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Sterilization and Disinfection


                      Presented by
                      R.Parthasarathy
TERMS AND DEFINITIONS
Sterilization
          The process by which an article, surface or medium is freed of all
viable microorganisms either in the vegetative or spore state is known as
sterilization.
Disinfection
• The process of destruction of pathogenic microorganisms by direct
exposure to chemical and physical agents are called as disinfection.
• The agents used to achieve these state is called disinfectant.
• Chemical disinfectants which can be safely applied to skin or mucous
membrane and are used to prevent infection by inhibiting the growth of
bacteria are called antiseptics.
Bactericidal agents and germicides
        Agents which are able to kill bacteria.
Bacteriostatic agents
        Agents which prevents the multiplication of bacteria ( doesn’t kill).
Various Agents In Sterilization
         PHYSICAL AGENTS                               CHEMICAL AGENTS
                                                              Alcohols:
                  Sunlight
                                                          Ethanol, isopropyl
                                                            Aldehydes:
                   Drying
                                                    Formaldehyde, Glutaraldehyde
                Dry heat :
                                                                 Dyes
    Hot air oven, Incineration, Flaming
                Moist heat:
Boiling, Pasteurization, tyndallisation, Auto                  Halogens
                  claving
                 Filtration                              Phenolic compounds
                                                               Gases
                  Radiation
                                                 Ethylene oxide, Formaldehyde, beta
           Ionizing, Non Ionizing
                                                        propiolactone(BPL).
            Ultrasonic vibration                Metallic salts and surface active agents
Physical Agents:
Sunlight
•Direct sunlight is a natural method of sterilization of water in tanks, rivers and
lakes.
•Direct sunlight has an active germicidal effect due to the combined effect of
ultraviolet and heat rays.

Drying
•4/5 of the bacterial weight is due to water.
•Therefore drying in air has deleterious effect on many bacteria.
•This is unreliable method, spores are unaffected by drying.

Dry heat
Flaming:
Inoculating loop or wire, the tip of forceps are held in a Bunsen flame till they
become red hot.
Incineration:
This medthod is used to destroy contaminated cloth, animal carcasses and
pathological materials.
Physical Agents:                                                                                    cont..
Hot air oven
         This method is applicable to metals, glassware, and some heat-
resistant oils and waxes that are immiscible in water.
Conditions
171ºc for at least one hour.
160ºc for at least two hour.
121ºc for at least sixteen hour.
Moist Heat:
             Method                              Uses                                   Comments
Water < 100°c (Pasteurization)   For sterilization of serum, vaccines      62°c for 15 min.
                                 and body fluids.                          72°c for 30 sec.
                                                                           Spores are not destroyed.
Water at 100°c                   For sterilization of glassware's, metal   Some spores are not destroyed.
                                 and rubber items.
Arnold steamer:                  For sterilization of culture media        Preserves properties of media.
Stream at atmospheric pressure   containing gelatin and sugar.
Autoclave :                      For sterilization of culture media and    121°c at 15 psi for 15-20 minutes.
Stream below atm pressure        laboratory materials.                     Almost Kills all the bacteria and spores.
Flash autoclaves use 134°C for 3 minutes.
Physical Agents:                                    cont..

Filteration:

Filtration helps to remove bacteria from large volumes of
fluid, especially fluid containing heat-labile components such as
sera, solution of sugars and antibiotics.

A pore size of 0.2 m is effective because filters act not only
mechanically but by electrostatic adsorption of particles to their
surface.

The filters are of two types (deep and membrane)
Physical Agents:                                                                cont..
                                                 FILTERS
DEEP FILTERS
                         Made up of               Examples                  Comments and Uses

Candle filters     1.Diatomaceous earth     Berkefeld filters     They are available in different porosity.
                   2.Unglazed porcelain     Chamberlain filters   Mostly used for the purification of
                                                                  drinking water and industrial uses.

Asbestos filters   Asbestos (magnesium      Seitz and Sterimat    They have high adsorbing capacity and
                   silicate)                filters               tend to alkalinize the filtered fluid.
                                                                  These are disposable , single use discs
                                                                  available in different grades.
                                                                  Asbestos is carcinogenic hence its use
                                                                  is discouraged.
Sintered glass     Fusing finely powdered                         They are expensive and brittle.
filters            glass particles                                They have low absorptive property.

