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Oral Microbio > Sterilization, Disinfection, and Antisepsis > Flashcards

Sterilization, Disinfection, and Antisepsis Flashcards

1
Q

What are routes for transmission during dental treatment?

A

Direct contact with infectious lesions, saliva, or blood
Indirect transmission via contaminated intermediate object
Spatter of blood, saliva, plaque, or nasopharyngeal secretions
Aerosolization of blood, saliva, plaque, or nasopharyngeal secretions

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2
Q

Ebola

A

50% fatality rate - greater age means higher rate
Symptoms: fever, headache, muscle pain, vomiting, diarrhea, stomach pain, bruising or bleeding
Highly infectious
Transmited by direct contact with body fluids of infected person
Killed by disinfecting agents
Incubation period 2-12 days
Not contagious until symptoms develop

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3
Q

HIV

A

Risk of transmission from healthcare worker to patient is very low
No documented cases of occupationally acquired infection
Standard infection control practices are highly effective
Risk from precutaneous exposure 3 or 4 per 1000 exposures
Immediate post-exposure retroviral therapy is effective

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4
Q

Hep B

A

300,000 persons infected every year
Many documented cases from and to health care workers
Vaccination

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5
Q

Tuberculosis

A

Risk of transmission during dental procedures appears to be low
Epidemic resurgence
Coughing produces aerosols
Not transmitted by surface contamination

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6
Q

Herpes

A

Herpes simplex I and II are frequently present in the oral cavity
May be transmitted to/from healthcare worker

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7
Q

What immunizations are recommended for healthcare providers by the CDC?

A 
Hep B
Influenza
Measles
Mumps
Rubella
Varicella zoster
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8
Q

Critical

A

Items come into contact with tissue or the vascular system (eg surgical instruments)

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9
Q

Semi-critical

A

Items come into contact with mucous membranes or non-intact skin (eg curing light)

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10
Q

Noncritical

A

Items touch intact skin (eg blood pressure cufF)

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11
Q

Sterilization

A

Destruction or removal of all forms of life (including spores)
Can be heat or chemical
Not used on humans (only inanimate objects)

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12
Q

What does the FDA mandate regarding sterilization

A

Liquid chemical sterilants used on critical and semicritical devises and gaseous sterilants

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13
Q

Disinfectants

A

Inhibition or destruction of pathogens
Spores are not killed
Regulated by both the FDA and EPA

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14
Q

What does the EPA mandate regarding disinfection?

A

Disinfectants used on noncritical surfaces

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15
Q

Antiseptics

A

Formulated to destroy pathogenic microorganisms on living tissues
Safe for use on human tissues
Regulated by the FDA

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16
Q

T/F - Antiseptics and disinfectants can be used interchangeably

A

False

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17
Q

High level disinfection

A

Destroys all microorganisms with the exception of spores

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18
Q

Intermediate-level disinfection

A

Inactivates M. tuberculosis, vegetative bacteria, most viruses, and most fungi
Does not necessarily kill bacterial spores

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19
Q

Low-level disinfection

A

Kills most bacteria, some viruses, and some fungi

Cannot be relied on to kill resistant microorganisms such as M. tuberculosis or bacterial spores

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20
Q

How do you clean Critical items?

A

Sterilization

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21
Q

Hoe do you disinfect Semicritical items?

A

High or intermediate-level disinfection is required

Sterilize if you can

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22
Q

How do you clean non-critical items?

A

Low-level disinfectants are sufficient

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23
Q

Why must items be cleaned off before sterilization?

A

Bioburdn may prevent sterilization

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24
Q

What is the most commonly used method of steam sterilization?

