Infection Control Levels and Techniques

Infection Control Levels

• Sanitization involves cleaning and scrubbing instruments and equipment to remove contaminants.
• Disinfection uses disinfectants to kill germs on non-living surfaces (inanimate objects).
• Sterilization destroys all forms of microbial life, including bacterial spores.

Sterilization Techniques

• Physical Sterilization uses techniques such as heat, radiation, and filtration.
• Chemical Sterilization uses chemical agents like disinfectants and antiseptics to eliminate microorganisms.

Disinfectants vs. Antiseptics

• Disinfectants are used to kill microorganisms on non-living surfaces.
• Antiseptics kill microorganisms on living tissue and skin.

Sterilization Principles

• Sterilization eliminates bacterial spores through the combination of high heat and pressure, or strong chemical compounds.
• Sterilization is crucial for reusable medical devices that may come in contact with non-intact skin.
• Disinfectants are suitable for general-purpose disinfection of building and fitting surfaces, and purposes that do not come in contact with non-intact skin.

Types of Disinfectants

• 70% Ethanol: Fast acting, no staining, used as a skin antiseptic and disinfectant on inanimate surfaces.
• Iodine (betadine): Skin antiseptic, used as a tincture.
• Benzalkonium chloride (Dettol): Disinfectant.
• Hypochlorite (Clorox): Disinfection of surfaces, blood spills, chlorination of drinking water, and swimming pools.

Chemical Sterilization

• Aldehydes:
  • Formaldehyde (formalin): surface disinfectant
  • Glutaraldehyde (CIDEX): 10 times more effective than formaldehyde, used in hospitals to sterilize respiratory therapy equipment, endoscopes, and hemodialysis equipment
• Crystal violet: Skin antiseptic

Sterilization Monitoring

• Physical indicators: Monitor the sterilization process.
• Chemical indicators: Monitor the presence of a chemical agent that indicates sterilization has occurred.
• Biological indicators (BIs): Assess the killing of known highly resistant, non-pathogenic bacterial spores directly.

Biological Indicators (BIs)

• Spore Tests: Monitor the efficacy of sterilization processes.
• Weekly Monitoring: Mandatory in oral healthcare facilities.
• Maintenance: Essential for machine functionality.
• Implant Quarantine: If a spore test fails, implants should be quarantined until results of a re-test are available.

Important Considerations

• Reusable vs. disposable: Choose the appropriate sterilization method based on whether the equipment is reusable or disposable.
• Decontamination vs. cleaning: Decontamination removes infectious agents from surfaces. Cleaning removes visible dirt and grime and may not be enough to eliminate microorganisms.