MEMBRANE           Cellulose esters                               They are routinely used for water
FILTERS            Other polymers                                 purification and analysis, sterilization,
                                                                  sterility testing and solutions of
                                                                  parenteral use.
                                                                  Wide range of average pore
                                                                  diameters(APD) are available but
                                                                  0.2mm size is widely used.
Physical Agents:                                                        cont..
                                       RADIATION
Non Ionisizing radiation:
      Types         Produced by   Mode of action             Uses                   Comments

Low energy          UV lamps      DNA damage       Infrared rays:                Use of UV light
(Infrared and                                      Sterilization of prepacked    is limited by
ultraviolet rays)                                  items such as syringes        penetration and
                                                   and catheters.                hazardous.
                                                   Ultraviolet rays:
                                                   Used for disinfecting
                                                   operation threatres and
                                                   laboratories.
Ionisizing radiation:
High energy       Cobalt-60       DNA damage       For the sterilization of     They are
ionizing type     based                            antibiotics, hormones        expensive.
(Gamma rays and instruments                        and other prepacked          They are very
high energy                                        disposable items such        effective due to
electrons such as                                  as catheters, gloves,        high penetrative
X-rays and                                         syringes, infusion sets,     power.
cosmic rays)                                       oils, animal feeds, etc.
Physical Agents:                                                   cont..

Ultrasonic and sonic vibration:
 High frequency sound waves beyond the sensitivity of human ears are
  called as ultrasonic waves.
 They have the property to disrupt the cells but the results have been variable.
 Gram negative rods are more sensitive to ultrasonic vibration whereas Gram
  positive cocci, spores of fungi and bacteria are resistant to the vibration.
 Ultrasonic devices are used in dental.
 However, most sonic machines are not reliable for routine use.
Chemical Agents:                                       cont..
Properties of Ideal antiseptics or disinfectants should

  Effective against all microorganisms and have a wide spectrum of
   activity.
 Have speedy action.
 Be effective in presence of organic matter.
 Be effective in varying pH(acidic and alkaline medium).
 Be active in presence of organic matter.
 Be stable.
 Also compatible with other antiseptics and disinfectants.
 Have high penetrating power.
 Not corrode metals.
 Not cause local irritation or sensitization.
 Not interfere with healing.
 Not be toxic if absorbed into circulation.
 Be cheap and safe.
Chemical Agents:                                              cont..

Factors influencing antiseptics or disinfectants:

 Time of action.
 Temperature.
 Concentration of the substance.
 pH of the medium.
 Nature of the organisms.
 Presence of foreign material.

Mode of action

 Protein coagulation.
 Disruption of cell membrane.
 Removal of free sulphydryl groups which is essential for the functioning of
 the enzymes.
 Substrate competition.
Chemical Agents:                                               cont..
Alcohols
Ethyl alcohol, isopropyl alcohol, and n-propanol exhibit rapid, broad-
spectrum antimicrobial activity against vegetative bacteria, viruses, and
fungi but are not sporicidal.
Activity is optimal when they are diluted to a concentration of 60–90% with
water.
Protein slows its action whereas 1% mineral acid or alkali enhances the
action.

Aldehydes
•Formaldehyde is bactericidal, sporicidal, and virucidal.
•It is active against the amino group in the protein molecule.
•Formaldehyde gas is used for sterilizing instruments and heat sensitive
 catheters and for fumigating wards, sick rooms and laboratories.
•Glutaraldehyde is used for low-temperature disinfection and sterilization of
  endoscopes and surgical equipment.
•It is normally used as a 2% solution to achieve sporicidal activity.
Chemical Agents:                                                       cont..
Dyes
Two groups of dyes are there
1.Aniline dyes
   eg: brilliant green, malachite green, crystal violet
2.Acridine dyes
  eg: proflavine, acriflavine, euflavine and aminacrine.
They are used as skin and wound antiseptics.
They are more active against Gram positive organisms than Gram negative organisms.

