2. LectureObjectives
By the end of this lecture the students
will be able to distinguish between
various types of disinfection and
isolation.
3/31/2019 Prof Dr Muhammad Tauseef 2
4. Cleaning
• Cleaning of instruments before
decontamination is an essential procedure.
• This allows the physical removal of
microorganisms.
• Individuals are recommended to maintain a
good hygiene by hand washing.
3/31/2019 Prof Dr Muhammad Tauseef 4
6. Disinfection
• Disinfectants are used on inanimate objects
only.
• Canbe done by:
• Using liquid chemicals on surfaces and at
room temperature tokill the microorganisms.
3/31/2019 Prof Dr Muhammad Tauseef 6
7. Disinfection cont.
• Ultraviolet light to disinfect the
patients infected with
rooms of
Clostridium
difficile after discharge.
• Disinfection is lesseffective than sterilization
becauseit does not kill bacterialendospores.
3/31/2019 Prof Dr Muhammad Tauseef 7
8. Chemical Disinfectants
should have high• Basically, a disinfectant
germicidal activity.
• They should rapidly kill a wide range of
microorganisms, including spores.
3/31/2019 Prof Dr Muhammad Tauseef 8
9. Chemical Disinfectants cont.
• Chemical disinfectants are hazardous
substances and may cause damage on contact
with skin, eyes or mucous membranes, by
inhalation of vapours or by absorption
through the skin.
3/31/2019 Prof Dr Muhammad Tauseef 9
10. Chemical Disinfectants
• All chemical disinfectants must be
labeled and used within the expiry
clearly
date,
freshly prepared and in correct concentration
and stored in an appropriatecontainer.
• It must not be mixed or detergents added
unless they are compatible.
3/31/2019 Prof Dr Muhammad Tauseef 10
11. Chemical Disinfectants and Antiseptics
• Alcohol
• Uses:for disinfection of skin prior toinjection.
• Todisinfect pre-operativeskin.
• It canbe used asabasefor other antiseptics.
• Alcohol-alcohol mixtures areflammable.
3/31/2019 Prof Dr Muhammad Tauseef 11
12. Chemical Disinfectants and Antiseptics
• Chlorine-based disinfectants
• Hypochlorites are most widely used.
• Aqueous solutions of sodium hypochlorite are
widely used ashousehold bleach.
3/31/2019 Prof Dr Muhammad Tauseef 12
13. Chemical Disinfectants and Antiseptics
• Phenolic: (carbolic acid) is the oldest
recognized disinfectant.
• Its useasagermicide in operating rooms.
• It disrupt plasma membranes,
enzymes, and denature proteins,
inactive
thereby
exerting antimicrobial activities.
3/31/2019 Prof Dr Muhammad Tauseef 13
14. Chemical Disinfectants and Antiseptics
• Other chemicals:
• Chlorhexidine, Quaternary ammonium
compounds (QAC), Hexachlorophane,
Triclosan phenol, Aldehydes, Glutaraldehyde,
Formaldehyde, Hydrogen peroxide, Ortho-
phthaladehyde (OPA)and Ethylene oxide.
3/31/2019 Prof Dr Muhammad Tauseef 14
15. Procedure ForTerminal Cleaning of ARoom
• Domestic staff should wear appropriate PPE.
• Discard all disposable items or equipment.
• Sealclinical waste bagsand dispose it.
• Removeany items or equipment to the dirtyarea.
• Sendappropriate items for sterilization.
• Wipe bed mattresses with warm water and
detergent and dried thoroughly.
3/31/2019 Prof Dr Muhammad Tauseef 15
16. Procedure ForTerminal Cleaning of ARoom
• Washsink with warm water anddetergent.
• Rinseand dry thoroughly.
• Wash floor and spot clean walls with detergent
solution.
• Open windows to facilitate thorough drying of all
surfaces.
3/31/2019 Prof Dr Muhammad Tauseef 16
17. Sterilization
• It is aprocess intended to kill allmicroorganisms.
• Sterilizers may be heat only, steam, or liquid
chemical.
• It is an effective way of preventing bacteria from
spreading.
• It should be used for the cleaning of the medical
instruments or gloves.
3/31/2019 Prof Dr Muhammad Tauseef 17
18. Ways of Sterilization
• Autoclave (by using high-pressure steam).
• dry heat (in anoven).
• by using chemical sterilants (glutaraldehydes,
formaldehyde).
