Selection of Sterilant / Disinfectant

Sterilization Disinfection
High Level Intermediate Low Level
Disinfection (Contact Level (Kill (Contact intact
Object Procedure
(For critical devices that enter sterile
Exposure mm/non-intact skin-Kill few
spores)
Mycobacteria, Fungi-Do skin/noncritical items-Kill
vegetative bacteria)
sites-Kill all spores)
Time not kill spores)
Exposure time 12-30 Exposure time ≥ 1 Exposure time ≥ 1
min at ≥ 200C min min
Ethyl/Isopropyl Ethyl/Isopropyl
Heat/Steam/Hot air 3-30 min ≥2% Glutaraldehyde
alcohol 70-90% alcohol18 70-90%
15
Sodium Sodium
Ethylene oxide gas Follow label OPA 0.55% Hypochlorite Househol Hypochlorite Househol
Bleach Diluted Bleach Diluted
Smooth, hard Hydrogen peroxide gas 13
surfaces Follow label 7.5 % H2O2 Phenolics21 Phenolics7, 12
plasma
≥ 2% Glutaraldehyde 10 h at 20-250C 7.5 % H2O2 + 0.23% PerAA Iodophores6 Iodophores14
13
7.5 % H2O2 6h Pasteurization –Wd 22

7.5 % H2O2 + 0.23% Quaternary

3-8 h Sod.hypochlorite8
PerAA ammonium11
Heat/Steam/Hot air 3-30 min ≥2% Glutaraldehyde

Tubing and Ethylene oxide gas 1-6 h OPA 0.55% 15

Hydrogen peroxide gas Ethyl/Isopropyl alcohol 70-

catheters, Lensed Follow label 7.5 % H2O2 90% For thermometers and
Instruments, plasma hinged instruments
Thermometers, 10 h at 20- 7.5 % H2O2 + 0.23%
≥ 2% Glutaraldehyde
Hinged 250C PerAA
Instruments (Resp Pasteurization/
therapy/Anesthesia 7.5 % H2O2 6h Washer-disinfector (Not
equipment)
for Lens)
19
7.5 % H2O2 + 0.23% PerAA 3-8 h Sod.Hypochlorite
Lt Col Nasrullah Malik
1. Rinse/Clean/apply detergent before applying disinfectant.
2. Sterilants are for surgical instruments, implants, ultrasound probes etc (if you enter sterile environment, cavity, vasculature)
3. High level disinfectants are for Flexible endoscope, laparoscope, arthroscope, anesthesia, resp equipment.
4. Intermediate level disinfectants are for B. P cuff, E.C.G. Electrode, PDA etc (depends on material, purpose/use, nature of contaminants).
5. Low level disinfectants are for tables, bedpans, furniture, countertops, crutches, floors, walls etc (depends on material, purpose/use, nature of
contaminants). Clean first with detergent.
6. Look label/literature for dilution, contact time, storage, shelf-life, material compatibility.
7. For mopping floors- change water-disinfectant mixture every fourth room or every hour.
8. For blood spills – use 1:10 or 1:100 dilution of 5-6% sodium hypochlorite. Corrodes metals.
9. For air filtration use HEPA filters or UV irradiation.
10. For haemodialysis units use glutaraladehyde or peracetic acid (or sod. Hypochlorite)
11. Examples of Quaternary ammonium compounds are Cetrimide (savlon = citrimide+chlorhexidine), Benzalkonium chloride.
Pseudo/Serratia can grow in it.
12. For bedside tables, bedrails, lab surfaces.
13. H2O2 will corrode Copper, Zinc, Brass
14. Example is povidone iodine. Used on skin, mm, wound, med equipment. Pseudo, Burkholderia can grow in it.
15. OPA = Ortho-phthalaldehyde is better than glutaraldehyde but is expensive.
16. 7.5 % H2O2 + 0.23% PerAA is good for hemodialyzers and endoscopes
17. For Safety cabinets, Isolation rooms, OTs – UV radiation is suggested.
18. For hand disinfection use chlorhexidine 4% or alcohol based preparations.
19. Per Acetic Acid with H2O2 is used for haemodialyzers. Alone it corrodes copper, brass, bronze.
20. Glutaraldehyde can be combined with “Per acetic acid” or phenolics.
21. Phenolics eg Lysol, dettol,
22. Washer-disinfector effect is similar to pasteurization.