Halogens
Iodine is an effective disinfectant that acts by iodinating or oxidizing essential
components of the microbial cell.
Iodine is rapidly bactericidal, fungicidal, tuberculocidal, virucidal, and sporicidal.
2% iodine in 50% alcohol (tincture), which kills more rapidly and effectively than alcohol
alone.
Iodophors (eg, povidone-iodine) are complexes of iodine and a solubilizing agent or
carrier, which acts as a reservoir of the active I2.
The most important types of chlorine-releasing agents are sodium hypochlorite,
chlorine dioxide, and sodium dichloroisocyanurate, which are oxidizing agents that
destroy the cellular activity of proteins
Chemical Agents:                                              cont..
Phenolic compounds:
The use of phenolic compounds are introduced by the Lister.
The mode of action is due to their capacity to disrupt the cell membrane.
Phenol(carbolic acid) is a potent protein denaturant and bactericidal agent.
It is used as disinfectants for various hospital purposes.
Cresol and Lysol are active against a wide range of organisms but they are
toxic and corrosive.
They are used to disinfect surgical instruments, contaminated materials and
floors.
Halogenated diphenyl compounds such as hexachlorophene and
chlorhexidine.
Hexachlorophene is toxic and should be handled with care.
Cholrhexidene is nontoxic, hence used as skin antiseptic which is more
effective against Gram positive organisms than Gram negative organisms.
Chemical Agents:                                                cont..

Gases:
Ethylene oxide is an inflammable and potentially explosive gas.
By mixing with inert gases like CO2 and N2 to concentration of 10% its
explosive tendency is eliminated.
It is an alkylating agent that inactivates microorganisms by replacing labile
hydrogen atoms on hydroxyl, carboxy, or sulfhydryl groups, particularly of
guanine and adenine in DNA.
Under controlled condition it is used to sterilise materials such as glass,
artificial heart valves, respirators, lung machines, equipments and clothing.
Formaldehyde gas and Betapropiolactone(BPL) are used for fumigation of
operation theatres and other rooms.
BPL is more efficient than formaldehyde gas.
Chemical Agents:                                          cont..
Surface active agents
These compounds have two regions in their molecular structures, one a
water-repelling (hydrophobic) group and the other a water-attracting
(hydrophilic) group.
They are classified into four groups; anionic, cationic, nonionic and
amphoteric.
They are mainly used as wetting agents, emulsifiers and detergents.
Cationic detergents, particularly the quaternary ammonium compounds
(“QACs") such as benzalkonium chloride, acetyl trimethyl ammonium
bromide are highly bactericidal.
They are effective against Gram +ve organisms than Gram –ve organisms.
They are more active in alkaline pH.
They are inactive against spores and viruses, tubercle bacilli.
Anionnic detergents Eg; common soap.
Amphoteric or ampholytic compounds or tego compounds are active against
Gram+ve organisms than Gram –ve organisms.
Generally it is not used.
Chemical Agents:                                             cont..

Metallic salts
Salts of mercury, copper and silver are used as disinfectant.
Mercuric chloride is highly toxic. Hence organic compounds such as
mercurochrome, phenyl mercury nitrate and thiomersal are used as
antiseptics(less toxic).Copper salts are used as fungicides.
Silver salts in aqueous solution have a limited use.

Testing of Disinfectants
Because of numerous parameters which influence disinfectant activity, there
is no reliable test to determine the efficiency of a disinfectant.
However Phenol is used as standard.
Thank you

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Sterilization and disinfection

