Infect Chemother.  2018 Jun;50(2):101-109. 10.3947/ic.2018.50.2.101.

Review of Disinfection and Sterilization – Back to the Basics

• Yoo JH

• KMID: 2415031
• DOI: http://doi.org/10.3947/ic.2018.50.2.101

Abstract

In-depth knowledge of disinfection and sterilization is a key component of infection control. Sterilization completely removes a spore, whereas disinfection cannot. Disinfectants are classified as oxidants and non-oxidants. The decision regarding which method to apply is based on Spaulding's classification. In this article, disinfection and sterilization are thoroughly reviewed, and extensive information from basic to practical points is discussed.

Keyword

Disinfection; Sterilization; Infection control

MeSH Terms

Classification
Disinfectants
Disinfection*
Infection Control
Methods
Oxidants
Spores
Sterilization*
Disinfectants
Oxidants

Figure

• 

  Figure 1 Structure of oxidizing agents. (A) sodium hypochlorite (B) povidone-iodine (C) hydrogen peroxide (D) peracetic acid.

• 

  Figure 2 Structure of non-oxidizing agents (coagulants). (A) ethanol (B) chlorhexidine (C) quaternary ammonium compound (D) glutaraldehyde (E) ortho-phthalaldehyde (F) ethylene oxide.

Reference

1. Yoo JH. Principle and perspective of healthcare-associated infection control. J Korean Med Assoc. 2018; 61:5–12.

2. Stokes HW, Gillings MR. Gene flow, mobile genetic elements and the recruitment of antibiotic resistance genes into Gram-negative pathogens. FEMS Microbiol Rev. 2011; 35:790–819.

3. Centers for Disease Control and Prevention (CDC). Disinfection and sterilization. Accessed 15 April 2018. Available at: https://www.cdc.gov/infectioncontrol/guidelines/disinfection/index.html.

4. Rutala WA, Weber DJ. Disinfection, sterilization, and antisepsis: An overview. Am J Infect Control. 2016; 44:Suppl. e1–e6.

5. McDonnell G, Russell AD. Antiseptics and disinfectants: activity, action, and resistance. Clin Microbiol Rev. 1999; 12:147–179.

6. Rutala WA, Weber DJ. Disinfection and sterilization in health care facilities: what clinicians need to know. Clin Infect Dis. 2004; 39:702–709.

7. Rutala WA, Weber DJ. Disinfection and sterilization in health care facilities: an overview and current issues. Infect Dis Clin North Am. 2016; 30:609–637.

8. Cadenas E. Biochemistry of oxygen toxicity. Annu Rev Biochem. 1989; 58:79–110.

9. Hayyan M, Hashim MA, AlNashef IM. Superoxide ion: generation and chemical implications. Chem Rev. 2016; 116:3029–3085.

10. Russell AD. Bacterial spores and chemical sporicidal agents. Clin Microbiol Rev. 1990; 3:99–119.

11. McDonnell G, Burke P. Disinfection: is it time to reconsider Spaulding? J Hosp Infect. 2011; 78:163–170.

12. Fenton HJ. Oxidation of tartaric acid in presence of iron. J Chem Soc Trans. 1894; 65:899–911.

13. McDonnell G. General mechanism of action. In : McDonnel GE, editor. Antisepsis, Disinfection, and Sterilization. 2nd ed. Washington DC: ASM Press;2017. p. 255–269.

14. Wallace CA. New developments in disinfection and sterilization. Am J Infect Control. 2016; 44:Suppl. e23–e27.

15. Rutala WA, Weber DJ. Uses of inorganic hypochlorite (bleach) in health-care facilities. Clin Microbiol Rev. 1997; 10:597–610.

16. Cotter JL, Fader RC, Lilley C, Herndon DN. Chemical parameters, antimicrobial activities, and tissue toxicity of 0.1 and 0.5% sodium hypochlorite solutions. Antimicrob Agents Chemother. 1985; 28:118–122.

17. Sattar SA. Microbicides and the environmental control of nosocomial viral infections. J Hosp Infect. 2004; 56:Suppl 2. S64–S69.

