Cleaning And Disinfectant Products

Cleaning: ◦ allows the physical removal of microorganisms ◦ allows prevents inactivation of the disinfectant by organic matter ◦ complete surface contact during further decontamination procedure Through cleaning of items is a prerequisite before disinfection and sterilization is

commenced Disinfection: ◦ by heat or chemicals will destroy microorganism but not bacterial spores ◦ chemical disinfection does not necessarily kill all microorganisms present but

reduces them to a level not harmful to health Antiseptics: ◦ the agents must have effective antimicrobial activity ◦ must not be toxic to living tissues ◦ chemicals used to kill microorganisms on skin or living tissue

Sterilization: ◦ a process which achieves the complete destruction or removal of all microorganisms

, including bacterial spores

Level of disinfection Spores TB Vegetative

bacteria Fungi Nonlipid &

small viruses

Lipid & medium-

size viruses

Cold chemical

sterilization

+

+

+

+

+

+

High + * + + + + +

Inter-mediate - might most most some +

Low - - +/- +/- +/- +

* high-level disinfectants may not be able to kill large numbers of spores

Unlike sterilization, disinfection is not sporicidal. A few disinfectants will kill spores with prolonged exposure times (3–12 hours); these are called chemical sterilants. At similar concentrations but with shorter exposure periods (e.g., 20 minutes for 2% glutaraldehyde), these same disinfectants will kill all microorganisms except large numbers of bacterial spores; they are called high-level disinfectants. Low-level disinfectants can kill most vegetative bacteria, some fungi, and some viruses in a practical period of time (<10 minutes). Intermediate-level disinfectants might be cidal for mycobacteria, vegetative bacteria, most viruses, and most fungi but do not necessarily kill bacterial spores. Germicides differ markedly, primarily in their antimicrobial spectrum and rapidity of action.

Low risk area : Financial , Official

Moderate risk areas : Hospital ordinarily wards High risk areas : ICU, NICU, Isolated rooms Very high risk areas : Operation rooms

Class of item Use of item Example Decont. level needed

Critical Enter vascular system or sterile body tissues

Hypodermic needle, Scalpels

and other surgical instruments,

Biopsy forceps

Sterilization

Semi-critical Comes in contact with

intact mucous membranes

Vaginal spec., Anaesthetic

equipment, flex. Endoscopes

High-level disinfection (by heat or chemicals)

Non-critical Touches only intact skin

Blood pressure cuff, Baby weigh scale, Examining

table top

Intermediate-level or low-

level disinfection

Biofilms are microbial communities that are tightly attached to surfaces and cannot be easly removed

Microbes within them can be resistant to disinfectants by multiple mechanisms, including physical characteristics of older biofilms, genotypic variation of the bacteria, microbial production of neutralizing enzymes, and physiologic gradients within the biofilm (e.g., pH)

Bacteria within biofilms are up to 1,000 times more resistant to antimicrobials than are the same bacteria in suspension

They are present on numerous medical devices (e.g., contact lenses, pacemakers, hemodialysis systems, urinary catheters, central venous catheters, endoscopes)

Enzymes and detergents can degrade biofilms or reduce numbers of viable bacteria within a biofilm.

•Cleaning and disinfection of the environment •Cleaning and disinfection of medical device •Disinfection of the skin and mucous membrane

Broadly active (killing pathogens) Not poisonous (or otherwise harmful) Penetrating (to pathogens) Resistant to inactviation Not damaging to non-livingmaterials Stable Easy to work with Otherwise not unpleasant

The Ideal Disinfectant

High Level ◦ Hydrogen Peroxide ◦ Peracetic acid ◦ Glutaraldehyde ◦ Formaldehyde

Intermediate Level ◦ Chlorine ◦ Iodine ◦ Alcohols

Low level ◦ Phenolics ◦ Quaternary Ammonium Compounds

Environmental surfaces

Strategies for cleaning and disinfecting surface ◦ Potential for direct patient contact ◦ Degree and frequency of hand contact ◦ Potential contamination of the surface with body substance

or environmental sources of microorganism (soil, dust, or water)

Justification for Using a Disinfectant ◦ Surfaces may contribute to transmission of

epidemiologically important microbes (e.g., VRE, MRSA, C. difficile)

◦ Needed for surfaces contaminated by blood and OPIM ◦ Disinfectants are more effective in reducing microbial load ◦ Detergents become contaminated and result in seeding the

patients environment with bacteria ◦ CDC recommends disinfection of noncritical equipment and

surfaces for patients on isolation precautions ◦ One product for decontamination of noncritical surfaces (that

is, floors and equipment)

Pathogens implicated in transmission via contaminated noncritical surfaces

Bacteria ◦ Acinetobacter, Pseudomonas, Clostridium difficile ◦ methicillin-resistant Staphylococcus aureus ◦ Vancomycin-resistant Enterococcus spp.

