Decontamination StepsDecontamination Steps

I. HeatI. Heat1- Moist heat or steam sterilization1- Moist heat or steam sterilization2- Dry heat sterilization2- Dry heat sterilization

II. Low temperature (cold):II. Low temperature (cold):1. chemical1. chemical

a. ethylene oxidea. ethylene oxideb. liquid sterilants: GLD, PAA, b. liquid sterilants: GLD, PAA,

H2O2H2O22- plasma sterilizer2- plasma sterilizer

III. Other sterilizers:III. Other sterilizers:1- ionizing radiation1- ionizing radiation2- filtration2- filtration3- microwaves; in pharmaceutical 3- microwaves; in pharmaceutical

industriesindustries

1- Chemical disinfection1- Chemical disinfection

2- Boiling water2- Boiling water

3- Pasteurization3- Pasteurization

4- Ultraviolet irradiation4- Ultraviolet irradiation

1- Alcohol 70% (ethyl and isopropyl):1- Alcohol 70% (ethyl and isopropyl):Exposure time:Exposure time: 5 min at least 5 min at leastUses: Uses: 1- disinfection of 1- disinfection of

a. external surfaces a. external surfaces b. non invasive instruments b. non invasive instruments

2- skin antiseptic, alone or added to iodine or 2- skin antiseptic, alone or added to iodine or chlorhexidinechlorhexidine

only works in presence of water and deactivated by organic soilingonly works in presence of water and deactivated by organic soiling

2- Biguanides (chlorhexidine):2- Biguanides (chlorhexidine):1- antiseptic for skin and mm, mouth wash (hexitol)2- combined with . Alcohol as hand rub

. Detergent as hand wash

3- Chlorine- active compounds (hypochlorite, house hold 3- Chlorine- active compounds (hypochlorite, house hold bleach): bleach):

1- decontamination of blood splashes and lab. Working 1- decontamination of blood splashes and lab. Working surfaces (100-1000ppm)surfaces (100-1000ppm)

2- linen bleaching2- linen bleaching3- disinfection of water3- disinfection of water

4- Iodine based compounds (most effective antiseptics):4- Iodine based compounds (most effective antiseptics):include include - tincture iodine- tincture iodine (iodine in alcohol), staining and (iodine in alcohol), staining and

irritantirritant - iodophores- iodophores (iodine with neutral carrier), slow (iodine with neutral carrier), slow release of free iodine, more penetration, no staining release of free iodine, more penetration, no staining and not irritant, betadine (30-50ppm)and not irritant, betadine (30-50ppm)used as skin antiseptic in surgical scrubbing and used as skin antiseptic in surgical scrubbing and before surgery.before surgery.

Both halogens exert their bactericidal action by irreversible oxidation of the Both halogens exert their bactericidal action by irreversible oxidation of the essential enzymes by the free radicalsessential enzymes by the free radicals

5- Phenol containing preparations (phenol\lysol) ILD:5- Phenol containing preparations (phenol\lysol) ILD:Used for floors, walls and furnitureUsed for floors, walls and furnitureHexaphenol (detol) was used as antiseptic, was proven to Hexaphenol (detol) was used as antiseptic, was proven to cause neurological damagecause neurological damage

6- Quternary ammonium compounds LLD:6- Quternary ammonium compounds LLD:detergent either .anionic as soapdetergent either .anionic as soapor . Cationic as LLDor . Cationic as LLD

.. Used for routine cleaning of walls, floors or furniture.Used for routine cleaning of walls, floors or furniture.

7- Hydrogen peroxide: (oxidizing agent) HLD& sterilants7- Hydrogen peroxide: (oxidizing agent) HLD& sterilants1- antiseptic for open wounds( kill anaerobes)1- antiseptic for open wounds( kill anaerobes)2-disinfection of soft contact lenses, some endoscopes2-disinfection of soft contact lenses, some endoscopes

8- Peracetic acid: (oxidizing agent) HLD& sterilants8- Peracetic acid: (oxidizing agent) HLD& sterilants

HLD, strilizant of instruments as endoscopesHLD, strilizant of instruments as endoscopes9- Glutaraldehyde(cidex) and Formaldehyde HLD& sterilants:9- Glutaraldehyde(cidex) and Formaldehyde HLD& sterilants:

GLD:GLD: HLD, sterilizant of instruments as endoscopes, respiratory and anaesthesia equipments HLD, sterilizant of instruments as endoscopes, respiratory and anaesthesia equipmentsFLD:FLD: gas not used now, found to be carcinogenic, only used in gas not used now, found to be carcinogenic, only used in

sterilization of HEPA filters. sterilization of HEPA filters.

Boiling at 100c for 20 min = HLDBoiling at 100c for 20 min = HLD

Only in emergenciesOnly in emergencies

It is heating at temperature less than 100cIt is heating at temperature less than 100c

1- Pasteurization of milk:1- Pasteurization of milk:

heating at 63c for 30 minheating at 63c for 30 min

or at 72c for 20 sec, this is followed by rapid cooling.or at 72c for 20 sec, this is followed by rapid cooling.

this destroys imp pathogenic bacteria as, MTB, salm, this destroys imp pathogenic bacteria as, MTB, salm, brucella, coxiellabrucella, coxiella

2- Pasteurization of water:2- Pasteurization of water:

heating at 77c for 30 min.heating at 77c for 30 min.

used for disinfection of items can’t withstand higher used for disinfection of items can’t withstand higher temptemp

it may be coupled with chemical disinfection to achieve it may be coupled with chemical disinfection to achieve higher higher level of disinfection or even sterilizationlevel of disinfection or even sterilization

It is heating at temperature less than 100cIt is heating at temperature less than 100c

1- Pasteurization of milk:1- Pasteurization of milk:

heating at 63c for 30 minheating at 63c for 30 min

or at 72c for 20 sec, this is followed by rapid cooling.or at 72c for 20 sec, this is followed by rapid cooling.

this destroys imp pathogenic bacteria as, MTB, salm, this destroys imp pathogenic bacteria as, MTB, salm, brucella, coxiellabrucella, coxiella

2- Pasteurization of water:2- Pasteurization of water:

heating at 77c for 30 min.heating at 77c for 30 min.

used for disinfection of items can’t withstand higher used for disinfection of items can’t withstand higher temptemp

it may be coupled with chemical disinfection to achieve it may be coupled with chemical disinfection to achieve higher higher level of disinfection or even sterilizationlevel of disinfection or even sterilization

UV is a low energy, non ionizing irradiationUV is a low energy, non ionizing irradiation

Its present in sun, artificially produced by mercury Its present in sun, artificially produced by mercury lampslamps

Over exposure may cause eye damage and skin Over exposure may cause eye damage and skin irritationirritation

Have extremely weak penetration powerHave extremely weak penetration power

Used only for:Used only for:Air and surface disinfection inAir and surface disinfection in

Operating roomsOperating rooms

Safety cabinetSafety cabinet