  • 1. Sterilization and Disinfection Presented by R.Parthasarathy
  • 2. TERMS AND DEFINITIONS Sterilization The process by which an article, surface or medium is freed of all viable microorganisms either in the vegetative or spore state is known as sterilization. Disinfection • The process of destruction of pathogenic microorganisms by direct exposure to chemical and physical agents are called as disinfection. • The agents used to achieve these state is called disinfectant. • Chemical disinfectants which can be safely applied to skin or mucous membrane and are used to prevent infection by inhibiting the growth of bacteria are called antiseptics. Bactericidal agents and germicides Agents which are able to kill bacteria. Bacteriostatic agents Agents which prevents the multiplication of bacteria ( doesn’t kill).
  • 3. Various Agents In Sterilization PHYSICAL AGENTS CHEMICAL AGENTS Alcohols: Sunlight Ethanol, isopropyl Aldehydes: Drying Formaldehyde, Glutaraldehyde Dry heat : Dyes Hot air oven, Incineration, Flaming Moist heat: Boiling, Pasteurization, tyndallisation, Auto Halogens claving Filtration Phenolic compounds Gases Radiation Ethylene oxide, Formaldehyde, beta Ionizing, Non Ionizing propiolactone(BPL). Ultrasonic vibration Metallic salts and surface active agents
  • 4. Physical Agents: Sunlight •Direct sunlight is a natural method of sterilization of water in tanks, rivers and lakes. •Direct sunlight has an active germicidal effect due to the combined effect of ultraviolet and heat rays. Drying •4/5 of the bacterial weight is due to water. •Therefore drying in air has deleterious effect on many bacteria. •This is unreliable method, spores are unaffected by drying. Dry heat Flaming: Inoculating loop or wire, the tip of forceps are held in a Bunsen flame till they become red hot. Incineration: This medthod is used to destroy contaminated cloth, animal carcasses and pathological materials.
  • 5. Physical Agents: cont.. Hot air oven This method is applicable to metals, glassware, and some heat- resistant oils and waxes that are immiscible in water. Conditions 171ºc for at least one hour. 160ºc for at least two hour. 121ºc for at least sixteen hour. Moist Heat: Method Uses Comments Water < 100°c (Pasteurization) For sterilization of serum, vaccines 62°c for 15 min. and body fluids. 72°c for 30 sec. Spores are not destroyed. Water at 100°c For sterilization of glassware's, metal Some spores are not destroyed. and rubber items. Arnold steamer: For sterilization of culture media Preserves properties of media. Stream at atmospheric pressure containing gelatin and sugar. Autoclave : For sterilization of culture media and 121°c at 15 psi for 15-20 minutes. Stream below atm pressure laboratory materials. Almost Kills all the bacteria and spores. Flash autoclaves use 134°C for 3 minutes.
  • 6. Physical Agents: cont.. Filteration: Filtration helps to remove bacteria from large volumes of fluid, especially fluid containing heat-labile components such as sera, solution of sugars and antibiotics. A pore size of 0.2 m is effective because filters act not only mechanically but by electrostatic adsorption of particles to their surface. The filters are of two types (deep and membrane)
  • 7. Physical Agents: cont.. FILTERS DEEP FILTERS Made up of Examples Comments and Uses Candle filters 1.Diatomaceous earth Berkefeld filters They are available in different porosity. 2.Unglazed porcelain Chamberlain filters Mostly used for the purification of drinking water and industrial uses. Asbestos filters Asbestos (magnesium Seitz and Sterimat They have high adsorbing capacity and silicate) filters tend to alkalinize the filtered fluid. These are disposable , single use discs available in different grades. Asbestos is carcinogenic hence its use is discouraged. Sintered glass Fusing finely powdered They are expensive and brittle. filters glass particles They have low absorptive property. MEMBRANE Cellulose esters They are routinely used for water FILTERS Other polymers purification and analysis, sterilization, sterility testing and solutions of parenteral use. Wide range of average pore diameters(APD) are available but 0.2mm size is widely used.
  • 8. Physical Agents: cont.. RADIATION Non Ionisizing radiation: Types Produced by Mode of action Uses Comments Low energy UV lamps DNA damage Infrared rays: Use of UV light (Infrared and Sterilization of prepacked is limited by ultraviolet rays) items such as syringes penetration and and catheters. hazardous. Ultraviolet rays: Used for disinfecting operation threatres and laboratories. Ionisizing radiation: High energy Cobalt-60 DNA damage For the sterilization of They are ionizing type based antibiotics, hormones expensive. (Gamma rays and instruments and other prepacked They are very high energy disposable items such effective due to electrons such as as catheters, gloves, high penetrative X-rays and syringes, infusion sets, power. cosmic rays) oils, animal feeds, etc.
  • 9. Physical Agents: cont.. Ultrasonic and sonic vibration:  High frequency sound waves beyond the sensitivity of human ears are called as ultrasonic waves.  They have the property to disrupt the cells but the results have been variable.  Gram negative rods are more sensitive to ultrasonic vibration whereas Gram positive cocci, spores of fungi and bacteria are resistant to the vibration.  Ultrasonic devices are used in dental.  However, most sonic machines are not reliable for routine use.
