P1 | Sterilization and Disinfection (LECTURE) Flashcards
Refers to the destruction of all forms of life, including bacterial spores
- Originated more than 100 years ago
- Complete removal of microorganisms including spores
- “All or nothing” process
Sterilization
What methods are used in Sterilization?
- Physical method
- Chemical method
Refers to a process that eliminates a defined scope of microorganisms, including some spores
- Reduces the number of microorganisms
- Physical or chemical methods may be used, but most disinfectants are chemical agents applied to inanimate objects
Disinfection
Substance applied to the skin for the purpose of eliminating or reducing the number of bacteria present
Do not kill spores and cannot be used as disinfectants
- destroy/inhibit the growth of microorganisms
- Joseph Lister used:
Antiseptic
E.g., Alcohol
- Carbolic acid
Factors that Affect the Degree of Killing of Microorganisms
(T.O, N.O, C.D.A, P.O.M, N.S.D, C.T, T, pH, BF, CoD)
- Types of Organisms
- Number of Organisms
- Concentration of Disinfecting Agent
- Presence of Organic Material
- Nature of Surface to be Disinfected
- Contact Time
- Temperature
- pH
- Biofilms
- Compatibility of Disinfectants
Different organisms have varying ability in withstanding and chemical and physical treatment due to the different biochemical composition of these organisms and various mechanisms that they use to protect themselves
Types of Organisms
Types of Organisms
(SFB, MB spp., BFB, P)
- Spore forming Bacteria
- Mycobacterium spp.
- Biofilm forming Bacteria
- Prions
Types of Organisms
Spores are coated with proteins, lipids and carbohydrates as well as dipicolinic acid calcium
SFB
- able to resist heat
Spore forming Bacteria
Types of Organisms
cell wall is high in lipid which enables them to become resistant to most environmental stress such as desiccation
MB spp.
Mycobacterium spp.
Types of Organisms
certain bacteria can aggregate into communities of bacteria which makes then resistant to chemical and physical means of destruction
(BFB)
Biofilm forming Bacteria
- Biofilm: microorganism living in community
Types of Organisms
naked pieces of proteins, similar to viruses but without the nucleic acid, that is most resistant to the action of heat, radiation, and chemicals
- agent able to cause the generative diseases of our nervous system
Prions
this factor basically refers to the amounts of organisms present in the object to be treated referred to as microbial load (bioburden)
- the higher the number of organisms, the longer the exposure time needed to eliminate 99.9% of the microorganisms
Number of Organisms
The amount needed to destroy microorganisms varies based on the agent to be used.
concentrated agents do not necessarily mean that it would work better
- It is therefore important to follow, the correct preparation and dilution as prescribed by the manufacturer.
- 1:10 bleach (common disinfectant)
Concentration of Disinfecting Agent
Blood, puss, and mucus are examples of organic materials that may prevent the full contact of the agent to the organisms, hence limiting its action
POM
- Example: is bleach (sodium hypochlorite) that is easily inactivated by organic material.
Presence of Organic Material
Some instrument that we use in the laboratory sometimes are made up of biomaterial which exempts them to disinfection or sterilization due to possible damage
NSD
- Example: is endoscopic instruments which can’t be autoclaved
Nature of Surface to be Disinfected
It is critical to observe proper (___) of the agent and the object to be disinfected or sterilized.
- In principle, (____) may be affected by all previous factors already mentioned as well as temperature
Contact Time
Alcohol and betadine has to be in contact for about (____) to work properly
1-2 minutes
- Spore forms may need more contact time than its vegetative counterpart
their activity may increase at a certain degree by a corresponding increase in temperature or may decrease when temperature is decreased
Temperature
Temperature
disinfectants are usually used at room temperature (____)
20C to 220C
Temperature
Too high or low temperature may?
inactivate disinfectants and sterilants
It is also important to consider the (____) of the material to be treated and he agent itself.
- Manufacturers usually optimize this factor to achieve maximum activity
pH
Certain bacteria have to ability to form communities of layers of bacteria with protective shield which is called as?
