Академический Документы
Профессиональный Документы
Культура Документы
disinfectant
Sunlight, air
Not reliable
disinfectant for
infectious
materials
Physical
disinfectant
Chemical
method
Dry Heat
Flaming glass slides
Ironing clothes
Hot air oven: 160c, for 60 min effective sterilization
but no power of penetration, so effective only for swabs
small dressings & sharp instruments (not for moist heat).
Moist Heat
More effective than dry heat because it kills
microorganisms by coagulation, denaturation of
their enzymes & destruction of their protein.
Boiling at 100c 10 min kill all germs but not
spores. Suitable for utensils, instruments, water & milk
Above 100c steam disinfections and autoclaves
Radiation
Ionizing radiation:
Great penetration and sterilization
power without heating.
Excellent for catgut, dressings,
catheters & disposal syringes.
Artificial Ultra-violet rays:
Disinfection of viral lab. & O.R.
of limited penetration
Chemical method
A- solids
B- liquid
C- gases
A- Solid disinfectants
Bleaching powder
k.perminganate
B- liquid
.Phenol 10% stools & sputum
floor 5%
.Lysol 10% stool, sputum & room
Chain of Infection
Pathogen
Susceptible Host
Entry
Source
Mode
Antimicrobial Resistance:
Prevent
Transmission
Pathogen
Prevent
Infection
Infection
Antimicrobi
al
Resistance
Effective
Diagnosis
& Treatment
Optimize
Use
Antimicrobial
Use
Viral hepatitis
Etiology:
Seven different types of hepatitis viruses
are identified:
A, B, C, D, E, F, G, H.
Transmitted
parenrally by infected blood,
except A & E by contaminated food & drinks.
Viral B hepatitis
serum hepatitis
By hepatitis B virus:
HBc Ag: core antigen first 3 months.
Then HBs Ag: surface antigen 2 years
This can cause the disease ranging
from mild liver dysfunction to acute
fulminant hepatic necrosis
Mode of transmission
Parentral transmission is most common:
Susceptible groups
Occupational:
Prevention
1-
Specific prevention
(Vaccination and Seroprophylaxis)
Vaccination by inactivated vaccine
against HB V.
to high risk group:
Long contacts with cases & sexual contacts
haemodialyis patients.
International travelers to endemic areas.
Seroprophylaxis
(human specific immunoglobulin) HSIG
Preventing Transmission of
Bloodborne Pathogens
Bloodborne viruses such as
hepatitis B virus (HBV), hepatitis C
virus (HCV), & human
immunodeficiency virus (HIV)
Factors Influencing
Occupational Risk
of Bloodborne Virus
Infection
Handwashing
Use of gloves, masks, eye
protection, and gowns
Patient care equipment
Environmental surfaces
Injury prevention
Risk
HBsAg+ and
+
HBeAg
clinical 31.0%-22.0%
hepatitis; 37%-62%
serological evidence of
HBV infection
clinical 6.0%-1.0%
hepatitis; 23%-37%
serological evidence of
HBV infection
HBsAg+ and
HBeAg
Blood
Serum
Wound exudates
Moderate
Semen
Vaginal Fluid
Saliva
Low/Not Detectable
Urine
Feces
Sweat
Tears
Breast Milk
Hepatitis B Vaccine
injury
Visible blood on device
Needle placed in artery or vein
Terminal illness in source patient
Source: Cardo, et al., N England J Medicine
1997;337:1485-90.
Better
Plain Soap
Antimicrobial
soap
Best
Alcohol-based
handrub
Source: http://www.cdc.gov/handhygiene/materials.htm
Personal
Protective
Equipment
Protective Clothing
Gloves
7- Sterilization and
Disinfection
of Patient Care Items
Critical Instruments
Penetrate mucous membranes
or contact bone, bloodstream,
or other normally sterile
tissues (of the mouth)
Semi-critical
Instruments
Contact mucous
membranes but do not
penetrate soft tissue
Heat sterilize or high-level disinfect
Examples: Dental mouth mirrors,
amalgam condensers, and dental
handpieces
Risk Assessment:
Mycobacterium
Non-lipid Viruses
Fungi
Vegatative Bacteria
Lipid Viruses
B. subtilis
M. tuberculosis
-Polio
-Rhino
,Cryptococcus sp
.Candida sp
.Pseudomonas
.Staphylococcus
.Salmonella
sp
sp
sp
Herpes
CMV
HBV
HIV
Sterilization
HLD
ILD
LLD
Automated Cleaning
Ultrasonic cleaner
Instrument washer
Washer-disinfector
Heat-Based Sterilization
Steam under pressure
(autoclaving)
Gravity displacement
Pre-vacuum
Dry heat
Unsaturated chemical vapor
Liquid Chemical
Sterilant/Disinfectants
Only for heat-sensitive
critical and semi-critical
devices
Powerful, toxic chemicals
raise safety concerns
Heat tolerant or
disposable alternatives are
available
Sterilization Monitoring
Types of Indicators
Mechanical
Chemical
Environmental Surfaces
May become contaminated
Not directly involved in infectious
disease transmission
Do not require as stringent
decontamination procedures
Clinical Contact
Surfaces
Housekeeping Surfaces
Principles of Waste
Infectious
Segregation
Waste
Patients
Room
Operation
Theatre
Kitchen
Sharp
Materials
&
Syringues
Glass
Liquids &
Chemicals
Waste
Red
Shar
p Box
Bag
Incinerator
White
Bucket
Blue
Opaque
Container
Black
Bag
Non-infectious Waste
Landfills
Microbial biofilms
form in small bore
tubing of dental units
Biofilms serve as a
microbial reservoir
Primary source of
microorganisms is
municipal water supply