Are there any safety-sensitive products recommended for hotel disinfection?

Is it omnipotent for hospitals to control ABC alcohol disinfection?

Welcome to hospital infection control ABC. Everyone knows that cleaning and disinfection is the basic content of hospital infection control, but there are so many disinfection products and disinfection methods. Do you know how to choose them correctly? In this issue, we will talk about these dazzling disinfection products!

Is alcohol everything?

When hand, foot and mouth disease broke out, were you still disinfecting with alcohol?

What is advanced disinfection? What is intermediate disinfection? What is low-level disinfection?

Is it necessary to use advanced disinfectants when multi-drug resistant bacteria are infected?

In this issue, let's talk about disinfectants.

Figure: What's the difference between various disinfectants?

How to choose disinfectant correctly

Q

Are cleaning, disinfection and sterilization the same?

Of course not!

Cleaning refers to the physical removal of dirt, dust and organic matter from the surface of an object. Microorganisms can be removed and reduced, but they cannot be killed. Common methods include water washing, mechanical decontamination and detergent decontamination.

Disinfection refers to the elimination or killing of all pathogenic microorganisms except spores by physical or chemical methods. It can only reduce the number of harmful microorganisms to the extent that they are not pathogenic, but can't completely kill microorganisms, which means it can only be effective for breeders and can't kill bacterial spores. The disinfectant used is called disinfectant.

Sterilization refers to killing all microorganisms, including pathogenic and non-pathogenic microorganisms and spores, by physical or chemical methods. Commonly used sterilization methods include high-pressure steam sterilization, boiling, hydrogen peroxide low-temperature plasma sterilization, ethylene peroxide sterilization and so on. Articles that are not contaminated after sterilization are called sterile articles. The uncontaminated area after sterilization is called sterile area.

Q

What do advanced disinfection, intermediate disinfection and low disinfection mean respectively?

According to the level of disinfection, it can be divided into advanced disinfection, intermediate disinfection and low-level disinfection.

Advanced disinfection refers to killing all bacterial propagules including mycobacteria, viruses, fungi and their spores and most bacterial spores. Common methods to achieve high-level disinfection include the use of chlorine-containing preparations, chlorine dioxide, o-phthalaldehyde, peracetic acid, hydrogen peroxide, ozone, tincture of iodine, acidic electrolyzed oxidizing water (AEOW) and other chemical disinfectants that can achieve sterilization effect, as well as the methods of disinfection under specific conditions with appropriate concentration and effective action time.

Intermediate disinfection refers to killing all kinds of pathogenic microorganisms including mycobacteria except bacterial spores. Common methods to realize intermediate disinfection include using iodine disinfectant (iodophor, chlorhexidine iodine, etc.). ), the compound of alcohol and chlorhexidine iodine, the compound of alcohol and quaternary ammonium compound, phenol and other disinfectants, and disinfect them under specified conditions with appropriate concentration and effective action time.

Low-level disinfection refers to chemical disinfection methods that can kill bacterial propagules (except mycobacteria) and lipophilic viruses, as well as mechanical disinfection methods such as ventilation and washing. Such as quaternary ammonium disinfectant (benzalkonium bromide, etc.). ) and biguanide disinfectants (chlorhexidine, etc. ) used for disinfection under specific conditions, with appropriate concentration and effective action time.

Q

What is the resistance of common pathogenic microorganisms to disinfectants?

The resistance of common pathogenic microorganisms to disinfection factors from weak to strong is: lipophilic virus, bacterial propagule, fungus, hydrophilic virus, mycobacterium, bacterial spore and prion. Lipophilic viruses are fat-soluble, can directly cross the cell membrane and are easily killed by disinfectants, including hepatitis B virus, hepatitis C virus, human immunodeficiency virus (AIDS) virus, influenza virus, herpes virus, respiratory syncytial virus, rhabdovirus (rabies virus), SARS virus and so on. Hydrophilic viruses, such as hepatitis A virus, hand-foot-mouth disease virus and polio virus, cannot penetrate the cell membrane and are difficult to be killed by disinfectants. Bacterial propagule refers to bacteria in reproductive state, as opposed to spores in dormant state.

Low-level disinfection can only kill the weakest lipophilic virus and bacterial propagules, intermediate disinfection can't kill spores, advanced disinfection can kill most spores, and sterilization level can kill all spores.

Figure: Resistance of common pathogenic microorganisms to disinfectants.

Q

Can a high level of disinfectant achieve a high level of disinfection effect?

Not necessarily.

Chlorine-containing disinfectant is the most commonly used advanced disinfectant. Therefore, it can kill most bacterial spores, as well as mycobacteria, hydrophilic viruses, fungi, reproductive bacteria and lipophilic viruses. But its disinfection effect is also affected by disinfection concentration and time. If the high concentration of available chlorine (2000mg/L~5000mg/L) acts for more than 30 minutes, all pathogens including bacterial spores can be killed, and a high level of disinfection effect can be achieved, while the low concentration of available chlorine (400~700mg/L) only acts for more than 10 minute. In addition, organic pollution has a great influence on the sterilization effect of available chlorine, that is, whether it is clean or not, and if it is not thoroughly cleaned before disinfection, it will also affect its disinfection level. Therefore, when using chlorine-containing disinfectants and other disinfection products, it is necessary to evaluate the types of disinfected articles and contaminated pathogens to determine the disinfection level to be achieved, so as to correctly configure the appropriate disinfection concentration and achieve reliable disinfection effect.

