Disinfection and Sterilization in Healthcare Facilities

Abstract

The effective use of proper disinfection and sterilization procedures plays a significant role in preventing healthcare associated infections. The purpose of this chapter is to describe the scientific rationale for disinfection and sterilization strategies used in hospitals and other healthcare facilities with a focus on chemical germicides formulated as disinfectants, and sterilization procedures that have been developed in the past decade. (move stentence up)Chemical germicides used in healthcare facilities include aldehydes, such as glutaraldehyde, ortho-phthaldehyde (OPA) and formaldehyde, peroxygens, which include hydrogen peroxide, peracetic acid and chlorine dioxide. Medical devices for many years have been sterilized by heat - steam autoclaving and dry heat. There are an increasing number of devices that cannot be sterilized by heat and must be sterilized by low temperature sterilization systems or disinfected by liquid chemical germicides. Ethylene oxides gas, and to a limited extent formaldehyde-steam, have been used for sterilization of heat sensitive instruments. Within the past 10 years a number of new low temperature sterilization systems, including hydrogen peroxide gas plasma sterilizers, and new high level disinfectants have been developed to process medical devices. These systems tend to be oxidative in their mode of action, use relatively low concentrations of the sterilizing agent, do not leave toxic residuals, have excellent compatibility with materials of medical devices, and have short process times.