• radiation (with the help ofphysical agents).
3/31/2019 Prof Dr Muhammad Tauseef 18
19. Ways of Sterilizationcont.
• Steamsterilization done at atemperature of
121 C(250 F)with apressure of 209kPa.
• Dry heat sterilization is performed at 170 Cfor
one hour
– 160 Cfor two hours.
– 121 Cfor at least 16hours.
3/31/2019 Prof Dr Muhammad Tauseef 19
20. Chemical Sterilization
• Called cold sterilization, it is moreexpensive
• It used to sterilize instruments that cannot
disinfected through the temperature.
• Commonly, glutaraldehydes and formaldehyde
are used in this process.
• than steamsterilization.
3/31/2019 Prof Dr Muhammad Tauseef 20
21. Isolation
• It is defined as “the voluntary or compulsory
separation and confinement of those known
or suspected to be infected with a contagious
disease agent (whether ill or not) to prevent
further infections”.
3/31/2019 Prof Dr Muhammad Tauseef 21
24. Types of Isolation
• Strict isolation
• It is used for diseasesspread through theair.
• Useaspecial room at the facility designed for
that purpose.
• It equipped with special equipment and waste
disposal.
3/31/2019 Prof Dr Muhammad Tauseef 24
25. Types of Isolation
• Contact isolation:
• It is used to prevent the spread of diseases
that can be spread through contact with open
wounds.
• Health care workers should wear gloves and
gown.
3/31/2019 Prof Dr Muhammad Tauseef 25
26. Types of Isolation
• Respiratoryisolation
• It is used for diseasesthat are spread through
particles that areexhaled.
• Thosehaving contact with or exposure to such
apatient are required to wear amask.
3/31/2019 Prof Dr Muhammad Tauseef 26
27. Types of Isolation
• Reverse isolation (Protectiveisolation):
• Usedfor Immunocompromisedpatients.
• Theyneed protection from personnel and the
environment.
• Isolation measures are usually maximal for
patients undergoing transplantation.
3/31/2019 Prof Dr Muhammad Tauseef 27
28. Types of Isolation
• High isolation:
• It is used to prevent the spread of highly contagious
infectious diseases(e.g., smallpox, Ebola virus).
• Mandatory use of: Gloves, Protective eyewear
(goggles or face shield), Waterproof gown andmask.
3/31/2019 Prof Dr Muhammad Tauseef 28
29. Alvarado CJ,StolzSM,Maki DG.Nosocomial infections from contaminated
endoscopes:
A flawed automatic endoscope washer. An investigation using molecular
epidemiology.
TheAmerican Journal of Medicine 1991; 91 (Suppl. 3B):S272–S280.
Alvarado CJ,Reichelderfer M. APICguideline for infection prevention and
control in
flexible endoscopy.American Journal of InfectionControl 2000; 28: 138–155.
American Society for Gastrointestinal Endoscopy. Ad Hoc Committee on
Disinfection:
Position Statement. Gastrointestinal Endoscopy1996; 43:540–545.
Sterilization of arthroscopes andAyliffe GAJ, Babb JR, Bradley CR.
laparoscopes.Journal
of Hospital Infection 1992; 22:265–269.
References
3/31/2019 Prof Dr Muhammad Tauseef 29
30. Spach DH, Silverstein FE, Stamm WE. Transmission of infection by
gastrointestinal endoscopy and bronchoscopy. Annals of Internal Medicine
1993; 118:117–128.
Spaulding EH. Chemical disinfection of medical and surgical materials. In:
Lawrence CA, Block SS (eds): Disinfection, Sterilization and Preservation.
Philadelphia: Lea& Febiger,1968:517–531.
Spaulding EH. Role of chemical disinfection in prevention of nosocomial
infections. In: Proceedings of the international conference on nosocomial
infections, 1970. Brachman PS, Eickhoff TC, (eds). Chicago, IL: American
HospitalAssociation; 1971:247–254.
Spaulding EH. Chemical disinfection and antisepsis in hospital. Journal of
Hospital Research1972; 9:5–31.
Tanaka H, Hirakata Y, Kaku M, Yoshida R, Takemura H,Mizukane R, et al.
Antimicrobial activity of superoxidized water. Journal of Hospital Infection
1996; 34:43–49.
References
3/31/2019 Prof Dr Muhammad Tauseef 30