Q

Can the ideal disinfection effect be achieved by choosing the appropriate disinfectant?

In addition to the selection and concentration of disinfectants, the cleaning and disinfection of hospital environmental surfaces should also focus on the following points:

1, should follow the principle of cleaning first and then disinfection, using wet sanitary cleaning method;

2, cleaning tools should use microfiber rags and floor towels, should be used in different areas, the implementation of color coding, after use, cleaning, disinfection, drying for later use;

3. Follow the operation of the cleaning unit and implement one bed, one towel and one disinfection;

4. Patients with blood and body fluid pollution should be cleaned and disinfected at any time;

5. Used or contaminated cloth towels or floor towels should not be repeatedly soaked in clean water, cleaning agents and disinfectants.

6, who carry out invasive operation, sputum aspiration and other highly dangerous medical activities, should immediately implement environmental cleaning and disinfection.

Of course, all disinfection and cleaning are the most basic work. Without qualified cleaning, no matter how good the disinfectant is, it is difficult to achieve the ideal disinfection effect.

Q

Is alcohol hand sanitizer omnipotent?

Alcohol hand sanitizer is not everything.

Alcohol belongs to Zhongxiao Yu disinfectant and has no effect on spores. Because Clostridium difficile produces spores, 75% alcohol is ineffective against Clostridium difficile compared with hand washing. In addition, alcohol has a poor effect on hydrophilic viruses. This is because the mechanism of alcohol disinfection is because alcohol can absorb the moisture of bacterial protein, make it dehydrated, denatured and solidified, thus achieving the purpose of killing bacteria. The osmotic pressure of 75% alcohol is similar to that of bacteria, which can gradually penetrate into the bacteria before protein denaturation on the surface of the bacteria, so that all protein of the bacteria can be dehydrated, denatured and solidified, and finally the bacteria can be killed. 75% alcohol can also destroy the lipid surface of lipophilic virus, so it can destroy lipophilic virus. Hydrophilic virus has no cell membrane, so alcohol is difficult to kill. Common hydrophilic viruses include hepatitis A virus, hand-foot-mouth disease virus, poliovirus and norovirus. Hand, foot and mouth disease is mainly caused by enterovirus. The main pathogens include Coxsackie virus, some serotypes in echovirus and enterovirus 7 1 (EV-A7 1).

Misunderstanding of disinfectant use

Myth 1: The higher the concentration of disinfectant, the better.

Disinfectants have certain toxic and side effects. Too high a concentration will irritate people's mouth, respiratory tract and lungs. After a long time, it may lead to organ damage and become fragile, but it is easy to be infected. So choose the right concentration, and don't blindly pursue high concentration.

Myth # 2: Disinfectant has an unclear validity period and is used beyond the time limit.

When using disinfectants, we should pay attention to the validity period of disinfectants. Small disinfectant, if ineffective, will not play its due disinfection role and will cause great losses.

Generally speaking, the service life of unopened volatile alcoholic products after opening a bottle does not exceed 30 days. The service life of unsealed nonvolatile products after opening bottles shall not exceed 60 days. Iodophor for skin disinfection should not exceed 7 days after starting, alcohol cotton balls for external disinfection should not exceed 24 hours, and chlorine-containing disinfectants should generally not exceed 24 hours. Chlorine concentration can be determined by chlorine test paper.

Myth 3: Do you need to increase the concentration of disinfectant when multidrug-resistant bacteria break out?

No need.

Multi-drug-resistant bacteria refer to bacteria that are resistant to a variety of antibacterial drugs. Drug-resistant bacteria are not necessarily resistant to disinfectants. Therefore, there is no need to increase the concentration of disinfectant when multi-drug resistant bacteria break out. It is necessary to strengthen cleaning and disinfection, implement contact isolation measures, increase the frequency of cleaning and disinfection, and choose disinfectants according to the types of pathogens.

Myth 4: Is it better to reuse several disinfectants?

Common combination taboos include: quaternary ammonium disinfectants (such as bromogeramine, benzalkonium bromide, disinfectant wipes, etc.). ) is a cationic surfactant. If it is mixed with anionic surfactants such as soap and washing powder, it will have antagonistic effect and reduce its disinfection effect. Similarly, quaternary ammonium salts can also be used with iodine or peroxides such as potassium permanganate and hydrogen peroxide. There are chlorine-containing disinfectants that are acidic, and toilet cleaning solutions are mostly strongly alkaline. When they meet, they will react violently, producing a large amount of toxic gas chlorine, causing cough and chest tightness, and in severe cases, chlorine poisoning, resulting in difficulty breathing. So disinfection products can't mix them at will.

Correct selection of disinfectants and standardized use of disinfection products can not only effectively disinfect and sterilize, but also protect the environment and ourselves. Clinical medical workers need to know what disinfection products to choose under what circumstances, and the correct choice of disinfection method is the premise of disinfection and isolation.