- community of bacteria
- Inanimate and animate objects
Biofilms
It is important to consider that (____) formation may require longer contact time or increase in the concentration of the agent
- E.g., Hospital – Catheter (lots of bacteria)
Biofilm
Some disinfectants may inactivate the action of another hence it is also important to consider the (____)
- bleach and quaternary ammonium compounds which may negate each other
Compatibility of Disinfectants
METHODS OF STERILIZATION
Physical methods:
* Moist Heat
* Dry Heat
* Ionizing Radiation
* Filtration
Chemical Methods:
* Peracetic Acid
* Formaldehyde Vapor/ Vapor Phase H2O2
* Glutaraldehyde
* Ethylene Oxide (ETO) Gas
Physical Methods
coagulation of bacterial proteins including bacterial enzymes
Moist Heat
Simplest means of sterilizing a material:
Heat
Types of moist heat:
A.T.I
- Autoclave
- Tyndallization
- Inspissation
Physical Methods: moist heat
operates based on the principle of steam under pressure
Autoclave
Physical Methods: moist heat
Effective indication:
* Sterilization:
* Decontamination:
* Biological indicator:
Autoclave
- 121C to 15lbs/ in2 for 15 minutes
- 135C for 30lbs in2 for 30 minutes
- Bacillus stearothermophilus
Physical Methods: moist heat
fractional discontinuous sterilization
Tyndallization
Physical Methods: moist heat
- Effective indication:
- Instrument:
Tyndallization
- 100C for 30-60 minutes
- Arnold’s Sterilizer
Physical Methods: moist heat
thickening through evaporation
Inspissation
Physical Methods: moist heat
- Effective indication:
- Instrument:
Inspissation
- 75C to 80C for 2 hours
- Inspissator
Control of Microorganisms using Heat Methods
BW(S), AC (SUP), PBM, PFM, O (DH)
Methods:
* Boiling Water (steam)
* Autoclave (steam under pressure)
* Pasteurization Batch Method
* Pasteurization Flash Method
* Over (Dry Heat)
Control of Microorganisms using Heat Methods
- Boiling Water (steam)
- Autoclave (steam under pressure)
- Pasteurization Batch Method
- Pasteurization Flash Method
- Over (Dry Heat)
Temperature
- 100 C
- 121.6 C
- 63 C
- 72 C
- 160-180 C
Temperature
Control of Microorganisms using Heat Methods
- Boiling Water (steam)
- Autoclave (steam under pressure)
- Pasteurization Batch Method
- Pasteurization Flash Method
- Over (Dry Heat)
Time required
- 15min
- 15min at 15psi
- 30min
- 15s
- 1.5-3hrs
Time required
Control of Microorganisms using Heat Methods
- Boiling Water (steam)
- Autoclave (steam under pressure)
- Pasteurization Batch Method
- Pasteurization Flash Method
- Over (Dry Heat)
Applications
- Kills microbial vegetative forms; endospores survive
- Sterilizes and kills endospores
- Disinfects and kills milk-borne pathogen and vegetable forms; endospores survive
- Same, but shorter time at higher temp.
- Sterilizes; keeps materials dry
Applications
METHODS OF STERILIZATION: Physical Methods
oxidation of bacterial components
DH
- requires longer exposure time
Dry Heat
Physical Methods: Dry heat
direct application of flame in aseptic technique
Direct Flame
Physical Methods: Dry heat
used in the sterilization of heat resistant materials
Dry/Hot Air Oven
Physical Methods: Dry heat
- Effective indication:
- Biological indicator:
Dry/Hot Air Oven
- 160-180C for 1.5 to 2 hours
- Bacillus subtilis var. niger
Physical Methods: Dry heat
burns materials into ashes; used in the disposable of biological wastes
Incineration
Physical Methods: Dry heat
- Effective indication:
Incineration
- 870-980C for 2 seconds
Physical Methods
works by alkylation of nucleic acid of bacteria using high energy short wavelength deep penetrating gamma rays; used for heat sensitive materials
- sterilization of recycled materials
Ionizing Radiation
Physical Methods: Ionizing Radiation
- Biological indicator:
- Bacillus pumilis
Physical Methods
- Based on membrane gradient by differences in particle size
- Used for the sterilization of heat sensitive materials
Filtration
Physical Methods: Filtration
Types of Filtration:
- Water/ Liquid Solutions/ Antibiotics/ Vaccines
- Air: High Efficiency Particulate Air Filter (HEPA)
Physical Methods: Filtration
usually uses a thin membrane filter of cellulose acetate with different pore size depending on the intended purpose
Water/ Liquid Solutions/ Antibiotics/ Vaccines
Physical Methods: Filtration
most bacteria, yeasts, and molds are retained but may allow passage of Pseudomonas- like organisms
Water/ Liquid Solutions/ Antibiotics/ Vaccines
(size)
0.45 – 0.80um
Physical Methods: Filtration
used to filter Pseudomonas- like organisms; used for critical sterilization of parenteral solutions
Water/ Liquid Solutions/ Antibiotics/ Vaccines
(size)
0.22um
Physical Methods: Filtration
able to retain small viruses
Water/ Liquid Solutions/ Antibiotics/ Vaccines
(size)
0.01um
Physical Methods: Filtration
Has a pore size of 0.3 μm; usually used in Biological Safety Cabinet (BSC) and rooms of immunocompromised patients
Air: High Efficiency Particulate Air Filter (HEPA)
Chemical Methods
for surgical instruments
Peracetic Acid
Chemical Methods
for HEPA filters and large spaces
Formaldehyde Vapor/ Vapor Phase H2O2
Chemical Methods
for medical instruments (e.g., bronchoscopes, etc.)
