DISINFECTION

D R . R A J A L EK S H M Y . P . R
D E PT O F S WA S T H A VR I T T A
A V C , C BE
 DEFINITION

 Disinfectant or germicide is a substance which

destroys harmful microbes with the object of
preventing transmission of disease. These are
suitable for application only to inanimate objects.
Antiseptic – a substance which destroys or inhibits
the growth of micro-organisms. suitable for
application to living tissues.
Sterilization – it is the process of destroying all life
including spores.
 Properties of an ideal disinfectant

An ideal disinfectant fulfills the following criteria -

1. Broad spectrum: should have a wide
antimicrobial spectrum.
2. Fast acting: should produce a rapid kill.
3. Not affected by environmental factors: should be
active in the presence of organic matter (e.g., blood,
sputum, faeces) and compatible with soaps,
detergents, and other chemicals encountered in
use.
4. Nontoxic: should not be harmful to the user or
patient.
5. Surface compatibility: should not corrode
instruments and metallic surfaces, and should not
cause the deterioration of cloth, rubber, plastics,
and other materials.
6. Residual effect on treated surfaces: should leave
an antimicrobial film on the treated surface.
7. Easy to use with clear label directions.
 Types of disinfection

 Concurrent – application of disinfective measures after the

discharge of infectious material from the body of an infected
person. Eg. Disinfection of urine, faeces, vomit etc.
Concurrent disinfection consists of usually disinfection of
urine, faeces, vomit, contaminated linen, clothes, hands,
dressings, aprons, gloves, etc throughout the course of an
illness.
 Terminal – this is applied after the patient has been removed
by death or in refferal cases
 Precurrent( prophylactic)- disinfection of water by chlorine,
pasteurization of milk.
 Natural agents

Sunlight Direct and continuous exposure to sunlight

is destructive to many disease producing organisms.
The UV rays of sunlight are particularly lethal to
bacteria and some viruses. Eg linen, bedding ,
furniture.
Air – open air acts by drying or evaporation of
moisture which is lethal to bacteria or viruses.
 Physical agents

Burning /incineration- Burning or incineration is an

excellent method of disinfection.
 Inexpensive articles such as contaminated
dressings, rags and swabs can be disposed off by
burning.
Addition of sawdust, paper, kerosene or other
combustible material aid in burning.
 Faeces can be disposed off by burning.
Burning should not be done in open air; it is best
done in an incinerator.
Hot air- useful for sterilization of glassware, syringes,
swabs ,dressings, sharp instruments.
It is done in hot air oven, temperature is maintained at
160- 180 deg C for at least 1 hr to kill spores.
 plastic, rubber & other delicate things such process is
not used.
Boiling - effective method, boiling for 5-10mins will kill
bacteria, but not spores & viruses.
 In boilers temp. is 90 deg C. It is suitable for small
instruments, tools, linen , utensils & bed pans.
Boiling for 30 mins. is adequate to disinfect linen,
utensils and bedpans.
Drawbacks – slow process, unsuitable for thick
beddings, woolen materials.
Autoclaving - sterilizers which operates at high
temperature (100 degC above) and pressure.
Mainly 2 categories – double chamber and single
chamber autoclaves.
Works on the principle as the domestic pressure
cooker.
Mainly used in hospitals and laboratory practice. It
destroys all forms of spores.
Used for sterilization of linen, dressings, gloves,
syringes.
Not suitable for plastics & sharp instruments.
 Cont…

Radiation – Ionizing radiation used for sterilization

of bandages, dressings, catgut and surgical
instruments.
This technique requires special packing &
equipment.
It is now one of the most viable, safe and economic
methods used today.
 CHEMICAL AGENTS

Articles which cannot be sterilized by boiling or autoclaving may be immersed in

chemical disinfectants.
Mainly used for faeces, urine and other contaminated material.
1) Phenol and related compounds :
a) Phenol :
It is used as a standard to compare the germicidal activity of
disinfectants.
b) Crude phenol :
commonly used
mixture of phenol + cresol
It is a dark oily liquid.
It is effective against gram positive & gram negative bacteria, certain
viruses.
Its effect weakened by dilution.
For faecal matter 10% stength, 5% for mopping floors & cleaning
drains.
 Cont…

c) Cresol :
excellent coal – tar disinfectant.
Faeces , urine – 5 to 10 % solution used.
d) Cresol emulsion :
cresol emulsified with soap.
Lysol (50 -60% cresol), izal & cyllin are cresol emulsions.
2% lysol – used for disinfection of faeces.
e) Chlorohexidine (hibitane) :
Most useful skin antiseptics.
Mostly active against gram positive organisms.
Used as effective hand lotions.
Recommended for burns & hand disinfectants.
 Cont…

