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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
Q

What are the autoclave conditions?

A 
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)
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26
Q

What are the advantages of an autoclave?

A

Short cycle time

Good penetration

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27
Q

What are the disadvantages of an autoclave

A

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
Q

What are the conditions of Statim brand Flash steam sterilization

A

Rapid cycle
134’ C (273’ F)
30 psi
6-12 minutes

29
Q

What is the major factor of sterilization

A

Denaturing vital proteins

30
Q

Why is more time required for dry heat sterilization?

A

Dehydrated proteins are more stable, so higher temperature for longer is required

31
Q

What are the conditions for dry heat sterilization?

A

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
Q

What are the advantages of dry heat sterilization?

A

Does not corrode or dull cutting edge

33
Q

What are the disadvantages of dry heat sterilization?

A

Long cycle
May discolor or char fabric
Destroys heat sensitive materials (rubber, plastic, soldered impression trays)
Unsuitable for handpiecesq

34
Q

Rapid heat transfer sterilization conditions

A

190’ C (375’ F)
12 minutes for wrapped items
6 minutes for unwrapped items

35
Q

Rapid heat transfer sterilization advantages

A

Short cycle
Dry at the end
Does not corrode or dull

36
Q

What are the disadvantages of rapid heat transfer sterilization?

A

Instruments must be dry to start
Destruction of heat labile items
Not suitable for handpieces
Unwrapped items not protected after cycle

37
Q

Unsaturated chemical vapor sterilization

A

“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
Q

Unsaturated chemical vapor conditions

A

131’ C (270’ F)
20 psi
20-40 minutes
Packaging material must allow for penetration of vapor (no closed metal or glass containers)

39
Q

What are the advantages of unsaturated chemical vapor sterilization

A

Short cycle time

Does not corrode or dull cutting edge

40
Q

What are the disadvantages of unsaturated chemical vapor sterilization?

A

Chemical odor and safety concerns
Instruments must be dry before use
Chemical solution required
Heat-sensitive material can get destroyed

41
Q

T/F - autoclave tapes indicate that items have been sterilized

A

False - they only indicated that they have been through the autoclave cycle
They do not ensure adequacy of sterilization cycle

42
Q

What are the best garuntee of sterilization

A

Biological indicators

43
Q

How do biological monitors work?

A

They contain spores that are more resistant than viruses or vegetative forms of bacteria
B. stearothermophilus (autoclaves and chemiclaves)
B. subtilis (dry heat)

44
Q

What are the two forms of biological monitors

A

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
Q

T/F - Chemical sterilants can be used instead of heat

A

False - only use when heat is inappropriate

46
Q

Ethylene oxide (ETO)

A

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
Q

Ethylene oxide sterilization cnditions

A

Room temperature (25’ C / 75’ F)
10-16 hours
Package in paper or plastic

48
Q

Ethylene oxide advantages

A

Does not damage heat or moisture labile materials

Does not leave a residue after adequate aeration

49
Q

Ethylene oxide disadvantages

A 
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
Q

Glutaraldehydes

A

Glutaraldehyde 2-3.2% solution
Effective against vegetative bacteria, including M. tuberculosis, fungi, viruses, and spores
EPA registered as chemical stimulant
Inactivates proteins

51
Q

Glutaraldehyde sterilization conditions

A

Room temperature
10 hours
Immersed in solution

52
Q

Glutaraldehyde sterilizaiton advantages

A

Most potent chemical germicide

Active in presence of organic debris

53
Q

Glutaraldehyde sterilizaiton disadvantages

A 
Long immersion interval
rinsing required
Severe tissue irritation and toxicity from fumes
Allergenic
Biologically non-verifiable
Cannot package items
Corrosive to metals
54
Q

Quaternary ammonium-alcohol combination disinfectant (CaviWipes)

A

Combo of alcohol and quaternary ammonium solution

Intermediate level disinfectant for semicritical items

55
Q

What are the advantages of Quaternary ammonium-alcohol combination disinfectant?

A

Low odor

Less toxic/irritating than phenolic compounds

56
Q

Accelerated Hydrogen Peroxide Disinfectants

A

Combo of 0.5% hydrogen peroxide, chelating agents, and wetting agents
Intermediate level disinfectant
Packaged as wipe or spray

57
Q

Accelerated Hydrogen Peroxide Disinfectants advantages?

A

No odor
Non-toxic
Short contact time
Cleans and disinfects

58
Q

Iodine and Iodophors

A

Good handwashing antiseptic
Iodinates proteins
Biocidal in 5-10 minutes

59
Q

Chlorine-containing compounds

A

Primary antimicrobioal activity by oxidaiton as hypochlorous acid
Rapidly causes unfolding and aggregation of proteins

60
Q

Chlorine-containing compound advantages

A 
EPA registered
High level disinfetant
Rapid action
Broad spectrum
Economical
61
Q

Chlorine-containing compound disadvantages

A

Unpleasant, persistent odor (swimming pool)
Irritating to skin, eyes
corrosive
Damages clothes
Degrades plastics and rubber
Chemically unstable - must be made fresh daily

62
Q

T/F - Gloves are a perfect barrier

A

False

63
Q

T/F - Alcohol-based hand rubs are the most efficacious agents for reducing the number of bacteria on teh hands of personnel

A

True

64
Q

When is soap and water handwashing indicated?

A

Visibly soiled hands

65
Q

Hand hygiene technique with alcohol rub

A

20-30 seconds
Dispense full pump of hand rub
Rub covering all surfaces until completely dry

66
Q

Hand hygiene technique with soap and water

A

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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