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Abstract Sterilization and disinfection are the basic components of hospital infection control activities. Keywords: Bundle approach, Disinfection techniques, Health care—associated infections, Medical equipment, Sterilization techniques. Background Sterilization and disinfection are the basic components of hospital infection control activities. Table Open in a separate window. Recommendation of Preferred Methods for Various Medical Devices The antimicrobial spectra of different methods are different from each other Fig.
Figure There must be separate area for removing PPE. Mopping of the hospital surfaces should be done using detergent. Table tops and counters should also be cleaned regularly by detergent only. Cleaning by vacuum pump and use of high-efficiency particulate air HEPA filters for the exhaust are preferred in these places.
The organic matter should be cleaned with absorbent material, and final disinfection may be done using sodium hypochlorite solution with dilution. Cleaning and Disinfection of Medical Instruments 15 , 16 , 17 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 The cleaning and disinfection of medical equipment depends on their physical nature, character of the material it is made up of, lumen size, etc. All the staffs during the process should use PPE. Hence, drying should be avoided by immersing the equipment in the detergent or disinfectant solution prior to cleaning.
The soaked matter can be cleaned by manual scrubbing and rubbing with brush or automated scrubber and thoroughly washed with water under pressure. Avoid prolonged or overnight soaking of the devices. Too low concentration may not work effectively to remove the organic materials or microorganisms. Delicate articles should be processed in neutral pH.
Enzymatic cleaners with neutral pH are preferred to avoid the damage of the articles. For example, in case of flexible endoscope, neutral pH detergent with enzymatic action is preferred. Cleaning and Reprocessing of Patient Care Equipment 14 Patients care equipment are divided into three categories critical, semicritical, and noncritical depending on the intended use and risk of transmission of infection. Items Methods Anesthetic equipment airways, endotracheal tubes, etc.
HLD , high-level disinfectant. Reprocessing of the Critical Items Devices that come in contact with the sterile parts of the body are included in critical items category. Reprocessing of Semicritical Items Items that come in contact with the mucous membrane of the skin are included in this category.
Reprocessing of Noncritical Items Items that come in contact with the intact skin are included within noncritical items. Reprocessing of Respiratory Apparatus and Endoscopes 15 , 21 , 24 , 29 , 30 , 31 , 32 , 33 , 34 Respiratory apparatus such as ventilators, humidifiers, nebulizers, pulmonary screening devices, anesthetic equipment, laryngoscope and its blade, and suction equipment are most important in the ICU setup because of its association with the risk of transmission of infection.
Ventilators Ventilators are important sources of hospital-acquired infection. Discard all disposals and perform hand hygiene after each handling. The condensate from the inspiratory lines may spill to the tracheobronchial tree of the patient or into the nebulizer while handling, changing, or manipulating the ventilator circuit.
Humidifiers For proper humidification, use sterile water in place of tap water to fill the humidifiers. Nebulizer Use sterile water for nebulization. Anesthetic Equipment Anesthetic equipment such as face mask, ambu bag, tubings, and endotracheal tubes should be regularly cleaned. Pulmonary Screening Device Do not routinely sterilize or disinfect the internal machinery of pulmonary function test machines.
Reprocessing of Endoscopes 29 , 35 Endoscopes are very useful tools for diagnostic as well as therapeutic processes. Store The disinfected endoscopes should be dried, capped, and kept vertically for the prevention of contamination. Risk of Nonendoscopic Transmission of Infection There are many issues regarding nonendoscopic transmission of various infections.
Processing of Other Scopes Laparoscope is one of the popular equipment that enters into the sterile space. Special Precaution for Inactivation of Creutzfeldt—Jakob Disease 13 , 23 , 29 , 30 CJD has become a major crisis for the medical field because of lack of curative treatment.
Risk assessment of the patient is done with the following criteria. Health Care—Associated Infections Definition 13 , 41 , 42 Hospital-acquired infection or nosocomial infection NI is defined as the localized or systemic infection acquired during the hospital care due to the adverse reactions to the presence of an infectious agent s or its toxin, which was neither present nor in incubating period during the time of admission.
Common Health Care—Associated Infections 48 HAIs can be transmitted by the medical devices or the unclean hands of the health care workers. Design of Operating Room 14 Designing the ORs is a complex task and should be done as per the recommendations.
Ventilation and Cleaning of the Operating Rooms In the ORs, air flow system or ventilation removes the majority of airborne bacteria. Microbiological Sampling Routine bacteriological surveillance of ORs should be done for monitoring the presence of various airborne pathogens.
Bundle Approach for Reducing Infection Bundle approach is an evidence-based group approach of preventive measures, which is found to be more effective when executed together. Conclusion To conclude, sterilization, disinfection, and cleaning are the mainstay of hospital infection control activities.
References 1. Sopwith W. Preventing infections from reusable medical equipment: a systematic review. BMC Infect Dis. Rutala W. New disinfection and sterilization methods. Emerg Infect Dis. Biron F. Transmission of the human immunodeficiency virus and hepatitis C virus. N Engl J Med. Gillespie T. Mycobacterium chelonae isolated from rinse water within an endoscope washer-disinfector. J Hosp Infect. Schelenz S. An outbreak of multidrug-resistant Pseudomonas aeruginosa infection associated with contamination of bronchoscopes and an endoscope washer-disinfector.
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APIC guideline for selection and use of disinfectants. Schembre D. Infectious complications associated with gastrointestinal endoscopy. Gastrointest Endosc Clin N Am. Nelson D. Current issues in endoscope reprocessing and infection control during gastrointestinal endoscopy. World J Gastroenterol. Multi society guideline for reprocessing flexible endoscopes. Society for health care epidemiology of America. Culver D.
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Such items include surgical instruments, biopsy forceps, and implanted medical devices. If these items are heat resistant, the recommended sterilization process is steam sterilization, because it has the largest margin of safety due to its reliability, consistency, and lethality. However, reprocessing heat- and moisture-sensitive items requires use of a low-temperature sterilization technology e.
Skip directly to site content Skip directly to page options Skip directly to A-Z link. Infection Control. Section Navigation. The method according to claim 1, wherein the sterilizing agent is a mixture of different vitamins.
The method according to claim 1, wherein the sterilizing agent comprises vitamin A. The method according to claim 1, wherein the sterilizing agent comprises vitamin E. The method according to claim 1, wherein the sterilizing agent comprises vitamin B 6 , B 12 or C. The method according to claim 2, wherein the sterilizing agent comprises at least one of vitamin A acetate and vitamin E acetate.
The method according to claim 6, wherein the sterilizing agent comprises a member selected from the group consisting of vitamins B 6 and B The method according to claim 1, wherein the treatment is effected in the presence of a substance capable of improving the solubility of the vitamin in aqueous solution.
The method according to claim 9, wherein the substance comprises Tween The method according to claim 1, wherein the vitamin is employed in about 0. The method according to claim 1, wherein the treatment is effected over about 1 to 24 hours. The method according to claim 1, wherein the treatment is effected over about 3 to 4 hours. The method according to claim 1, wherein the material sterilized comprises a concentrate of red cells, granulocytes, platelets, lymphocytes or blood serum.
The method according to claim 1, wherein the material sterilized comprises plasma, a cryo poor plasma, a coagulation factor, a cryoprecipitate or an immunoglobulin. The method according to claim 1, including the further step of subjecting the mixture of member being sterilized and sterilizing agent to washing, gel filtration, adsorption or ultrafiltration to separate the sterilizing agent from the sterilized material.
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