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Am I Using a Right Disinfectant

By

D. Gandhiraj
Definitions

 Chemical disinfectant
A product which is capable of chemical disinfection.

 Chemical disinfection
The reduction of the number of microorganisms in or on an inanimate matrix.

There are 2 goals for disinfection:

1. Make an object “safe for purpose” (like sterilisation)


2. Prevent the spreading of microorganisms
How to Select Disinfectants ?

• Fundamental Aspects
– General : There is no “ ideal ” active substance for all purposes
• spectrum of activity ( depending on “ microbial risk ” )

• other aspects

– tolerance against interfering substances present at the application


site ( e.g. blood )
– speed of activity ( necessary contact time )
– corrosiveness ( material and living tissues )
– inflammability and explosiveness
– easy preparation and application
– Biodegradability

– Disinfectant must have efficacy testing report and registered


with EPA or equivalent.

– COA

– Price / cost
Active substances :

• Alcohol
• Aldehyde
• Chlorine
• Iodine
• Phenol
• Quarternary ammonium compounds
• Biguanides
Alcohol Aldehydes

Examples : Examples :
ethanol , 1-propanol , 2-propanol formaldehyde , glutaraldehyde , glyoxal

Microbicidal activity : Microbicidal activity :


bacteria ( incl. Tb ) , fungi , bacteria ( incl. Tb ) , fungi , viruses ,
viruses [partly] , no bacterial spores bacterial spores
Ethanol is the best alcohol against
viruses , mycobacteria and fungal
spores
Properties : Properties :
fast acting , well tolerated by the skin , stinging odour ( warning function )
inflammable , easily evaporating
( then explosive )

Application : Application :
hands , skin , small surfaces instruments , surfaces , excretions ,
textile
Chlorine Iodine

Examples : Examples :
dichlor isocyanurate polyvinyl pyrrolidone ( PVP ) iodine
chloramine T peracetic acid
sodium hypochlorite hydrogen peroxide , ozone

Microbicidal activity :
bacteria ( incl. Tb ) , fungi , viruses , bacterial spores

Properties :
fast acting , corrosive ( the more and faster active , the more corrosive – destroys
even cotton tissue ), easily neutralized in the presence of organic material ,
smelly
Application :
water , surfaces , hands , mucous membranes , instruments , textile , excretion
cleaning in place ( CIP )
Phenol

Examples :
orthophenyl phenol , benzylchlorphenol

Microbicidal activity :
bacteria ( incl. Tb ) , fungi , viruses ( very limited ) , no bacterial
spores

Properties :
no or very little reduction of its activity in the presence of
organic material ( blood ) ,
corrosive , smelly , low degree ( or slowly ) biodegradable

Application :
excretion , instruments , surfaces , hand disinfection ( as additive )
Quarternary Ammonium Compounds
( Amphotensides / Biguanides )

Examples :
benzalkoniumchloride , didecyldimethylammoniumchloride

Microbicidal activity :
bacteria ( excl. Tb ) , fungi , viruses ( only limited ) , no bacterial spores

Properties :
pleasant smell , restricted activity in the presence of organic material ,
limited biodegradability

Application :
instruments , surfaces , additive to surgical and skin disinfectants
Tertiary Ammonium Compounds

Examples :
bis ( 3-aminopropyl ) dodecylamine

Microbicidal activity :
bacteria ( incl. Tb ) , but problems with staphylococci , fungi ,
viruses ( only limited ) , no bacterial spores

Properties :
very modern active substance - side effects are not yet sufficiently known ,
smelly ( ammonia )

Application :
instruments , surfaces
Proposals for a Good Disinfection Practice
Formation of an infection control team ( doctors incl. microbiologists /
epidemiologists for infectious diseases , nurses , cleaning staff ,
administrators , pharmacists ) , which
◆ drafts guidelines and rules for the staff ,
◆ especially develops „ hygiene - plans “

Most of the measures and procedures will be the same in the institutions .
But :
Every hospital , medical practice and institution needs a special way of
Disinfection Practice.

◆ The manufacturer / distributor of a special preparation can only give


recommendations and basic instructions for use
References

Scott R II. The direct medical costs of healthcare-associated infections in U.S. hospitals and the
benefits of prevention. Atlanta (GA): Centers for Disease Control and Prevention; 2009. [18
October 2016]. https://www.cdc.gov/HAI/pdfs/hai/Scott_CostPaper.pdf.

Magill SS, Edwards JR, Bamberg W, et al. Multistate Point-Prevalence Survey of Health Care–
Associated Infections. NEJM 2014;370:1198-208.

EPA: Environmental Protection Agency: www.epa.gov: accessed 4/1/2017.


Thank You