Glutaraldehyde
Chemical Methods
This method is also used extensively by the manufacturing industry for the sterilization of low-cost thermoplastic products
- For large spaces and spaceships and other heat sensitive materials
Ethylene Oxide (ETO) Gas
Chemical Methods: Ethylene Oxide (ETO) Gas
- The recommended concentration of ethylene
oxide is (____) - per liter of chamber space at (____)
- 450 to 700mg
- 55C to 60C for 2 hours
Chemical Methods: Ethylene Oxide (ETO) Gas
- Biological indicator:
- Bacillus subtilis var. globijii
METHODS OF DISINFECTION
Physical Methods
* Boiling
* Pasteurization
* Non-Ionizing Radiation
Chemical Methods
* Alcohol
* Halogens
* Heavy Metals
* Quaternary Ammonium Compounds (QUATS)
* Phenol/Phenolic Compounds/Bisphenols
Physical Methods
Destroys vegetative cells of bacteria but not their spores
Boiling
Physical Methods: Boiling
- Effective indication:
- 100C for 15-30 minutes
Physical Methods
Used for the preservation of alcoholic beverages such as beers, wines, and also dairy products such as milks and yogurt
Pasteurization
Physical Methods: Pasteurization
- Batch:
- Flash:
- Ultra-High Temperature (UHT):
- 62.5C for 30 minutes
- 72C for 15 seconds
- 72C to 110C for 5 seconds
Physical Methods
Uses low energy long wavelength ultraviolet rays to disinfect heat sensitive materials as well as large spaces
Non-Ionizing Radiation
Chemical Methods: Alcohol
- MOA:
- Minimum Contact Time:
- 70% Alcohol not 90%
- Ethyl and Isopropyl alcohol kills (____)
- Dehydration, Lipid dissolution and Protein denaturation
- 1-2 minutes or until completely evaporated
- Mycobacterium tuberculosis
Chemical Methods: Halogens
- MOA:
- Chloride (Cl) IN NaOCl:
- commonly used in household
- inhibits protein function and acts as strong oxidizing agents
- used as disinfecting agents in many laboratory and hospitals spaces, surfaces, and also in treating water for portability Iodine (I2) in Betadine used as a household antiseptics and surgical antiseptics
- Sodium hydrochloride
Chemical Methods: Heavy Metals
- MOA:
- Mercury (Hg):
- Cooper (Cu):
- Silver (Ag):
- Denaturation of enzymes and other essential bacterial proteins
- active ingredient or merthiolate but this is already banned in the market due to its known toxicity
- CuSO4 crystals are used as algaecide in swimming pools and aquarium
- 1% AgNO3 – used as prophylactic agent in Crede’s Prophylaxis in suspected cases of Ophthalmia neonatorum (caused by Neisseria gonorrhoeae) (replaced with erythromycin)
Chemical Methods: Quaternary Ammonium Compounds (QUATS)
- MOA:
- Zephiran:
- Cepacol:
- enzyme inhibition, protein denaturation, and disruption of plasma membrane
- enzyme inhibition, protein denaturation, and disruption of plasma membrane
- Benzalkonium chloride
- Cetylpyridium chloride
Chemical Methods: Phenol/Phenolic Compounds/Bisphenols
- MOA:
- Germicidal soaps
- Plasma membrane destruction and enzyme denaturation
Chemical Agents Commonly used as Disinfectants and Antiseptics (SUMMARY)
TYPES:
- Alcohols (50%-70%)
- Aldehydes (in solution)
- Halogens
- Heavy Metals
- Detergents
- Phenolics
- Gases
Chemical Agents Commonly used as Disinfectants and Antiseptics (SUMMARY)
- Alcohols (50%-70%)
- Aldehydes (in solution)
- Halogens
- Heavy Metals
- Detergents
- Phenolics
- Gases
Agent/s
- Ethanol, isopropanol, benzyl alcohol
- Formaldehyde (8%), glutaraldehyde (2%)
- Tincture of iodine (2% in 70% alcohol) Chlorine and chlorine compounds
- Silver nitrate (AgNO3) & Mercuric chloride (HgCl2)
- Quaternary ammonium compounds
- Phenol, carbolic acid, Lysol, hexachlorophene
- Ethylene oxide
Chemical Agents Commonly used as Disinfectants and Antiseptics (SUMMARY)
- Alcohols (50%-70%)
- Aldehydes (in solution)
- Halogens
- Heavy Metals
- Detergents
- Phenolics
- Gases
Action
- Denature proteins; make lipids soluble
- React with NH2+, -SH and -COOH groups
- (Inactive proteins) Reacts with water to
form hypochlorous acid (HClO); oxidizing agent - Precipitates proteins Reacts with -SH groups; lyses cell membrane
- Disrupt cell membranes
- Denature proteins; disrupt cell membranes
- Alkylating agent
Chemical Agents Commonly used as Disinfectants and Antiseptics (SUMMARY)
- Alcohols (50%-70%)
- Aldehydes (in solution)
- Halogens
- Heavy Metals
- Detergents
- Phenolics
- Gases
Applications and Precautions
- Skin antiseptics
- Disinfectants; kill endospores; toxic to humans
- (Skin disinfectants) Used to disinfect drinking water; surface disinfectants
- Eye drop (1% solution) Disinfectant; toxic at high concentrations
- Skin antiseptics; disinfectants
- Disinfectants at high concentrations; used in soaps at low concentration
- Sterilization of heat-sensitive objects