  • 10. Chemical Agents: cont.. Properties of Ideal antiseptics or disinfectants should  Effective against all microorganisms and have a wide spectrum of activity. Have speedy action. Be effective in presence of organic matter. Be effective in varying pH(acidic and alkaline medium). Be active in presence of organic matter. Be stable. Also compatible with other antiseptics and disinfectants. Have high penetrating power. Not corrode metals. Not cause local irritation or sensitization. Not interfere with healing. Not be toxic if absorbed into circulation. Be cheap and safe.
  • 11. Chemical Agents: cont.. Factors influencing antiseptics or disinfectants: Time of action. Temperature. Concentration of the substance. pH of the medium. Nature of the organisms. Presence of foreign material. Mode of action Protein coagulation. Disruption of cell membrane. Removal of free sulphydryl groups which is essential for the functioning of the enzymes. Substrate competition.
  • 12. Chemical Agents: cont.. Alcohols Ethyl alcohol, isopropyl alcohol, and n-propanol exhibit rapid, broad- spectrum antimicrobial activity against vegetative bacteria, viruses, and fungi but are not sporicidal. Activity is optimal when they are diluted to a concentration of 60–90% with water. Protein slows its action whereas 1% mineral acid or alkali enhances the action. Aldehydes •Formaldehyde is bactericidal, sporicidal, and virucidal. •It is active against the amino group in the protein molecule. •Formaldehyde gas is used for sterilizing instruments and heat sensitive catheters and for fumigating wards, sick rooms and laboratories. •Glutaraldehyde is used for low-temperature disinfection and sterilization of endoscopes and surgical equipment. •It is normally used as a 2% solution to achieve sporicidal activity.
  • 13. Chemical Agents: cont.. Dyes Two groups of dyes are there 1.Aniline dyes eg: brilliant green, malachite green, crystal violet 2.Acridine dyes eg: proflavine, acriflavine, euflavine and aminacrine. They are used as skin and wound antiseptics. They are more active against Gram positive organisms than Gram negative organisms. Halogens Iodine is an effective disinfectant that acts by iodinating or oxidizing essential components of the microbial cell. Iodine is rapidly bactericidal, fungicidal, tuberculocidal, virucidal, and sporicidal. 2% iodine in 50% alcohol (tincture), which kills more rapidly and effectively than alcohol alone. Iodophors (eg, povidone-iodine) are complexes of iodine and a solubilizing agent or carrier, which acts as a reservoir of the active I2. The most important types of chlorine-releasing agents are sodium hypochlorite, chlorine dioxide, and sodium dichloroisocyanurate, which are oxidizing agents that destroy the cellular activity of proteins
  • 14. Chemical Agents: cont.. Phenolic compounds: The use of phenolic compounds are introduced by the Lister. The mode of action is due to their capacity to disrupt the cell membrane. Phenol(carbolic acid) is a potent protein denaturant and bactericidal agent. It is used as disinfectants for various hospital purposes. Cresol and Lysol are active against a wide range of organisms but they are toxic and corrosive. They are used to disinfect surgical instruments, contaminated materials and floors. Halogenated diphenyl compounds such as hexachlorophene and chlorhexidine. Hexachlorophene is toxic and should be handled with care. Cholrhexidene is nontoxic, hence used as skin antiseptic which is more effective against Gram positive organisms than Gram negative organisms.
  • 15. Chemical Agents: cont.. Gases: Ethylene oxide is an inflammable and potentially explosive gas. By mixing with inert gases like CO2 and N2 to concentration of 10% its explosive tendency is eliminated. It is an alkylating agent that inactivates microorganisms by replacing labile hydrogen atoms on hydroxyl, carboxy, or sulfhydryl groups, particularly of guanine and adenine in DNA. Under controlled condition it is used to sterilise materials such as glass, artificial heart valves, respirators, lung machines, equipments and clothing. Formaldehyde gas and Betapropiolactone(BPL) are used for fumigation of operation theatres and other rooms. BPL is more efficient than formaldehyde gas.
  • 16. Chemical Agents: cont.. Surface active agents These compounds have two regions in their molecular structures, one a water-repelling (hydrophobic) group and the other a water-attracting (hydrophilic) group. They are classified into four groups; anionic, cationic, nonionic and amphoteric. They are mainly used as wetting agents, emulsifiers and detergents. Cationic detergents, particularly the quaternary ammonium compounds (“QACs") such as benzalkonium chloride, acetyl trimethyl ammonium bromide are highly bactericidal. They are effective against Gram +ve organisms than Gram –ve organisms. They are more active in alkaline pH. They are inactive against spores and viruses, tubercle bacilli. Anionnic detergents Eg; common soap. Amphoteric or ampholytic compounds or tego compounds are active against Gram+ve organisms than Gram –ve organisms. Generally it is not used.
  • 17. Chemical Agents: cont.. Metallic salts Salts of mercury, copper and silver are used as disinfectant. Mercuric chloride is highly toxic. Hence organic compounds such as mercurochrome, phenyl mercury nitrate and thiomersal are used as antiseptics(less toxic).Copper salts are used as fungicides. Silver salts in aqueous solution have a limited use. Testing of Disinfectants Because of numerous parameters which influence disinfectant activity, there is no reliable test to determine the efficiency of a disinfectant. However Phenol is used as standard.