F) Hexachlorophane :
Highly active against gram positive
organisms.

g) Dettol :
Non – toxic antiseptic, can be used safely in high conc:
It is active against streptococci
Suitable for disinfection of instruments & plastic
equipment , minimum 15 mins.
Contact required for disinfection purpose.
 Quaternary ammonia compounds

Cetrimide : trade name cetavlon, bactericidal

against vegetative gram positive organisms.
Savlon : combination of cetavlon & hibitane.
Plastic appliances may be disinfected by keeping
them in normal strength savlon for 20 minutes.
 Halogens and their compounds

They are potent bactericidal, fungicidal, sporicidal,

tuberculocidal and virucidal.

1) Bleaching powder-Bleaching powder or chlorinated lime

(CaOCl.2) is a white amorphous powder with a pungent smell of
chlorine.
A good sample of bleaching powder contains about 33 per cent of
"available chlorine.
Bleaching powder is widely used in public health practice in
India for disinfection of water, faeces and urine; and as a
deodorant.
The chief drawback of bleaching powder is that it is an unstable
compound and loses its chlorine content on storage.
2) Sodium hypochloride – stronger than bleaching powder, contains
80,000 to 180,000 ppm of available chlorine.

3) Halogen tablets – chlorine tab., 1 tab = 4mg halogen sufficient to

disinfect about 1 lit of water in ½ to 1 hr.

4) Iodine : effective skin antiseptics available which stains the skin.
Iodine is bactericidal, fungicidal, virucidal and lethal to spore-bearing
organisms. Iodine is cheap, readily available and quick in action.

5) Iodophors : complex iodine (betadine)

Halogens are actively bactericidal agents

 Formaldehydes

Commonly known as formalin

Highly toxic & irritant gas
Effective against vegetative bacteria, fungi & viruses,
acid fast bacteria
Commonly used for disinfection of rooms
 Miscellaneous

1) Lime – cheapest disinfectants, sprinkled in cattle

sheds & stables, in public places urinals & latrines
2) Ethylene oxide : kills bacteria, spores, viruses.
Mainly used to sterilize fabrics, plastic equipment,
cardiac catheters
 RECOMMENDED DISINFECTION PROCEDURE

1. Feaeces and urine:

Should be collected in impervious vessels and
disinfected by adding an equal volume of one of the
disinfectants and allowed to stand for 1-2 hours.
Faeces should be broken with a stick to allow proper
disinfection.
Disinfectant Amount per Percent
litre
Bleaching powder 50 gm 5
Crude phenol 100 ml 10
Cresol 50 ml 5
Formalin 100 ml 10
• If the above disinfectants are not available, an equal
amount of quick lime or freshly prepared milk of
lime (1 of lime to 4 of water) may be added, mixed
and left for 2 hours.
• If none is available, a bucket of boiling water may
be added to the faeces which is then covered and
allowed to stand until cool.
• After disinfection, the excretal matter may be
emptied into water closet or buried in ground.
• Bedpans and urinals may be steam disinfected or
disinfected with 2 ½ percent cresol for an hour
after cleaning.
• 2. Sputum:
• Best received in gauze or paper hand kerchiefs and
destroyed by burning.
• It may be disinfected by boiling or autoclaving for
2o minutes at 20lbs pressure.
• Alternatively, the patient may be asked to spit in a
sputum cup half filled with 5 percent cresol. When
the cup is full , it is allowed to stand for an hour and
the contents may be emptied and disposed off.
• 2. Room:
• Usually thorough cleaning, airing and exposure to
direct sunlight when possible for several hours will
be sufficient.
• For chemical disinfection, floors and hard surfaces
should be sprayed or mopped with: chlorine
preparations such as chlorinated lime in
concentration that leaves 25 ppm or more of free
chlorine, formaldehyde solution at a concentration
of 1 percent or more; phenolic disinfectants such as
2 ½ percent cresol.
• The solution should remain in contact with the
surface for atleast 4 hours before final washing.
• On rare occasions, when fumigation is required,
formaldehyde gas is used.
• It may be generated by boiling commercial formalin
in 2 volumes of water (500ml of formalin plus 1
litre of water per 30 cu metres of space) in a
stainless steel vessel.
• There is vigorous boiling and liberation of
formaldehyde.
• The room is kept closed for 6-12 hours to allow
disinfection.
• Formaldehyde disinfection is highly effective at a
high temperature and a relative humidity of 80-90
percent.