Viruses ◦ SARS ◦ Rotavirus ◦ Respiratory syncytial virus (RSV)

Enterococcus Countertops: E. faecalis = 5 d, E. faecium = 7 d Bedrails = 24 hours Telephone handpieces = 60 minutes Stethoscopes = 30 minutes Gloved and ungloved fingers >60 minutes Noskin G, et al. ICHE 1995;16:577-581.

deconex 50AF Aldehyde free surface disinfectant For disinfection and cleaning of floors, walls and medical devices

Quat + Amine + Guanidine 0.5-2% in 5-30 min 1 day in use

Before using for the first time, prior cleaning with deconex 36 INTENSIV is recommended.

DGHM approved

deconex SURFACE AF For disinfection and cleaning of floors, walls and medical devices

Newly formulated according to latest demands. Non contaminated use solution can be stored for

14 days. Ecofriendly Economical

Contact time 5min 15min

Concentration In use 1% 0.5%

Before using for first time, prior cleaning with Deconex 36 INTENSIVE is recommended

VAH Approved

deconex SOLARSEPT Ready to use, alcoholic disinfectant with rapid effect For spray- and/or wipe disinfection of small surfacesincluding such of medical devices

VAH Approved

Contact time 30 s 30 s

Efficacy ضد ويروس ضد باکتری ،قارچ و باسيل سلHIV,HBV

Medical instruments

deconex 53 PLUS Aldehyde-free, non-fixing disinfectant for instruments

Contact time 15min 30min 60min Concentration In use 2% 1.5% 1%

Quat + Guanidine 14 days in use 30 days out of use

A visibly contaminated solution must be replaced with a fresh solution. Before using for the first time, prior cleaning with deconex 36INTENSIV is recommended.

deconex 53 INSTRUMENT Aldehyde-free, non-fixing disinfectant for instruments For manual disinfection and cleaning of surgical instruments, care utensils and dental instruments. High efficacy at low concentrations

VAH Approved

Ultrasonic bathQuat + Guanidine 14 days in use 30 days out of use

Contact time 5min 15min

Concentration In use 2% 0.5%

A visibly contaminated solution must be replaced with a fresh solution. Before using for the first time, prior cleaning with deconex 36 INTENSIV is recommended.

deconex 54 SPORCIDE For sporicidal disinfection of all medical instruments and utensils, including flexible endoscopes Ready-to-use, based on glutaraldehyde

Dosage/exposure time

For bactericidal, tuberculocidal, fungicidal and virucidal effect

10 min

For sporicidal effect 60 min Thoroughly clean the instrument

Before using Deconex 54 SPORCIDE

35 days in use solution

deconex HLD PA / PA20 For high-level disinfection of all medical instruments and utensils, including flexible endoscopes Based on peracetic acid

decode HLD PA activated with deconex PA20 is a : ready-to use, high-level disinfectant

In use solution : more than 14 days deconex TEST-PA specifically

developed for use with deconex HLD PA. Dosage/exposure time

For bactericidal, tuberculocidal, fungicidal and virucidal (HIV, HBV)effect

5min

For sporicidal effect 5min

Alcohol hand rubs

decosept decosept HA Rub-in hand disinfectant For hygienic and surgical hand disinfection

Quat + Alcohol 30 sec for hygienic disinfection 60-90 sec for Surgical disinfection HA without scent and dye

VAH Approved

COMPETITORS INFORMATION COMPARISON TABLE

PARTICULES SIZE

METHODS

LIMITS

15 µ →100µ

Pulverization The particles are too heavy. The particles drop too quickly then product does not sufficiently disinfect top surfaces. It has not enough time to threat all surfaces (including those unreachable or hidden).

5 µ →15µ

Fogging (Sterinis : 8 to 12µ)

An ideal size of the particles. The disinfectant does not accumulate quickly. It has time to reach all surfaces and then to efficiently threat.

1 → 5µ

Nebulization

The particles tend to quickly vaporize. Then the disinfectant does not have enough time to threat effectively.

0.1 →1 µ

Gas vaporization

What is the Dry Mist Technology? Mist Technology

TM

A UNIQUE AND PATENTED TECHNOLOGY

An aerospray system that produces an aerosol-quality mist with droplets between 8µ and 12µ (Gauss average)

Sterinis® A device using a new technology of diffusion based on

Dry Mist TechnologyTM

Sterusil® A powerful disinfectant product combining

two efficient active substances (H202 + Ag+)

Place Sterinis in an angle of the room.

Door has to be closed

Windows have to be closed

Automatic washer-disinfector Concentrated solutions

1. deconex 28 ALKAONE 2. deconex 26 PLUS 3. deconex 64 NEUTRADRY 4. deconex 41STS 5. deconex 41CLEAR 6. deconex TWIN BASIC/TWIN ZYME 7. deconex ENDOMATIC 8. deconex 25 ORGANACID

7 bar operating pressure constant availability of steam, no

pressure losses high heating power, constant

pressure level perfect quality in "2-chamber

design" environment-friendly without any

chemicals with fixed nozzle or flexible hand

piece, connection for compressed air optional

The new Elmasonic S units are available in 16

different sizes ranging from 0,5 litres to 90 litres

cleaning tank made of cavitation-resistant stainless steel

LED degas function 30° up to 80°C

electronic time and temperature control

High-performance transducer systems

run dry safe heating quick degassing

(Degas/Autodegas) electronic sound field

oscillation (Sweep) Tank capacity: 6,9 l