sterilization
Sterilization and Disinfection
Sterilization: Process where all living microorganisms, including bacterial spores, are killed. Achieved through physical, chemical, and physiochemical means. Chemicals used as sterilizing agents are known as chemisterilants.
Disinfection: Elimination of most pathogenic microorganisms (excluding spores) on inanimate objects. Achieved using physical or chemical methods, with chemicals referred to as disinfectants. Not all disinfectants can kill all microorganisms.
Decontamination: Removal of contaminating pathogenic microorganisms using sterilization or disinfection.
Sanitization: Chemical or mechanical cleansing to reduce microbes on food utensils to public health-safe levels, primarily used in the food industry.
Asepsis: Techniques (gloves, air filters, UV rays) employed to achieve a microbe-free environment.
Antisepsis: Use of chemicals (antiseptics) to eliminate pathogenic microorganisms from skin or mucus membranes.
Bacteriostasis: Inhibition of bacterial growth without killing them.
Bactericidal: Chemicals that can kill or inactivate bacteria, categorized by their spectrum of activity (e.g., virucidal, fungicidal).
Antibiotics: Substances produced by one microbe that either inhibit or kill another microbe.
Physical Methods of Sterilization
Sunlight
Microbicidal activity primarily due to UV rays; effective in tropical regions.
Disinfects water bodies; not sporicidal, thus does not provide complete sterilization.
Heat
Considered the most reliable method for sterilizing heat-stable articles. Acts through oxidative effects and protein denaturation.
Factors affecting efficiency of heat sterilization:
Nature of Heat: Moist heat is more effective than dry heat.
Temperature and Time: Inversely proportional; increases in temperature decrease the required time.
Microorganism Count: Higher microbial load may require increased temperature or longer exposure.
Species and Strain Sensitivity: Different microorganisms respond differently to heat.
Material Type: Heavily contaminated materials need longer sterilization.
Organic Material Presence: Increases exposure time needed for sterilization.
Dry Heat Techniques
Red Heat: Effectiveness in sterilizing small instruments by heating until red hot.
Flaming: Passing articles through flame; effective against vegetative cells but not guaranteed to kill spores.
Incineration: Complete destruction of contaminated materials through burning.
Hot Air Oven: Effective for heat-stable articles; requires high temperatures for specific times.
Sterilization cycle considerations: time to reach temperature, maintenance at sterilizing temperature, cooling time.
Efficacy checked by physical (temperature charts), chemical (Browne’s tube), and biological methods (spore tests).
Moist Heat Techniques
Moist heat acts by coagulation and denaturation of proteins.
Below 100°C: Pasteurization
Holder method: 63°C for 30 minutes.
Flash method: 72°C for 15 seconds, rapidly cooled.
Vaccine bath: 60°C for 1 hour inactivates bacteria in vaccines.
Serum bath: 56°C for 1 hour on successive days to disinfect serum.
At 100°C
Boiling: Kills most vegetative bacteria but doesn’t eliminate spores. Enhanced by adding sodium bicarbonate.
Steaming: Involves exposing items to free steam at 100°C for specific time periods.
Tyndallisation: Intermittent sterilization by exposing items to steam over multiple days.
Above 100°C
Autoclaving: Effective sterilization using steam under pressure.
Advantages include better penetration and condensation of steam, requiring significant procedural precision.
Must ensure no trapped air; monitored through temperature control measures.
Radiation
Types of Radiation
Non-ionizing: UV rays (200-280 nm) that cause thymine-thymine dimers, used in surface disinfection.
Ionizing: Electron beams and gamma rays, penetrate better, damaging nucleic acids of microorganisms; used in food and sterilizing disposable items.
Filtration
Non-killing: Does not directly kill microbes but separates them from liquids.
Membrane filters (0.2-0.45 µm) are used for heat-labile liquids and preparation of sterility testing baths.
Chemical Methods of Disinfection
Disinfectants chemically destroy pathogenic microorganisms. Vary in spectrum and include chemisterilants and antiseptics.
Ideal properties for disinfectants include wide spectrum, rapid activity, stability, and non-toxic effects.
Classification of Disinfectants
Based on consistency: Liquid (alcohols, phenols), Gaseous (formaldehyde vapor).
Based on activity level: High, Intermediate, Low.
Based on action mechanism: Disrupting membranes, denaturing proteins, oxidations, etc.
Example Disinfectants
Alcohols: Dehydrate cells and cause coagulation (e.g., ethyl, isopropyl alcohol).
Aldehydes: Kill all microorganisms including spores (e.g., formaldehyde, gluteraldehyde).
Phenols: Disrupt membranes, precipitate proteins (e.g., chlorhexidine, hexachlorophene).
Halogens: Oxidizing agents (e.g., chlorine, iodine).
Heavy Metals: Precipitate proteins; use in specific applications (e.g., silver nitrate).
Surface Active Agents: Disrupt microbial cell membranes (e.g., detergents).
Dyes: Interact with nucleic acids, effective against gram-positive bacteria (e.g., acridine dyes).
Hydrogen Peroxide: Releases nascent oxygen, damages proteins and DNA.
Ethylene Oxide: Alkylation agent; effective for heat-labile items.
Beta-propiolactone: Effective sporicidal agent with broad-spectrum activity.