heat sealed 1 year
 Autoclave
• Linen packs
• Pack should not exceed 30 X 30 X 50 cm (12 X 12 X
20 inches) in size
• Pack should not exceed 5.5 kg (12 lb) in weight
• Pack should not exceed 115 kg/m3 in density
 Autoclave
• Pouch packs
• Used for single instruments, sponges, etc.
• Previous guidelines apply
• Pouches are heat sealed or ends are rolled and securely
taped with autoclave tape
• Labeled as above
 Autoclave
• Hard goods
• Stainless steel or other hard instruments, trays, bowls,
laboratory cages and other equipment may be
autoclaved without wrapping
• Must be physically clean and rinsed in de-ionized
water
• Syringes and plungers are separated before autoclaving
 Autoclave
• Liquids
• Contained in Pyrex flasks 3 times larger than contents
require
• Cover loosely with applied lid or paraffin film, or
place a needle through the stopper to allow air
exchange
• Sterility of liquids processed in the autoclave is in
question
• Removing liquids from the chamber is hazardous to
personnel
 Autoclave
• Contaminated objects
• Used before disposal to decontaminate syringes,
culture plates, etc., that contain biohazardous waste
• Place objects in a container appropriate for disposal
• Special autoclavable biohazard bags are available
 Autoclave
• Chamber loading
• Must allow free circulation of steam
• Use perforated or wire mesh shelves
• Linen packs have 2.5cm to 7.5cm space between
• Place multiple packs on edge instead of stacking
• Paper/plastic pouches are placed in specially designed baskets that support
them on edge with the paper side of each package facing the plastic side of
the adjacent package
• Solid bowls or basins are placed upside down or on edge
• Mixed loads (hard goods and wrapped goods) have wrapped goods on upper
shelf
 Autoclave
• Autoclave cycles
• Wrapped goods
• Hard goods
• Liquids
 Autoclave
• Autoclave cycles
• Wrapped goods
• Has “dry” cycle that allows wrapped packs to dry
• Used for most surgical packs
 Autoclave
• Autoclave cycles
• Hard goods
• Has no dry cycle
• Used for trays, bowls, cages, etc. that will not be maintained in a
sterile condition
• Also used for flash autoclaving to quickly sterilize
instruments that are needed immediately
 Autoclave
• Autoclave cycles
• Liquids
• Exhausts steam more slowly than other cycles
• Used for liquids that would be forced from containers during
a faster exhaust cycle
 Quality Control
• The effectiveness of any method of microbial
control must be monitored regularly
• Verification of the effectiveness of microbial
control should be performed at least monthly
 Quality Control
• Methods
• Recording thermometer
• Thermocouple
• Chemical indicator
• Biological testing
• Bowie Dick test
• Surface sampling
• Serology
 Quality Control
• Methods
• Recording thermometer
• Displays the temperature of the autoclave chamber
• Operator observes for correct temperature during cycle
• Some autoclaves are equipped with printed tape of chamber
temperatures during cycle
 Quality Control
• Methods
• Thermocouple
• Used in steam and dry heat sterilization chambers
• Temperature sensors are placed in the part of a test pack that
is most inaccessible to steam penetration
 Quality Control
• Methods
• Chemical indicator
• Paper strips impregnated with sensitive chemicals change
color when conditions of sterility are met
• Used with autoclaves and ethylene oxide systems
• Placed deep inside packs before sterilization
 Quality Control
• Methods
• Biological testing
• Bacterial spores are exposed to autoclave or ethylene oxide
and then cultured
• Recommended method for verification of proper autoclave
operation in veterinary clinics
 Quality Control
• Methods
• Bowie Dick test
• Tests pre-vacuumed autoclaves for complete removal of air
and uniform steam penetration
• Uses a pack of uniform dimensions with a cross of autoclave
tape in the center
 Quality Control
• Methods
• Surface sampling
• Surface to be tested is swabbed with a sterile applicator and transferred
to a suitable media plate for growth
• Surface or item is rinsed with a sterile solution, which is examined for
contamination
• “Contact plate” of media is touched to the surface and incubated
• Recommended method for ensuring proper disinfection of surgical suites
in veterinary clinics
 Quality Control
• Methods
• Serology
• The presence of viruses in the environment is monitored by
serological testing of animals to determine the presence of
antibodies
• Animals maintained for this purpose are referred to as
sentinel animals