A

Autoclave

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25
What are the autoclave conditions?
``` Steam under pressure 121' C (250' F) 15 psi 15-20 minutes Packaging material must allow for penetration of steam (paper, plastic and cloth ok; not closed metals or glass containers) ```
26
What are the advantages of an autoclave?
Short cycle time | Good penetration
27
What are the disadvantages of an autoclave
Corrosion (oxidaiton) of unprotected carbon steel and dulling of cutting agents (may be prevented with 1% sodium nitrite solution) Deposits from hard water (use distilled) May remain wet at the end of cycle Destruction of heat sensitive materials
28
What are the conditions of Statim brand Flash steam sterilization
Rapid cycle 134' C (273' F) 30 psi 6-12 minutes
29
What is the major factor of sterilization
Denaturing vital proteins
30
Why is more time required for dry heat sterilization?
Dehydrated proteins are more stable, so higher temperature for longer is required
31
What are the conditions for dry heat sterilization?
160' C (320' F) for 2 hours 170' C (340' F) for 1 hour Packaging material must allow transfer of heat - paper, plastic, aluminum
32
What are the advantages of dry heat sterilization?
Does not corrode or dull cutting edge
33
What are the disadvantages of dry heat sterilization?
Long cycle May discolor or char fabric Destroys heat sensitive materials (rubber, plastic, soldered impression trays) Unsuitable for handpiecesq
34
Rapid heat transfer sterilization conditions
190' C (375' F) 12 minutes for wrapped items 6 minutes for unwrapped items
35
Rapid heat transfer sterilization advantages
Short cycle Dry at the end Does not corrode or dull
36
What are the disadvantages of rapid heat transfer sterilization?
Instruments must be dry to start Destruction of heat labile items Not suitable for handpieces Unwrapped items not protected after cycle
37
Unsaturated chemical vapor sterilization
"Chemiclave" Depends on heat, water, and chemical synergy Mixing of methyl alcohol, formaldehyde, ketone, acetone, and water used to produce sterilizing vapor Penetration isn't as good as steam, so items must be loosely packaged and dry
38
Unsaturated chemical vapor conditions
131' C (270' F) 20 psi 20-40 minutes Packaging material must allow for penetration of vapor (no closed metal or glass containers)
39
What are the advantages of unsaturated chemical vapor sterilization
Short cycle time | Does not corrode or dull cutting edge
40
What are the disadvantages of unsaturated chemical vapor sterilization?
Chemical odor and safety concerns Instruments must be dry before use Chemical solution required Heat-sensitive material can get destroyed
41
T/F - autoclave tapes indicate that items have been sterilized
False - they only indicated that they have been through the autoclave cycle They do not ensure adequacy of sterilization cycle
42
What are the best garuntee of sterilization
Biological indicators
43
How do biological monitors work?
They contain spores that are more resistant than viruses or vegetative forms of bacteria B. stearothermophilus (autoclaves and chemiclaves) B. subtilis (dry heat)
44
What are the two forms of biological monitors
Glass vials containing suspensions of spores plus a pH indicator - if spores germinate and produce acid, we can see a color change Spore-impregnated strips in glassine envelopes that must be sent to service for checking
45
T/F - Chemical sterilants can be used instead of heat
False - only use when heat is inappropriate
46
Ethylene oxide (ETO)
Alkylating agent - irreversibly inactivates nucleic acids and proteins Used as sterilization of heat and moisture sensitive items CDC and ADA recognize as acceptable Will burn tissue
47
Ethylene oxide sterilization cnditions
Room temperature (25' C / 75' F) 10-16 hours Package in paper or plastic
48
Ethylene oxide advantages
Does not damage heat or moisture labile materials | Does not leave a residue after adequate aeration
49
Ethylene oxide disadvantages
``` Slow Hazardous chemical Items must be clean and dry beforehand Retained in liquids and rubber items for long time Toxic residue if not well aerated ```
50
Glutaraldehydes
Glutaraldehyde 2-3.2% solution Effective against vegetative bacteria, including M. tuberculosis, fungi, viruses, and spores EPA registered as chemical stimulant Inactivates proteins
51
Glutaraldehyde sterilization conditions
Room temperature 10 hours Immersed in solution
52
Glutaraldehyde sterilizaiton advantages
Most potent chemical germicide | Active in presence of organic debris
53
Glutaraldehyde sterilizaiton disadvantages
``` Long immersion interval rinsing required Severe tissue irritation and toxicity from fumes Allergenic Biologically non-verifiable Cannot package items Corrosive to metals ```
54
Quaternary ammonium-alcohol combination disinfectant (CaviWipes)
Combo of alcohol and quaternary ammonium solution | Intermediate level disinfectant for semicritical items
55
What are the advantages of Quaternary ammonium-alcohol combination disinfectant?
Low odor | Less toxic/irritating than phenolic compounds
56
Accelerated Hydrogen Peroxide Disinfectants
Combo of 0.5% hydrogen peroxide, chelating agents, and wetting agents Intermediate level disinfectant Packaged as wipe or spray
57
Accelerated Hydrogen Peroxide Disinfectants advantages?
No odor Non-toxic Short contact time Cleans and disinfects
58
Iodine and Iodophors
Good handwashing antiseptic Iodinates proteins Biocidal in 5-10 minutes
59
Chlorine-containing compounds
Primary antimicrobioal activity by oxidaiton as hypochlorous acid Rapidly causes unfolding and aggregation of proteins
60
Chlorine-containing compound advantages
``` EPA registered High level disinfetant Rapid action Broad spectrum Economical ```
61
Chlorine-containing compound disadvantages
Unpleasant, persistent odor (swimming pool) Irritating to skin, eyes corrosive Damages clothes Degrades plastics and rubber Chemically unstable - must be made fresh daily
62
T/F - Gloves are a perfect barrier
False
63
T/F - Alcohol-based hand rubs are the most efficacious agents for reducing the number of bacteria on teh hands of personnel
True
64
When is soap and water handwashing indicated?
Visibly soiled hands
65
Hand hygiene technique with alcohol rub
20-30 seconds Dispense full pump of hand rub Rub covering all surfaces until completely dry
66
Hand hygiene technique with soap and water
Wet hands Apply soap Wash all surfaces including thumb and fingertips Use disposable towels Dry hands completely before donning gloves Do not touch contaminated taps or waste cans after washing

Oral Microbio (11 decks)

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