18. International Specialty Products. PVP-Iodine-Povidone Iodine antiseptic agent. Accessed 15 April 2018. Available at: https://web.archive.org/web/20060313193322/http://www.ispcorp.com/products/pharma/content/brochure/pvpiodine/pvpiodine.pdf.

19. Strand CL, Wajsbort RR, Sturmann K. Effect of iodophor vs iodine tincture skin preparation on blood culture contamination rate. JAMA. 1993; 269:1004–1006.

20. Berkelman RL, Holland BW, Anderson RL. Increased bactericidal activity of dilute preparations of povidone-iodine solutions. J Clin Microbiol. 1982; 15:635–639.

21. Falagas ME, Thomaidis PC, Kotsantis IK, Sgouros K, Samonis G, Karageorgopoulos DE. Airborne hydrogen peroxide for disinfection of the hospital environment and infection control: a systematic review. J Hosp Infect. 2011; 78:171–177.

22. Kyi MS, Holton J, Ridgway GL. Assessment of the efficacy of a low temperature hydrogen peroxide gas plasma sterilization system. J Hosp Infect. 1995; 31:275–284.

23. Mannion PT. The use of peracetic acid for the reprocessing of flexible endoscopes and rigid cystoscopes and laparoscopes. J Hosp Infect. 1995; 29:313–315.

24. Cheung RJ, Ortiz D, DiMarino AJ Jr. GI endoscopic reprocessing practices in the United States. Gastrointest Endosc. 1999; 50:362–368.

25. Kim JB, Han DS, Lee HL, Kim JP, Sohn JH, Oh MS, Lee JH, Hahm JS, Gang JO. The value of peracetic acid (SCOTELIN®) for endoscope disinfection. Korean J Gastrointest Endosc. 2004; 28:284–290.

26. Russell AD, Day MJ. Antibacterial activity of chlorhexidine. J Hosp Infect. 1993; 25:229–238.

27. Kampf G, Jarosch R, Ruden H. Limited effectiveness of chlorhexidine based hand disinfectants against methicillin-resistant Staphylococcus aureus (MRSA). J Hosp Infect. 1998; 38:297–303.

28. Bragg R, Jansen A, Coetzee M, van der Westhuizen W, Boucher C. Bacterial resistance to Quaternary Ammonium Compounds (QAC) disinfectants. Adv Exp Med Biol. 2014; 808:1–13.

29. Tabata A, Nagamune H, Maeda T, Murakami K, Miyake Y, Kourai H. Correlation between resistance of Pseudomonas aeruginosa to quaternary ammonium compounds and expression of outer membrane protein OprR. Antimicrob Agents Chemother. 2003; 47:2093–2099.

30. Lynam PA, Babb JR, Fraise AP. Comparison of the mycobactericidal activity of 2% alkaline glutaraldehyde and ‘Nu-Cidex’ (0.35% peracetic acid). J Hosp Infect. 1995; 30:237–240.

31. Walsh SE, Maillard JY, Russell AD. Ortho-phthalaldehyde: a possible alternative to glutaraldehyde for high level disinfection. J Appl Microbiol. 1999; 86:1039–1046.

32. Hugo WB. A brief history of heat and chemical preservation and disinfection. J Appl Bacteriol. 1991; 71:9–18.

33. Donk PJ. A highly resistant thermophilic organism. J Bacteriol. 1920; 5:373–374.

34. Dancer SJ. Controlling hospital-acquired infection: focus on the role of the environment and new technologies for decontamination. Clin Microbiol Rev. 2014; 27:665–690.

35. Abreu AC, Tavares RR, Borges A, Mergulhao F, Simoes M. Current and emergent strategies for disinfection of hospital environments. J Antimicrob Chemother. 2013; 68:2718–2732.

36. Rutala WA, Gergen MF, Weber DJ. Comparative evaluation of the sporicidal activity of new low-temperature sterilization technologies: ethylene oxide, 2 plasma sterilization systems, and liquid peracetic acid. Am J Infect Control. 1998; 26:393–398.